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https://www.readbyqxmd.com/read/29341044/antenatal-medical-therapies-to-improve-lung-development-in-congenital-diaphragmatic-hernia
#1
Aidan Kashyap, Philip DeKoninck, Kelly Crossley, Marta Thio, Graeme Polglase, Francesca Maria Russo, Jan Deprest, Stuart Hooper, Ryan Hodges
Congenital diaphragmatic hernia (CDH) is a birth defect characterized by failed closure of the diaphragm, allowing abdominal viscera to herniate into the thoracic cavity and subsequently impair pulmonary and vascular development. Despite improving standardized postnatal management, there remains a population of severe CDH for whom postnatal care falls short. In these severe cases, antenatal surgical intervention (fetoscopic endoluminal tracheal occlusion [FETO]) may improve survival; however, FETO increases the risk of preterm delivery, is not widely offered, and still fails in half of cases...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29340289/automatic-segmentation-method-of-pelvic-floor-levator-hiatus-in-ultrasound-using-a-self-normalizing-neural-network
#2
Ester Bonmati, Yipeng Hu, Nikhil Sindhwani, Hans Peter Dietz, Jan D'hooge, Dean Barratt, Jan Deprest, Tom Vercauteren
Segmentation of the levator hiatus in ultrasound allows the extraction of biometrics, which are of importance for pelvic floor disorder assessment. We present a fully automatic method using a convolutional neural network (CNN) to outline the levator hiatus in a two-dimensional image extracted from a three-dimensional ultrasound volume. In particular, our method uses a recently developed scaled exponential linear unit (SELU) as a nonlinear self-normalizing activation function, which for the first time has been applied in medical imaging with CNN...
April 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29338992/subsequent-fertility-pregnancy-and-gynecologic-outcomes-after-fetoscopic-laser-therapy-for-twin-twin-transfusion-syndrome-compared-to-normal-monochorionic-twin-gestations
#3
Simen Vergote, Liesbeth Lewi, Willem Gheysen, Luc de Catte, Roland Devlieger, Jan Deprest
BACKGROUND: An improved survival and quality of life for neonatal survivors after fetoscopic laser therapy (FLC) for twin-twin transfusion syndrome (TTTS) has been reported. However, little is known about the medium-term maternal effects after FLC with respect to reproductive and gynecologic outcomes. OBJECTIVE: To document reproductive, obstetric, gynecologic and psychological outcomes in women who underwent FLC for TTTS. STUDY DESIGN: Monocentric controlled study on consecutive women who underwent FLC for TTTS between 2007 and 2013 at the University Hospitals Leuven (cases; n=198)...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29322541/in-case-you-missed-it-the-prenatal-diagnosis-editors-bring-you-the-most-significant-advances-of-2017
#4
Brynn Levy, Diana W Bianchi, Tim Van Mieghem, Jan Deprest, Alessandro Ghidini, Lyn S Chitty
No abstract text is available yet for this article.
January 10, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29313089/first-delivery-and-ovariectomy-affect-biomechanical-and-structural-properties-of-the-vagina-in-the-ovine-model
#5
Iva Urbankova, Geertje Callewaert, Silvia Blacher, Dries Deprest, Lucie Hympanova, Andrew Feola, Laurent De Landsheere, Jan Deprest
INTRODUCTION AND HYPOTHESIS: Animal models are useful for investigating the genesis of pelvic floor dysfunction and for developing novel therapies for its treatment. There is a need for an alternative large-animal model to the nonhuman primate. Therefore we studied the effects of the first vaginal delivery, ovariectomy and systemic hormonal replacement therapy (HRT) on the biomechanical and structural properties of the ovine vagina. METHODS: We examined the gross anatomical properties of nulliparous, primiparous, ovariectomized multiparous, and ovariectomized hormone-replaced multiparous sheep (six animals per group)...
