Incarceration of a pedunculated uterine fibroid in an umbilical hernia

PubMed Central

Kim, Mi Ju; Seong, Won Joon

2017-01-01

Uterine fibroids are common benign tumors that may cause an umbilical hernia in patients with increased intra-abdominal pressure due to pregnancy, obesity, ascites, and intra-abdominal tumors. However, the simultaneous occurrence of uterine fibroids and umbilical hernias, or fibroids and an associated umbilical hernia, during pregnancy has rarely been reported. Here, we present the case of a fibroid presenting as an incarcerated umbilical hernia in a menopausal patient. PMID:28534020

Deformation and Flexibility Equations for Idealized ARIS Umbilicals, Under Planar End-Loading Conditions

NASA Technical Reports Server (NTRS)

Hampton, R. David; Quraishi, Naveed (Technical Monitor)

2003-01-01

The International Space Station (ISS) relies on the Active Rack Isolation System (ARIS) as the central component of an integrated, station-wide strategy to isolate microgravity space-science experiments. ARIS uses electromechanical actuators to isolate an International Standard Payload Rack (ISPR) from disturbances due to the motion of the ISS. Disturbances to microgravity experiments on ARIS-isolated racks are primarily transmitted via the ARTS power and vacuum umbilicals. Recent experimental tests indicate that these umbilicals resonate at frequencies outside the ARIS controller's bandwidth, at levels of potential concern for certain microgravity experiments. Reduction in the umbilical resonant frequencies could help to address this issue. This report develops equations for the in-plane deflections and flexibilities of an idealized umbilical (thin, flexible, cantilever beam) under end-point, in-plane loading (inclined-force and moment). The effect of gravity is neglected due to the on-orbit application. The analysis assumes an initially straight, cantilevered umbilical with uniform cross-section, which undergoes large deflections with no plastic deformation, such that the umbilical terminus remains in a single quadrant and the umbilical slope changes monotonically. The analysis is applicable to the ARIS power and vacuum umbilicals, under the indicated assumptions.

Deformation and Flexibility Equations for Idealized ARIS Umbilicals, Under Planar End-Loading Conditions

NASA Technical Reports Server (NTRS)

Hampton, R. David; Quraishi, Naveed; Rupert, Jason K.

2000-01-01

The International Space Station (ISS) relies on the Active Rack Isolation System (ARIS) as the central component of an integrated, station-wide strategy to isolate microgravity space-science experiments. ARIS uses electromechanical actuators to isolate an International Standard Payload Rack (ISPR) from disturbances due to the motion of the ISS. Disturbances to microgravity experiments on ARIS-isolated racks are primarily transmitted via the ARIS power and vacuum umbilicals. Recent experimental tests indicate that these umbilicals resonate at frequencies outside the ARIS controller's bandwidth. at levels of potential concern for certain microgravity experiments. Reduction in the umbilical resonant frequencies could help to address this issue. This paper develops equations for the in-plane deflections and flexibilities of an idealized umbilical (thin, flexible, cantilever beam) under end-point, in-plane loading (inclined-force and moment). The effect of gravity is neglected due to the on:orbit application. The analysis assumes an initially straight. cantilevered umbilical with uniform cross-section. which undergoes large deflections with no plastic deformation, such that the umbilical terminus remains in a single quadrant and the umbilical slope changes monotonically. The analysis is applicable to the ARIS power and vacuum umbilicals. under the indicated assumptions.

Automated Ground Umbilical Systems (AGUS) Project

NASA Technical Reports Server (NTRS)

Gosselin, Armand M.

