scholarly journals Review of the theories of gastroschisis pathogenesis

2020 ◽  
pp. 86-89
Author(s):  
A.A. Pereyaslov ◽  

Gastroschisis and omphalocele are the most common congenital malformations of the abdominal wall that required surgical correction. Despite of the long history of the gastroschisis’ study, there is no generally accepted theory of the pathogenesis of this malformation. There are numerous theories of the pathogenesis of gastroschisis discussed in the modern literature: disorders of differentiation of embrionic mesenchyme as the result of teratogenic influence on the early stages of the embryonic development; rupture of amniotic membrane at the base of the umbilical cord; vascular disorders during of the embryonic development; disorders of the yolk-sac escape. Each of existing theories has its supporters and opponents. It is no generally accepted theory of the pathogenesis of gastroschisis. Most likely is the rupture of physiological hernia along the umbilical cord in its pars flaccid, with the subsequent elongation of the midgut out of the abdominal cavity with the vascular compression, especially of venous and lymphatic vessels. Narrow mesenteric root and narrow-sized defect may contribute to various complications that jeopardize the ultimate prognosis. Further studies are needed to finalize the pathogenesis of gastroschisis. No conflict of interest was declared by the author. Key words: gastroschisis, pathogenesis, vascular disorders, embryonic disorders.

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Dorcas Oyueley Kodie ◽  
Noah Segun Oyetayo ◽  
Oladotun Solomon Awoyemi ◽  
Cecelia Omowunmi Oguntoye ◽  
Oghenemega David Eyarefe

Abstract Background Cryptorchidism in dogs is of clinical concern due to its association with development of Sertoli cell tumours, seminomas and spermatic cord torsion. A patent inguinal ring has been found as a risk factor for peritoneal content migration and inguinal hernias. This study reports a case of bowel migration through a patent inguinal ring in a bilaterally cryptorchid dog and incarceration within the vaginal tunic of the left testicle. Case presentation A three-and-a-half-year-old bilaterally cryptorchid Lhasa Apso with a history of anorexia, vomiting, stranguria and inability to defecate was diagnosed with bowel incarceration in the vaginal tunic of a retained left testicle. Surgery performed under epidural anaesthesia with acepromazine/butorphanol premedication revealed a loop of the colon entrapped in the vaginal tunic of the retained left testicle. The incarcerated bowel was thoroughly examined for viability and repositioned into the abdominal cavity. The inguinal ring was repaired and bilateral cryptorchidectomy performed. Conclusion Cryptorchidectomy in dogs is often considered when there is concern for neoplasm or torsion of retained testes. However, this report suggests that cryptorchidectomy should be considered also to preclude the possibility of bowel obstructive emergencies.


Author(s):  
Elia Shazniza Shaaya ◽  
Siti Atiqah Abdul Halim ◽  
Ka Wen Leong ◽  
Kevin Boon Ping Ku ◽  
Pei Shan Lim ◽  
...  

Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid– Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.


2002 ◽  
Vol 116 (4) ◽  
pp. 288-290 ◽  
Author(s):  
C. V. Praveen ◽  
R. M. Terry ◽  
M. Elmahallawy ◽  
C. Horsfield

Pneumocystis carinii is an opportunistic infection found in patients with impaired immunity. Under favourable conditions the parasite can spread via the blood stream or lymphatic vessels and cause extrapulmonary dissemination. We report a case of P carinii infection presenting as bilateral aural polyps, otitis media and mastoiditis in human immunodeficiency (HIV)-positive patient with no history of prior or concomitant P carinii infection.


1974 ◽  
Vol 106 (4) ◽  
pp. 367-376 ◽  
Author(s):  
W. W. Sawchyn ◽  
C. Gillott

AbstractLestes congener Hagen overwinters in the egg stage. There is a diapause just before blastokinesis, during which the egg is extremely resistant to low temperatures and desiccation. Post-diapause embryonic development can occur near 0 °C but will not take place until the eggs are wetted as the pond habitat fills in the spring. Hatching does not occur until the temperature exceeds about 5 °C and is highly synchronous. Larval development is rapid and is completed in the field in about 50 days. Emergence of the adults also is synchronous. Sexual maturation requires 3 weeks. Oviposition occurs immediately after copulation while the pair are still in tandem. It takes place only in dry stems of Scirpus. Adaptations of L. congener for life under rigorous prairie conditions are discussed.


2020 ◽  
Vol 10 (4) ◽  
pp. 347-354
Author(s):  
Dmitriy M. Il’in ◽  
Vladimir A. Makeev

The introduction of robotic-assisted surgery into clinical practice has opened up new possibilities for the surgical treatment of urological patients. Robot-assisted radical prostatectomy (RARP) is one of the most commonly performed robot-assisted surgery. The review is devoted to the main surgical approaches for RARP. An analysis of publications on this topic was carried out using the search engines of the scientific databases PubMed, Medscape, Google Scholar, eLibrary when writing the article The article presents an overview of the advantages and disadvantages of the existing four access options for RARP: anterior, perineal, lateral and posterior, as well as oncological and functional outcomes of operations. It has been shown that a surgeon with different approaches can choose the most suitable one for a given clinical situation, focusing on the stage of the disease, the patients age, anatomical features of the prostate gland, the state of the patients erectile function, and the history of operations on the abdominal cavity and pelvic organs.