January 8, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29278046/pregnancy-affects-the-pharmacokinetics-of-sildenafil-and-its-metabolite-in-the-rabbit
#6
Francesca M Russo, Paola Mian, Elke Hj Krekels, Kristel Van Calsteren, Dick Tibboel, Jan Deprest, Karel Allegaert
There is growing interest in the use of sildenafil during pregnancy for various maternal and fetal conditions. This study aims to investigate the effect of pregnancy on the maternal pharmacokinetics (PK) of sildenafil and its main metabolite desmethylsildenafil in rabbits. Using NONMEM, population PK-modelling was performed based on plasma samples from 31 rabbits of whom 15 were pregnant and 16 were not. All received a single subcutaneous sildenafil dose of 10mg/kg. One sample was obtained per rabbit at either 30, 60, 120, 360, 720 or 1320 minutes after sildenafil administration...
December 26, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/29178347/tissuepatch-is-biocompatible-and-seals-iatrogenic-membrane-defects-in-a-rabbit-model
#7
Alexander C Engels, Luc Joyeux, Johannes Van der Merwe, Julio Jimenez, Savitree Prapanus, David W Barrett, Che Connon, Tina T Chowdhury, Anna L David, Jan Deprest
OBJECTIVE: To evaluate novel sealing techniques for their biocompatibility and sealing capacity of iatrogenic fetal membrane defects in a pregnant rabbit model. METHOD: At day 23 of gestation (term=d31), a standardized fetoscopy was performed through a 14G cannula. The resulting fetal membrane defect was closed with either condensed collagen, collagen with fibrinogen, Tissuepatch®, Duraseal®, or a conventional collagen plug (Lyostypt®) as reference. At d30 the fetuses were harvested and full thickness fetal membrane samples were analyzed...
November 25, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29170524/quantitative-analysis-of-motor-evoked-potentials-in-the-neonatal-lamb
#8
Luc Joyeux, Marjolijn Deprez, Ahmad Khatoun, Kris Van Kuyck, Kelly Pelsmaekers, Alexander C Engels, Hongmei Wang, Marina Gabriela Monteiro Carvalho Mori da Cunha, Stephanie De Vleeschauwer, Myles Mc Laughlin, Jan Deprest
Evoking motor potentials are an objective assessment method for neuromotor function, yet this was to our knowledge never done in neonatal lambs. There is neither a method for standardized quantification of motor evoked potentials (MEPs). We first aimed to evaluate the feasibility of MEP recording in neonatal lambs and test its validity. Second we aimed to develop an algorithm for its quantification and test its reliability since manual input is required. We recorded myogenic MEPs after transcranial motor cortex stimulation in 6 lambs aged 1-2 days...
November 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29169875/current-and-future-antenatal-management-of-isolated-congenital-diaphragmatic-hernia
#9
REVIEW
Francesca Maria Russo, Paolo De Coppi, Karel Allegaert, Jaan Toelen, Lennart van der Veeken, George Attilakos, Mary Patrice Eastwood, Anna Louise David, Jan Deprest
Congenital diaphragmatic hernia is surgically correctable, yet the poor lung development determines mortality and morbidity. In isolated cases the outcome may be predicted prenatally by medical imaging. Cases with a poor prognosis could be treated before birth. However, prenatal modulation of lung development remains experimental. Fetoscopic endoluminal tracheal occlusion triggers lung growth and is currently being evaluated in a global clinical trial. Prenatal transplacental sildenafil administration may in due course be a therapeutic approach, reducing the occurrence of persistent pulmonary hypertension, either alone or in combination with fetal surgery...
November 21, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29101642/prenatal-surgery-for-spina-bifida-a-therapeutic-dilemma-proceedings-of-the-shine-conference-belfast
#10
Mano Shanmuganathan, Deborah A Sival, Kelly-Ann Eastwood, Katie Morris, Jacqueline Cartmill, Axel Heep, Janusz Bohosiewicz, Agnieszka Pastuszka, Alyson Hunter, Amanda Ali, Roy McConnell, Darach Crimmins, Fergal Malone, Carolyn Bailie, Jan Deprest, Cathy McKillop, Zarko Alfirevic, Fionnuala McAuliffe, Stephen Ong
This is a transcript of a scientific conference on the subject of prenatal surgery for spina bifida. It represents the views of three patients, an obstetrician, a postnatal neurosurgeon, a neonatologist, a paediatric neurologist, two surgeons who practice open spina bifida foetal surgery, a fetoscopic surgeon and an obstetrician experienced in randomised trials and systematic reviews. Implications for current practice and recommendations for future research are also discussed in detail.