2007-01-01

All space vehicles require ground umbilical systems for servicing. Servicing requirements can include, but are not limited to, electrical power and control, propellant loading and venting, pneumatic system supply, hazard gas detection and purging as well as systems checkout capabilities. Of the various types of umbilicals, all require several common subsystems. These typically include an alignment system, mating and locking system, fluid connectors, electrical connectors and control !checkout systems. These systems have been designed to various levels of detail based on the needs for manual and/or automation requirements. The Automated Ground Umbilical Systems (AGUS) project is a multi-phase initiative to develop design performance requirements and concepts for launch system umbilicals. The automation aspect minimizes operational time and labor in ground umbilical processing while maintaining reliability. This current phase of the project reviews the design, development, testing and operations of ground umbilicals built for the Saturn, Shuttle, X-33 and Atlas V programs. Based on the design and operations lessons learned from these systems, umbilicals can be optimized for specific applications. The product of this study is a document containing details of existing systems and requirements for future automated umbilical systems with emphasis on design-for-operations (DFO).

Umbilical hernia repair in pregnant patients: review of the American College of Surgeons National Surgical Quality Improvement Program.

PubMed

Haskins, I N; Rosen, M J; Prabhu, A S; Amdur, R L; Rosenblatt, S; Brody, F; Krpata, D M

2017-10-01

Umbilical hernias present commonly during pregnancy secondary to increased intra-abdominal pressure. As a result, umbilical hernia incarceration or strangulation may affect pregnant females. The purpose of this study is to detail the operative management and 30-day outcomes of umbilical hernias in pregnant patients using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). All female patients undergoing umbilical hernia repair during pregnancy were identified within the ACS-NSQIP. Preoperative patient variables, intraoperative variables, and 30-day patient morbidity and mortality outcomes were investigated using a variety of statistical tests. A total of 126 pregnant patients underwent umbilical hernia repair from 2005 to 2014; 73 (58%) had incarceration or strangulation at the time of surgical intervention. The majority of patients (95%) underwent open umbilical hernia repair. Superficial surgical site infection was the most common morbidity in patients undergoing open umbilical hernia repair. Based on review of the ACS-NSQIP database, the incidence of umbilical hernia repair during pregnancy is very low; however, the majority of patients required repair for incarceration of strangulation. When symptoms develop, these hernias can be repaired with minimal 30-day morbidity to the mother. Additional studies are needed to determine the long-term recurrence rate of umbilical hernia repairs performed in pregnant patients and the effects of surgical intervention and approach on the fetus.

Nutritional status and umbilical hernia in Nigerian school children of different ethnic groups.

PubMed Central

Ebomoyi, E.; Parakoyi, D. B.; Omonisi, M. K.

1991-01-01

The relationship between nutritional status and umbilical hernia was assessed among Hausa and Yoruba school children in rural areas of Kwara State, Nigeria. The prevalence of umbilical hernia in the rural school pupils was 19.4%. The Yoruba school children had a higher prevalence rate of 22.0%, while the prevalence rate for Hausa pupils was 16.9%. The association between umbilical hernia and primary school class was statistically significant. More school children suffering from protein energy malnutrition presented with umbilical hernia. The association between umbilical hernia and nutritional status was weak. The school health component of the national primary health program should be intensified to screen school children regularly for umbilical hernia. The school health environment of rural Nigerian schools should be improved through government efforts. Images Figure 1 Figure 2 PMID:1800766

Umbilical paracentesis for incarcerated umbilical hernia in patients with end-stage liver disease.

PubMed

Alonso, S; Donat, M; Carrion, L; Rodriguez, J M; Diego, L; Acin, D; Serrano, A; Perez, E; Pereira, F

2016-08-01

Patients with cirrhosis and ascites are prone to abdominal wall complications largely predominate by umbilical hernia. Elective surgery is indicated in select patients but a high morbidity and mortality rate occurs if it is performed in emergency conditions. We present a clinical case of a patient with advanced alcoholic liver disease who came to the emergency room for an acutely incarcerated umbilical hernia. Due to the high surgical risk, we had to discuss other treatment options. The use of umbilical paracentesis for incarcerated hernia reduction in cirrhotic patients with tense ascites is a safe and reproducible technique. Umbilical paracentesis could be considered as an alternative to emergency surgery in these high-risk patients.

