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fetal surgery

Sophia S Yu, Lindsay A Bischoff
Owing to the young median age of diagnosis, thyroid cancer in women can coincide with pregnancy and affect its management. The evaluation of a thyroid nodule in pregnant women is similar to that in nonpregnant women, but special consideration must be taken for the impact of a cancer diagnosis and its sequelae in pregnancy. The initial comprehensive exam for pregnant and nonpregnant women includes evaluation of the biochemical function and structure of the thyroid gland, and then fine-needle aspiration biopsy of any suspicious nodule...
October 14, 2016: Seminars in Reproductive Medicine
Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
October 14, 2016: Seminars in Reproductive Medicine
Bethany Stetson, Judith U Hibbard, Isabelle Wilkins, Heidi Leftwich
OBJECTIVE: To examine the differences in perinatal outcomes among women with a prior preterm birth who received cerclage compared with cerclage plus 17α-hydroxyprogesterone caproate. METHODS: Women with transvaginal cerclage placement and a prior delivery between 16 and 36 weeks of gestation were identified over a 10-year period (July 2002 to May 2012) in this retrospective cohort study. Exclusion criteria were delivery at another institution, abdominal cerclage, multiple gestations, and major fetal anomalies...
October 6, 2016: Obstetrics and Gynecology
Francisca Caimari, Elena Valassi, Patricia Garbayo, Charlotte Steffensen, Alicia Santos, Rosa Corcoy, Susan M Webb
Pregnancy in Cushing's syndrome (CS) is extremely rare due to the influence of hypercortisolism on the reproductive axis. Purpose of this study is to investigate whether the etiology of CS in pregnancy determines a different impact on the fetal/newborn and maternal outcomes. We performed a systematic review of cases published in the literature from January 1952 to April 2015 including the words "Cushing AND pregnancy". We included 168 manuscripts containing 220 patients and 263 pregnancies with active CS during pregnancy and with a history of CS but treated and cured hypercortisolism at the time of gestation...
October 4, 2016: Endocrine
Maki Itokazu, Shigeyuki Wakitani, Hisashi Mera, Yoshihiro Tamamura, Yasushi Sato, Mutsumi Takagi, Hiroaki Nakamura
OBJECTIVE: The object of this study was to determine culture conditions that create stable scaffold-free cartilage-like cell-sheets from human bone marrow-derived mesenchymal stem cells (hBMSCs) and to assess their effects after transplantation into osteochondral defects in nude rats. DESIGN: (Experiment 1) The hBMSCs were harvested from 3 males, the proliferative and chondrogenic capacities were assessed at passage 1, and the cells were expanded in 3 different culture conditions: (1) 5% fetal bovine serum (FBS), (2) 10% FBS, and (3) 5% FBS with fibroblast growth factor 2 (FGF-2)...
October 2016: Cartilage
Sung Hye Byun, So Young Lee, Seong Yeon Hong, Taeha Ryu, Baek Jin Kim, Jin Yong Jung
INTRODUCTION: In fetuses who are predicted to be at risk of catastrophic airway obstruction at delivery, the ex utero intrapartum treatment (EXIT) procedure is useful for securing the fetal airway while maintaining fetal oxygenation via placental circulation. Factors, including poor posture of the fetus and physician, narrow visual field, and issues of contamination in the aseptic surgical field, make fetal intubation during the EXIT procedure difficult. Herein, we report our experience of the usefulness of the GlideScope video laryngoscope (GVL) for intubation during the EXIT procedure...
September 2016: Medicine (Baltimore)
Martin Neovius, Olof Stephansson
No abstract text is available yet for this article.
September 27, 2016: Evidence-based Medicine
Joshua L Gu, Anthony Johnson, Marcia Kerr, Kenneth J Moise, Michael W Bebbington, Claudia Pedroza, David I Sandberg
BACKGROUND/AIMS: This study evaluates the predictive value of prenatal imaging measurements regarding the need for cerebrospinal fluid (CSF) diversion for fetal hydrocephalus in the first 3 months after birth. METHODS: We retrospectively reviewed a consecutive case series of patients with fetal hydrocephalus from January 2011 to December 2014 (n = 45). Prenatal measurements included head circumference (HC), biparietal diameter (BPD), and lateral ventricle (LV) width...