November 3, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29056972/methotrexate-and-valproic-acid-affect-early-neurogenesis-of-human-amniotic-fluid-stem-cells-from-myelomeningocele
#11
Vardine Sahakyan, Enrico Pozzo, Robin Duelen, Jan Deprest, Maurilio Sampaolesi
Myelomeningocele (MMC) is a severe type of neural tube defect (NTD), in which the backbone and spinal canal do not close completely during early embryonic development. This condition results in serious morbidity and increased mortality after birth. Folic acid significantly reduces, and conversely, folate antagonist methotrexate (MTX) and valproic acid (VPA) increase the occurrence of NTDs, including MMC. How these pharmacological agents exactly influence the early neurulation process is still largely unclear...
2017: Stem Cells International
https://www.readbyqxmd.com/read/29024208/does-the-site-of-the-cord-insertion-increase-the-risk-of-adverse-outcome-twin-to-twin-transfusion-syndrome-and-discordant-growth-in-monochorionic-twin-pregnancies
#12
Isabel Couck, Nada Mourad Tawfic, Jan Deprest, Luc De Catte, Roland Devlieger, Liesbeth Lewi
BACKGROUND: It is insufficiently known to what degree the site of the cord insertions influences the risk of a complicated outcome in monochorionic twin pregnancies. OBJECTIVES: The purpose is to examine if the site of cord insertions as determined on prenatal ultrasound scan increases the risk of adverse outcome -defined as fetal or neonatal loss or birth prior to 32 weeks-, twin-to-twin transfusion syndrome (TTTS) and discordant growth. METHODS: We retrospectively studied a consecutive cohort of monochorionic diamniotic twin pregnancies followed from the first trimester...
October 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28950821/modelling-bronchopulmonary-dysplasia-in-animals-arguments-for-the-preterm-rabbit-model
#13
Thomas Salaets, Andre Gie, Bieke Tack, Jan Deprest, Jaan Toelen
Bronchopulmonary dysplasia (BPD) remains a frequent and disabling consequence of preterm birth, despite the recent advances in neonatal intensive care. There is a need to further improve outcomes and many novel therapeutic or preventive strategies are therefore investigated in animal models. We discuss in this review the aspects of human BPD pathophysiology and phenotype, which ideally should be mimicked by an animal model for this disease. Prematurity remains the common denominator in the heterogeneous spectrum of human BPD, and preterm animal models thus have a clear translational advantage...
September 26, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28866670/clinical-outcome-for-congenital-diaphragmatic-hernia-at-the-age-of-1-year-in-the-era-of-fetal-intervention
#14
Eva Van Ginderdeuren, Karel Allegaert, Herbert Decaluwe, Jan Deprest, Anne Debeer, Marijke Proesmans
BACKGROUND: Congenital diaphragmatic hernia (CDH) is an abnormal development of the diaphragm leading to high neonatal mortality and morbidity. Beyond the neonatal period, prospective data on overall long-term outcome in CDH survivors is scarce. In particular, for those treated with fetoscopic endoluminal tracheal occlusion (FETO), a promising new technique to increase survival chances for severe cases, the outcomes are even less documented. AIM: To prospectively document the clinical outcome of CDH at 1 year including FETO-treated infants in relation to ante- and postnatal variables...
2017: Neonatology
https://www.readbyqxmd.com/read/28842991/the-amniotic-fluid-as-a-source-of-mesenchymal-stem-cells-with-lung-specific-characteristics
#15
Flore Lesage, Silvia Zia, Julio Jiménez, Jan Deprest, Jaan Toelen
The amniotic fluid is a clinically accessible source of mesenchymal stem cells (AF-MSC) during gestation, which enables autologous cellular therapy for perinatal disorders. The origin of AF-MSC remains elusive: renal and neuronal progenitors have been isolated from the AF-MSC pool, yet no cells with pulmonary characteristics. We analyzed gene expression of pulmonary and renal markers of 212 clonal lines of AF-MSC isolated from amniocentesis samples. AF-MSC were cultured on dishes coated with extracellular matrix (ECM) proteins from decellularized fetal rabbit lungs...