Spontaneous Endometriosis Within a Primary Umbilical Hernia

PubMed Central

Yheulon, Christopher G

2017-01-01

Umbilical hernias are rather common in the General Surgery clinic; however, endometriosis of an umbilical hernia is rare. It is especially unusual to have endometriosis of an umbilical hernia spontaneously occur compared to occurring at a site of a prior surgery. We present a case of spontaneous endometriosis of an umbilical hernia without prior surgery to her umbilicus. She had not presented with the usual symptoms of endometriosis and it was not considered as a diagnosis prior to surgery. Umbilical endometriosis is rare but usually occurs after prior laparoscopic surgery. We believe this is the second reported case in the English literature and the first such case reported from North America of spontaneous endometriosis of an umbilical hernia. This case highlights the importance of a full review of systems and qualifying the type and occurrence of pain. Additionally, it is always important to analyze surgical specimens in pathology to avoid errors in diagnosis. PMID:29164008

Umbilical hernia with cholelithiasis and hiatal hernia: a clinical entity similar to Saint's triad.

PubMed

Yamanaka, Takahiro; Miyazaki, Tatsuya; Kumakura, Yuji; Honjo, Hiroaki; Hara, Keigo; Yokobori, Takehiko; Sakai, Makoto; Sohda, Makoto; Kuwano, Hiroyuki

2015-01-01

We experienced two cases involving the simultaneous presence of cholelithiasis, hiatal hernia, and umbilical hernia. Both patients were female and overweight (body mass index of 25.0-29.9 kg/m(2)) and had a history of pregnancy and surgical treatment of cholelithiasis. Additionally, both patients had two of the three conditions of Saint's triad. Based on analysis of the pathogenesis of these two cases, we consider that these four diseases (Saint's triad and umbilical hernia) are associated with one another. Obesity is a common risk factor for both umbilical hernia and Saint's triad. Female sex, older age, and a history of pregnancy are common risk factors for umbilical hernia and two of the three conditions of Saint's triad. Thus, umbilical hernia may readily develop with Saint's triad. Knowledge of this coincidence is important in the clinical setting. The concomitant occurrence of Saint's triad and umbilical hernia may be another clinical "tetralogy."

Spontaneous Endometriosis Within a Primary Umbilical Hernia.

PubMed

Laferriere, Nicole R; Yheulon, Christopher G

2017-11-01

Umbilical hernias are rather common in the General Surgery clinic; however, endometriosis of an umbilical hernia is rare. It is especially unusual to have endometriosis of an umbilical hernia spontaneously occur compared to occurring at a site of a prior surgery. We present a case of spontaneous endometriosis of an umbilical hernia without prior surgery to her umbilicus. She had not presented with the usual symptoms of endometriosis and it was not considered as a diagnosis prior to surgery. Umbilical endometriosis is rare but usually occurs after prior laparoscopic surgery. We believe this is the second reported case in the English literature and the first such case reported from North America of spontaneous endometriosis of an umbilical hernia. This case highlights the importance of a full review of systems and qualifying the type and occurrence of pain. Additionally, it is always important to analyze surgical specimens in pathology to avoid errors in diagnosis.

Neonatal oxidative stress depends on oxygen blood pressure in umbilical artery.