September 28, 2016: Pediatric Neurosurgery
Teruyoshi Kageji, Takeshi Miyamoto, Yumiko Kotani, Tsuyoshi Kaji, Yoshimi Bando, Yoshifumi Mizobuchi, Kohei Nakajima, Shinji Nagahiro
PURPOSE: Craniopharyngiomas are 5-10 % of all pediatric tumors, but are seldomly encountered in the perinatal period. Only seven instances of a truly antenatal diagnosis of a congenital craniopharyngioma that subsequently underwent radical surgery have been reported. We present the case of a patient who received the diagnosis of a suprasellar tumor during the prenatal period and received radical surgery. METHODS: We report a case of a neonatal craniopharyngioma treated surgically...
September 26, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Deanna Gigliotti, Jeff R S Leiter, Peter B MacDonald, Jason Peeler, Judy E Anderson
BACKGROUND: Rotator-cuff injury (RCI) is common and painful; even after surgery, joint stability and function may not recover. Relative contributions to atrophy from disuse, fibrosis, denervation, and satellite-cell responsiveness to activating stimuli are not known. METHODS AND FINDINGS: Potential contributions of denervation and disrupted satellite cell responses to growth signals were examined in supraspinatus (SS) and control (ipsilateral deltoid) muscles biopsied from participants with RCI (N = 27)...
2016: PloS One
Lior Segev, Yakir Segev, Shlomi Rayman, Ron Shapiro, Aviram Nissan, Eran Sadot
BACKGROUND: The optimal surgical approach to acute appendicitis in pregnancy remains controversial. Our aim was to compare perioperative and obstetric outcomes associated with laparoscopic and open appendectomy in a large contemporary cohort of pregnant women. METHODS: Retrospective review of all women who underwent appendectomy during pregnancy in a single hospital during 2000-2014. RESULTS: Ninety-two patients met the study criteria. Fifty (54%) underwent laparoscopic appendectomy and 42 (46%) open appendectomy...
September 26, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
R Q Yang, Z Y Liu, J L Zhang, Y Nan, L M Fan
Objective: To investigate the relationship among the prenatal ultrasound, prognosis and chromosome results of fetal bowel dilatation. And in order to further improve the positive rate of prenatal chromosome examination operation, and reduce the risk of missed diagnosis. Methods: Ninety fetuses who were diagnosed as fetal bowel dilatation by prenatal ultrasound from June 2013 to December 2015 in the Second hospital of Jilin University were enrolled. Chromosomes were examined by amniotic cavity puncture or umbilical cord blood puncture...
September 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Manisha Gandhi, Anitra Beasley, Emily Vinas, Haleh Sangi-Haghpeykar, Susan M Ramin, Charlie C Kilpatrick
OBJECTIVE: To evaluate the use of mobile technology to facilitate resident learning, assess clinical knowledge, and guide curricular development in a busy clinical environment. METHODS: This was a cross-sectional study conducted in a large (N=48) urban obstetrics and gynecology residency program. Question sets were created in the following areas: office gynecology, general obstetrics, gynecologic surgery and urogynecology, maternal-fetal medicine and ultrasonography, reproductive endocrinology and pediatric gynecology, and gynecologic oncology...
October 2016: Obstetrics and Gynecology
Sevan A Vahanian, Anthony M Vintzileos
PURPOSE OF REVIEW: Placental implantation abnormalities (PIAs) comprise a large group of disorders associated with significant maternal, fetal, and neonatal morbidity. RECENT FINDINGS: Risk factors include prior uterine surgery/myometrial scarring and the presence of placenta previa with or without prior cesarean delivery. Newly identified risk factors include previous prelabor cesarean delivery and previous postpartum hemorrhage. PIAs contribute substantially to preterm birth with prematurity rates ranging from 38 to 82%...