2005 ◽  
Vol 102 ◽  
pp. 107-110 ◽  
Author(s):  
Vasilios A. Zerris ◽  
Georg C. Noren ◽  
William A. Shucart ◽  
Jeff Rogg ◽  
Gerhard M. Friehs

Object.The authors undertook a study to identify magnetic resonance (MR) imaging techniques that can be used reliably during gamma knife surgery (GKS) to identify the trigeminal nerve, surrounding vasculature, and areas of compression.Methods.Preoperative visualization of the trigeminal nerve and surrounding vasculature as well as targeting the area of vascular compression may increase the effectiveness of GKS for trigeminal neuralgia. During the past years our gamma knife centers have researched different MR imaging sequences with regard to their ability to visualize cranial nerves and vascular structures. Constructive interference in steady-state (CISS) fusion imaging with three-dimensional gradient echo sequences (3D-Flash) was found to be of greatest value in the authors' 25 most recent patients.In 24 (96%) out of the 25 patients, the fifth cranial nerve, surrounding vessels, and areas of compression could be reliably identified using CISS/3D-Flash. The MR images were acceptable despite patients' history of microvascular decompression, radiofrequency (RF) ablation, or concomitant disease. In one of 25 patients with a history of multiple RF lesions, the visualization was inadequate due to severe trigeminal nerve atrophy.Conclusions.The CISS/3D-Flash fusion imaging has become the preferred imaging method at the authors' institutions during GKS for trigeminal neuralgia. It affords the best visualization of the trigeminal nerve, surrounding vasculature, and the precise location of vascular compression.


Genes ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1611
Author(s):  
Ningfei Liu ◽  
Minzhe Gao

This study explored mutations in the Fms-related tyrosine kinase 4/vascular endothelial growth factor receptor 3 gene (FLT4) and lymphatic defects in patients with Milroy disease (MD). Twenty-nine patients with lower limb lymphedema were enrolled. Sixteen patients had a familial history of MD, while 13 patients exhibited sporadic MD. Clinical signs, FLT4 mutations, indocyanine green (ICG) lymphography findings, and skin tissue immunohistochemical staining results were evaluated. Twenty-eight variants in FLT4 were identified. Twelve of these have previously been reported, while 16 are novel. Of the 28 variants, 26 are missense mutations, and the remaining two comprise a splicing mutation and a non-frame shift mutation. Twenty-five variants are located in the intracellular protein tyrosine kinase domain; three are located in the extracellular immunoglobulin domain. Substantially delayed contrast-enhanced tortuous lymphatic vessels were visualized to the ankle or knee level in 15 of 23 patients who underwent ICG lymphography. No initial lymphatic vessels were visualized in skin specimens from four patients who did not exhibit lymphatic vessels during imaging analyses. No specific variant was identified in relation to the unique clinical phenotype. Segmental dysfunction of lymphatic vessels and initial lymphatic aplasia are present in MD patients with FLT4 mutations.


2013 ◽  
Vol 113 (suppl_1) ◽  
Author(s):  
Sarah E Wetzel-Strong ◽  
Manyu Li ◽  
Toshio Nishikimi ◽  
Kathleen M Caron

The multi-functional peptide adrenomedullin ( Adm = gene, AM = protein) plays important roles in embryonic development and disease. Previous studies demonstrated that Adm knockout mice die at embryonic day 13.5 with small, disorganized hearts and hypoplastic lymphatic vessels, highlighting the importance of this peptide in normal cardiovascular development. Since Adm knockout animals are embryonic lethal, our goal was to generate and characterize a novel model of Adm over-expression to study the role of Adm during development and disease processes. Through gene targeting techniques, we generated a novel mouse model of Adm over-expression, abbreviated as Adm hi/hi . When we assessed gene expression of Adm from 10 different tissues, we found Adm hi/hi mice express 3- to 15-fold more Adm than wildtype littermates. Additionally, peptide levels of AM in lung and kidney, as well as circulating plasma levels of AM were elevated 3-fold over wildtype mice, indicating a functional increase in AM. Our initial analysis revealed that adult Adm hi/hi mice have larger heart weight to body weight ratios than wildtype littermates (4.93±0.23 vs. 5.96±0.29, n = 11-12). We found that compared to wildtype, Adm hi/hi embryos have more proliferating cells during heart development (14.46±1.11 vs. 31.97±2.84, n=4), indicating that hyperplasia drives Adm hi/hi heart enlargement. By crossing the Adm hi/hi line to different tissue-specific Cre lines, we were able to excise the stabilizing bovine growth hormone 3’UTR, thereby returning Adm expression levels back to wildtype in cells with active Cre recombinase. Using this approach, we identified the epicardium as a major source of AM during cardiac development. In conclusion, we found that AM derived primarily from the epicardium drives cardiac hyperplasia during embryonic development resulting in persistent, enlarged hearts of adult Adm hi/hi mice. Since our Adm hi/hi mice recapitulate the 3-fold plasma elevation of AM observed during human disease, this mouse line will be a useful tool for studying the role of elevated AM during disease.


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