PubMed

Proietti, F; De Bernardo, G; Longini, M; Sordino, D; Scaramuzzini, G; Tataranno, M L; Belvisi, E; Bazzini, F; Perrone, S; Buonocore, G

2016-01-01

With advancing gestation, partial pressure of oxygen (pO2) and pH fall significantly. Hypoxia is a main factor inducing free radical generation and thereby oxidative stress (OS). Placental and fetal tissue response when oxygen becomes restricted is complex and partially known. We tested the hypothesis that changes in umbilical artery and vein blood gas concentrations modulate OS occurrence in the newborn. Seventy umbilical artery and vein plasma samples were collected from healthy term newborns immediately after delivery. F2 Isoprostanes (F2-Isop) were measured in all samples as reliable markers of lipid peroxidation. Significantly lower pCO2 and higher pO2 and pH were found in umbilical vein than in artery, as expected. A positive correlation was detected between pH and pO2 only in umbilical artery (p=0.019). F2-Isop levels were no different between artery and vein in cord blood. Significant correlations were found between F2-Isop and pCO2 (p=0.025) as well as between F2-Isop and pH in umbilical vein (p=0.027). F2-Isop correlated with pCO2 (p=0.007) as well as with pO2 values (p=0.005) in umbilical artery blood. Oxidative stress (OS) in newborns depends on oxygen concentrations in umbilical artery. OS biomarkers significantly correlate with pO2 and in umbilical artery but not in umbilical vein. In normoxic conditions fetal-maternal gas exchanges occurring in placenta re-establish normal higher oxygen levels in umbilical vein than artery, with a normal production of free radicals without any deleterious effects.

Discordant Umbilical Cord Drug Testing Results in Monozygotic Twins.

PubMed

Alexander, Amy; Abbas, Liaqat; Jones, Mary; Jones, Joseph; Lewis, Douglas; Negrusz, Adam

2018-06-01

Our laboratory received segments of umbilical cord that originated from identical twins for routine toxicology analysis. The specimens were analyzed multiple times by liquid chromatography tandem mass spectrometry. The umbilical cord from newborn #1 was positive for hydromorphone only (1.06 ng/g), and the umbilical cord from newborn #2 was positive for hydromorphone (0.81 ng/g) and benzoylecgonine (5.41 ng/g). The hydromorphone results are consistent with maternal administration of hydromorphone; however, the cause of the discrepant benzoylecgonine results in the umbilical cords from the identical twins is unknown.

Catamenial Pain in Umbilical Hernia with Spontaneous Reduction: An Unusual Presentation of a Rare Entity.

PubMed

Pandey, Divya; Sharma, Ritu; Salhan, Sudha

2015-08-01

Spontaneous umbilical endometriosis occurring in absence of any previous abdominal or uterine surgery is extremely atypical. Its association with umbilical hernia is very rare and hernia getting spontaneously resolved has not been reported in literature so far. Here we report a case of a patient with spontaneous umbilical endometriosis associated with umbilical hernia which led to spontaneous hernia reduction. This was also associated with multiple uterine fibromyoma and bilateral ovarian endometrioma which were simultaneously treated by total abdominal hysterectomy with bilateral salpingo-oopherectomy along with surgical excision of the endometriotic tissue and repair of the abdominal wall defect. To the best of our knowledge, this is the first described case of spontaneous umbilical hernia reduction due to development of endometriosis.

Surgical anatomy and morphologic variations of umbilical structures.

PubMed

Fathi, Amir H; Soltanian, Hooman; Saber, Alan A

2012-05-01

The umbilicus is the main access route to the abdominal cavity in laparoscopic surgeries. However, its anatomical configuration is rarely studied in the surgical and anatomical literature. With introduction of laparoendoscopic single-site surgery and considering the significant number of primary and postoperative umbilical hernias, we felt the necessity to comprehensively study the umbilical structures and analyze their protective function against hernias. Twenty-four embalmed cadavers were studied in the anatomy laboratory of Case Western Reserve University. Round hepatic, median and medial ligaments, umbilical ring, umbilical and umbilicovesicular fasciae, and pattern of attachment to the ring were dissected and measured. Mean age was 82.1 years, ranging between 56 and 96 years, with a male-to-female ratio of 1.4:1. Ninety-two per cent was white and 8 per cent black adults. According to shape and attachment pattern of ligaments, umbilical ring is classified into five types. Hernia incidence was 25 per cent. All hernia cases lacked the umbilical fascia and the round hepatic ligament was not attached to the inferior border of the ring. The umbilical ring and its morphologic relation with adjacent ligaments are described and classified into five types. In contrary to sparse existing literature, we propose that umbilical fascia is continuation and condensation of umbilicovesicular rather than transversalis fascia. It was absent in cadavers forming conjoined median and medial ligaments with a single insertion site to the ring. Round ligament insertion to the inferior border of the ring provides another protective factor. These two protective measures were absent in all the observed umbilical hernias.