August 26, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28803112/in-vivo-documentation-of-shape-and-position-changes-of-mri-visible-mesh-placed-in-rectovaginal-septum
#16
Iva Urbankova, Nikhil Sindhwani, Geertje Callewaert, Alice Turri, Rita Rinkijevic, Lucie Hympanova, Andrew Feola, Jan Deprest
BACKGROUND AND OBJECTIVE: Large deformations in synthetic meshes used in pelvic organ prolapse surgery may lead to suboptimal support for the underlying tissue, graft-related complications as well as recurrence. Our aim was to quantify in vivo longitudinal changes in mesh shape and geometry in a large animal model. We compare two commonly used mesh shapes, armed and flat, that are differently affixed. The secondary outcomes were active and passive biomechanical properties. METHODS: A total of 18 animals were used...
August 5, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28752425/minimal-modulation-of-the-host-immune-response-to-sis-matrix-implants-by-mesenchymal-stem-cells-from-the-amniotic-fluid
#17
F Lesage, S Pranpanus, F M Bosisio, M Jacobs, S Ospitalieri, J Toelen, J Deprest
PURPOSE: Surgical restoration of soft tissue defects often requires implantable devices. The clinical outcome of the surgery is determined by the properties inherent to the used matrix. Mesenchymal stem cells (MSC) modulate the immune processes after in vivo transplantation and their addition to matrices is associated with constructive remodeling. Herein we evaluate the potential of MSC derived from the amniotic fluid (AF-MSC), an interesting MSC source for cell therapeutic applications in the perinatal period, for immune modulation when added to a biomaterial...
July 27, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28709445/twin-twin-transfusion-syndrome-study-protocol-for-developing-disseminating-and-implementing-a-core-outcome-set
#18
Asma Khalil, Helen Perry, James Duffy, Keith Reed, Ahmet Baschat, Jan Deprest, Kurt Hecher, Liesbeth Lewi, Enrico Lopriore, Dick Oepkes
BACKGROUND: Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice...
July 14, 2017: Trials
https://www.readbyqxmd.com/read/28680967/a-continuum-robot-and-control-interface-for-surgical-assist-in-fetoscopic-interventions
#19
George Dwyer, Francois Chadebecq, Marcel Tella Amo, Christos Bergeles, Efthymios Maneas, Vijay Pawar, Emanuel Vander Poorten, Jan Deprest, Sebastien Ourselin, Paolo De Coppi, Tom Vercauteren, Danail Stoyanov
Twin-twin transfusion syndrome requires interventional treatment using a fetoscopically introduced laser to sever the shared blood supply between the fetuses. This is a delicate procedure relying on small instrumentation with limited articulation to guide the laser tip and a narrow field of view to visualize all relevant vascular connections. In this letter, we report on a mechatronic design for a comanipulated instrument that combines concentric tube actuation to a larger manipulator constrained by a remote centre of motion...
March 8, 2017: IEEE Robotics and Automation Letters
https://www.readbyqxmd.com/read/28668592/physiologic-musculofascial-compliance-following-reinforcement-with-electrospun-polycaprolactone-ureidopyrimidinone-mesh-in-a-rat-model
#20
Lucie Hympanova, Marina Gabriela Monteiro Carvalho Mori da Cunha, Rita Rynkevic, Manuel Zündel, Monica Ramos Gallego, Jakob Vange, Geertje Callewaert, Iva Urbankova, Frank Van der Aa, Edoardo Mazza, Jan Deprest
PURPOSE: Electrospun meshes may be considered as substitutes to textile polypropylene implants. We compared the host response and biomechanical properties of the rat abdominal wall following reinforcement with either polycaprolactone (PCL) modified with ureidopyrimidinone-motifs (UPy) or polypropylene mesh. METHODS: First we measured the response to cyclic uniaxial load within the physiological range both dry (room temperature) and wet (body temperature). 36 rats underwent primary repair of a full-thickness abdominal wall defect with a polypropylene suture (native tissue repair), or reinforced with either UPy-PCL or ultra-light weight polypropylene mesh (n = 12/group)...
October 2017: Journal of the Mechanical Behavior of Biomedical Materials
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