September 21, 2016: Current Opinion in Obstetrics & Gynecology
Ryo Yamamoto, Keisuke Ishii, Aki Mabuchi, Shiyo Oota, Kazufumi Haino, Shusaku Hayashi, Takeshi Kanagawa, Nobuaki Mitsusda
AIM: To investigate the association between uterine bleeding preceding fetoscopic laser photocoagulation (FLP) and the presence of discolored amniotic fluid that impedes FLP. METHODS: A retrospective review of all multiple gestations requiring FLP at the present institution was conducted. The rate of low visibility because of discolored amniotic fluid at the beginning of FLP was compared between patients with and without a history of uterine bleeding, defined as either genital bleeding or ultrasonographically detected subchorionic hematoma...
September 20, 2016: Journal of Obstetrics and Gynaecology Research
Kimberly J Dunham-Snary, Danchen Wu, Edward A Sykes, Amar Thakrar, Leah Rg Parlow, Jeffrey D Mewburn, Joel L Parlow, Stephen L Archer
Hypoxic pulmonary vasoconstriction (HPV) is a homeostatic mechanism that is intrinsic to the pulmonary vasculature. Intrapulmonary arteries constrict in response to alveolar hypoxia, diverting blood to better-oxygenated lung segments, thereby optimizing ventilation-perfusion matching and systemic oxygen delivery. In response to alveolar hypoxia, a mitochondrial sensor dynamically changes reactive oxygen species and redox couples in PASMC. This inhibits potassium channels, depolarizes PASMC, activates voltage-gated calcium channels, and increases cytosolic calcium, causing vasoconstriction...
September 16, 2016: Chest
Kate Denton, Karen Moritz, Lindsey Booth, Clive May, Geoff Head, Markus Schlaich, Reetu Singh
OBJECTIVE: Renal sympathetic nerves contribute significantly to the control of kidney function and blood pressure. A critical question is whether catheter-based renal denervation (cDNX) has adverse consequences, in situations of clinical challenge, such as hemorrhage. The aim was to examine the effects of cDNX on basal mean arterial pressure (MAP) and glomerular filtration rate (GFR) and in response to hemorrhage in hypertensive sheep with chronic kidney disease (CKD). DESIGN AND METHOD: Hypertension and CKD was induced in sheep by performing fetal unilateral nephrectomy (CKD; N = 14)...
September 2016: Journal of Hypertension
Philip Dueppers, Klaus Grabitz, You Li, Hubert Schelzig, Markus Udo Wagenhäuser, Mansur Duran
BACKGROUND: The risk of deep venous thrombosis is elevated during pregnancy and the puerperium. Therapy is usually limited to conservative measures as invasive thrombus removal is feared because of possible complications. However, leg- or life-threatening situations require fast thrombus removal, and the long-term rate of post-thrombotic syndrome (PTS) may be reduced by venous recanalization. Our center's experience may give support to surgical venous thrombectomy (VT). METHODS: Between 1996 and 2016, all women who received VT for pregnancy-related deep venous thrombosis in our department were included...
October 2016: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Agnes Rosarina Prita Sari, Nicholas Wolfgang Rufaut, Leslie Norman Jones, Rodney Daniel Sinclair
CONTEXT: In androgenetic alopecia, follicular miniaturization and dynamic changes to the hair cycle produce patterned baldness. The most effective treatment for baldness is hair transplantation surgery. The major limitation to hair transplantation is the availability of donor hair from the relatively unaffected occipital scalp. Hair induction with in vitro expansion of donor follicle populations has the potential to overcome this. The major obstacle to this is that in vitro expansion of human dermal papilla cell (DPC) colonies is associated with irreversible loss of aggregative behavior and hair follicle-inductive potential...
July 2016: International Journal of Trichology
Lene Osterballe, Erik Clasen-Linde, Dina Cortes, Gerda Engholm, Rasmus Hertzum-Larsen, Susanne Reinhardt, Jorgen Thorup
INTRODUCTION: Cryptorchidism is a risk factor for testicular cancer in adult life. It remains unclear how prepubertal surgery for cryptorchidism impacts later development of adult testicular cancer. The aim of study was to investigate tools to identify the cryptorchid boys who later develop testicular cancer. METHODS: The study cohort consisted of 1403 men operated prepubertally/pubertally for undescended testis between 1971 and 2003. At surgery testicular biopsies were taken from the cryptorchid testes...
August 27, 2016: Journal of Pediatric Surgery
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