Umbilical scarring in hatchling American alligators

USGS Publications Warehouse

Wiebe, J.J.; Sepulveda, M.S.; Buckland, J.E.; Anderson, S.R.; Gross, T.S.

2004-01-01

Umbilical scarring is the presence of excess scar tissue deposited between abdominal dermal layers at the site of yolk sac absorption in hatchling American alligators (Alligator mississippiensis). The presence of this dermal condition plays a key evaluatory role in the overall quality and subsequent value for various commercial leather products. Despite the prevalent nature of this condition, currently the industry has no standardized protocols for its quantification. The objectives of this study were to examine the relationship between hatchling weight and age and incidence of umbilical scarring and to develop a quantifiable and reproducible technique to measure this dermal condition in hatchling American alligators. Thirty eggs from each of nine clutches were incubated in two separate incubators at different facilities and hatchling umbilical scarring was measured at 2 and 10 days of age using digital calipers. Umbilical area was calculated by multiplying umbilical length times umbilical width. There was a significant effect of both age and clutch on umbilical area (overall decline of 64%) by 10 days post-hatch. However, only five of the nine clutches utilized expressed a noticeable decline in the size of this dermal condition (range 67-74%). We had hypothesized that larger hatchlings would have larger umbilical areas and a slower rate of improvement in this condition during the first few days post-hatch. The differences in umbilical area and percent decline with age across clutches, however, were not associated with differences in initial hatchling weights. Within clutches and time periods, hatchling weight had no significant effect on the size and/or rate of decline of this condition. ?? 2004 Published by Elsevier B.V.

A Grounded theory study of the intention of nurses to leave the profession.

PubMed

Alilu, Leyla; Zamanzadeh, Vahid; Valizadeh, Leila; Habibzadeh, Hosein; Gillespie, Mark

2017-06-05

this study explores the process of the development of an intention to leave bedside nursing. the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them. este estudo explora o processo de desenvolvimento da intenção de deixar a enfermagem de cabeceira. o processo foi estudado desde a perspectiva de 21 enfermeiras utilizando o método da Grounded Theory (Teoria Fundamentada). Os dados foram coletados utilizando entrevistas semi-estruturadas e o método comparativo constante de Corbin e Strauss se utilizou para analisar os dados. segundo os participantes, duas categorias principais, "imagem social da enfermagem" e "cultura e estrutura de cabeceira", foram os fatores contextuais que influenciam as razões para que as enfermeiras estejam deixando o cuidado de cabeceira. A decepção com a percepção de falta de progresso ou melhora na experiência clínica cria preocupações psicossociais primárias para as participantes. A competência e o processo de autocontrole são passos dados pelas participantes. Isso associado a condições de intervenção foram os resultados da perda do compromisso profissional que as leva a deixar o cuidado de cabeceira. "O fracasso em integrar expectativas pessoais e expectativas da organização: em busca de uma saída" foi a categoria central do estudo que uniu as categorias. os achados deste estudo proporcionam informação útil sobre as necessidades das enfermeiras para superar as intenções de deixar o cuidado de cabeceira. A identificação deste processo pode ajudar a reconhecer os problemas emergentes e oferecer soluções para resolvê-los. este estudio explora el proceso de desarrollo de la intención de dejar la enfermería de cuidado de cabecera. el proceso fue estudiado desde la perspectiva de 21 enfermeras utilizando el método de la Grounded Theory (Teoría Fundamentada). Los datos se recogieron utilizando entrevistas semiestructuradas; para analizar los datos se utilizó el método comparativo constante de Corbin y Strauss. según los participantes dos categorías principales ("imagen social de la enfermería" y "cultura y estructura del cuidado de cabecera ") fueron los factores contextuales que influenciaron las razones para que las enfermeras deseasen dejar el cuidado de cabecera. La decepción con una percepción de falta de progreso o mejora en la experiencia clínica causó preocupaciones psicosociales primarias en las participantes. La competencia y el proceso de autocontrol fueron considerados por las participantes, y esto asociado a las condiciones de intervención resultaron en la pérdida del compromiso profesional que las lleva a dejar el cuidado de cabecera. La categoría central del estudio que unió las categorías encontradas fue: "Fracaso para integrar las expectativas personales con expectativas de la organización: en busca de una salida". los hallazgos de este estudio proporcionan información útil sobre las necesidades de las enfermeras para superar las intenciones de abandonar el cuidado de cabecera. La identificación de este proceso puede ayudar a reconocer los problemas emergentes y ofrecer soluciones para resolverlos.

Deformation and Flexibility Equations for ARIS Umbilicals Idealized as Planar Elastica

NASA Technical Reports Server (NTRS)

Hampton, R. David; Leamy, Michael J.; Bryant, Paul J.; Quraishi, Naveed

2005-01-01

The International Space Station relies on the active rack isolation system (ARIS) as the central component of an integrated, stationwide strategy to isolate microgravity space-science experiments. ARIS uses electromechanical actuators to isolate an international standard payload rack from disturbances due to the motion of the Space Station. Disturbances to microgravity experiments on ARIS isolated racks are transmitted primarily via the ARIS power and vacuum umbilicals. Experimental tests indicate that these umbilicals resonate at frequencies outside the ARIS controller s bandwidth at levels of potential concern for certain microgravity experiments. Reduction in the umbilical resonant frequencies could help to address this issue. This work documents the development and verification of equations for the in-plane deflections and flexibilities of an idealized umbilical (thin, flexible, inextensible, cantilever beam) under end-point, in-plane loading (inclined-force and moment). The effect of gravity is neglected due to the on-orbit application. The analysis assumes an initially curved (not necessarily circular), cantilevered umbilical with uniform cross-section, which undergoes large deflections with no plastic deformation, such that the umbilical slope changes monotonically. The treatment is applicable to the ARIS power and vacuum umbilicals under the indicated assumptions.

The Development and Implementation of the Kennedy Space Center Umbilical Clearance Tool

NASA Technical Reports Server (NTRS)

Chesnutt, David

2016-01-01

In preparation for NASAs upcoming Space Launch System program, the Kennedy Space Center is currently developing subsystems to provide fuel, purges and communications to the flight vehicle, known as umbilicals. It is vital to the crew and mission that these umbilicals release at T-0 without re-contacting the vehicle as it is accelerating from the launch pad. To help ensure this requirement is met by the program, a methodology of evaluating the moving bodies was developed and implemented into a tool using MATLAB. The tool, known as the KSC Umbilical Clearance Tool, takes a given elevation of interest and an umbilical retract profile within the plane to evaluate the clearance between the umbilical arm and thousands of independent flight vehicle drift profiles from a Monte Carlo analysis. The presentation will delve into the challenges associated with developing and implementing the tool framed in the context of evaluating the clearance for one of the SLS umbilicals.

[Intestinal polyp of the umbilical cord].

PubMed

Guschmann, M; Janda, J; Wenzelides, K; Vogel, M

2002-02-01

The morphology, pathogenesis, complications and differential diagnosis of an intestinal polyp of the umbilical cord are presented. The polyp were detected postnatal on the umbilical cord in an healthy male newborn. The presents of intestinal tissue upon the umbilical cord ist possible about the persistence from remnants of the ductus omphalomesentericus with prolapse and differentiation of the intestinal cells. The ductus omphalomesentericus is a tubular structure, a communication between the developing embryonic gut and the yolk sac, forming during the early embryonic life. Obliteration of the omphalomesenteric duct is usually complete by the 10(th) week of gestation. Various portions of the duct may persist, however, giving rise to polyps, fistulas or cysts of the umbilical cord with potentially dangerous clinical consequences. Other tumors of the umbilical cord are myxoma, angioma and teratoma are differential diagnosis.

[Umbilical hernia repair in conjunction with abdominoplasty].

PubMed

Bai, Ming; Dai, Meng-Hua; Huang, Jiu-Zuo; Qi, Zheng; Lin, Chen; Ding, Wen-Yun; Zhao, Ru

2012-09-01

To investigate the feasibility and clinical benefits of umbilical hernia repair in conjunction with abdominoplasty. The incision was designed in accord with abdominoplasty. The skin and subcutaneous tissue was dissected toward the costal arch, and then the anterior sheath of rectus abdominus was exposed. After exposure and dissection of the sac of umbilical hernia, tension-free hernioplasty was performed with polypropylene mesh. After dissecting the redundant skin and subcutaneous tissue, the abdominal wall was tightened. Between May 2008 and May 2011, ten patients were treated in the way mentioned above. The repair of umbilical hernia and the correction of abdominal wall laxity were satisfactory. There was no recurrence of umbilical hernia, hematoma, seroma or fat liquefaction. Through careful selection of patients, repair of umbilical hernia and body contouring could be achieved simultaneously.

Therapy of umbilical hernia during laparoscopic cholecystectomy.

PubMed

Zoricić, Ivan; Vukusić, Darko; Rasić, Zarko; Schwarz, Dragan; Sever, Marko

2013-09-01

The aim of this study is to show our experience with umbilical hernia herniorrhaphy and laparoscopic cholecystectomy, both in the same act. During last 10 years we operated 89 patients with cholecystitis and pre-existing umbilical hernia. In 61 of them we performed standard laparoscopic cholecystectomy and additional sutures of abdominal wall, and in 28 patients we performed in the same act laparoscopic cholecystectomy and herniorrhaphy of umbilical hernia. We observed incidence of postoperative herniation, and compared patients recovery after herniorrhaphy combined with laparoscopic cholecystectomy in the same act, and patients after standard laparoscopic cholecystectomy and additional sutures of abdominal wall. Patients, who had in the same time umbilical hernia herniorrhaphy and laparoscopic cholecystectomy, shown better postoperative recovery and lower incidence of postoperative umbilical hernias then patients with standard laparoscopic cholecystectomy and additional abdominal wall sutures.

Umbilical hernia masking primary umbilical endometriosis - a case report.

PubMed

Brătilă, Elvira; Ionescu, Oana Maria; Badiu, Dumitru Cristinel; Berceanu, Costin; Vlădăreanu, Simona; Pop, Doina Mihaela; MehedinŢu, Claudia

2016-01-01

Endometriosis is a gynecologic condition affecting mainly the pelvic organs. However, extrapelvic endometriosis has been reported in almost all parts of the body. Umbilical endometriosis, either primary or secondary, is uncommon and has a documented neoplastic risk. We present the case of a 46-year-old woman with a large umbilical hernia associating primary umbilical endometriosis discovered during surgery and confirmed later by pathological and immunohistochemical exams. The patient underwent omphalectomy and partial omentum resection, alongside with mesh abdominal wall repair. The patient was informed about the recurrence risk and was asymptomatic at follow-up consults.

Acute Abdomen Secondary to Incarcerated Umbilical Hernia after Treatment of Massive Cirrhotic Ascites

PubMed Central

Tan, Hiang Keat; Chang, Pik Eu

2013-01-01

Umbilical herniation is common in patients with liver cirrhosis and ascites. Rarely, they suffer from incarceration and strangulation of the umbilical hernia after treatment of ascites. We report 3 cases of umbilical hernia incarceration following removal of massive ascites with different treatment modalities. Physicians managing this group of patients should be aware of this rare and potentially fatal complication. PMID:25374722

Effect of body position and ventilation on umbilical artery and venous blood flows during delayed umbilical cord clamping in preterm lambs.

PubMed

Hooper, Stuart B; Crossley, Kelly J; Zahra, Valerie A; van Vonderen, Jeroen; Moxham, Alison; Gill, Andrew W; Kluckow, Martin; Te Pas, Arjan B; Wallace, Euan M; Polglase, Graeme R

2017-07-01

While delayed umbilical cord clamping (UCC) is thought to facilitate placental to infant blood transfusion, the physiological factors regulating flow in the umbilical arteries and veins during delayed UCC is unknown. We investigated the effects of gravity, by changing fetal height relative to the placenta, and ventilation on umbilical blood flows and the cardiovascular transition during delayed UCC at birth. Catheters and flow probes were implanted into preterm lambs (128 days) prior to delivery to measure pulmonary, carotid, umbilical artery (UaBF) and umbilical venous (UvBF) blood flows. Lambs were placed either 10 cm below or 10 cm above the ewe. Ventilation commenced 2-3 min before UCC and continued for 30 min after UCC. Gravity reduced umbilical and cerebral flows when lambs were placed below the midline, but the reduction in UaBF and UvBF was similar. Ventilation during delayed UCC reduced UvBF and UaBF by similar amounts, irrespective of the lamb's position, such that flows into and out of the placenta remained balanced. The effects of ventilation on umbilical flows were much greater than the effects of gravity, but no net placental to lamb blood transfusion could be detected under any condition. Cardiovascular parameters, cerebral oxygen kinetics and final blood volumes were similar in both groups 5 min after UCC. Gravity caused small transient effects on umbilical and cerebral flow, but given changes were similar in umbilical arteries and veins, no net placental transfusion was detected. Ventilation during delayed UCC has a markedly greater influence on cardiovascular function in the newborn. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Umbilical cord care in newborns

MedlinePlus

... the stump clean with gauze and water only. Sponge bathe the rest of your baby, as well. ... Neonatal care - umbilical cord Images Umbilical cord healing Sponge bath References Carlo WA, Ambalavanan N. The umbilicus. ...

Umbilical metastasis derived from early stage rectal cancer: a case report

PubMed Central

2014-01-01

Background Umbilical metastasis, also called Sister Mary Joseph’s nodule (SMJN), is defined as the umbilical nodule associated with advanced metastatic intra-abdominal and pelvic malignancies. A patient with umbilical metastasis has been deemed to have a poor prognosis. Rectal cancer presenting with a SMJN is a rare phenomenon, especially in the early stage and in middle-low rectal cancer. Case presentation We report a case of a 70-year-old male presenting with umbilical metastasis derived from rectal cancer (10 cm from the anal verge, T2N0). Discussion and conclusion For rectal cancer with umbilical metastasis, the exact metastatic routes as well as the criterion of diagnosis and treatments are not very clear. Here we review the literature on rectal cancer and SMJN to deepen the understanding of this disease. PMID:24708697

An ovary as unusual contents of an incarcerated umbilical hernia

PubMed Central

Ahmed, R; Kamat, S; Elkholy, K

2014-01-01

We present the unusual case of a woman presenting with an incarcerated umbilical hernia. Intraoperatively, the contents of the hernia were found to be an ovary. We outline the clinical presentation of our patient, investigations and management as well as a discussion on unusual contents of umbilical hernias. To our knowledge, this is the first case of a non-malignant ovary incarcerated in an umbilical hernia. PMID:25198958

An ovary as unusual contents of an incarcerated umbilical hernia.

PubMed

Ahmed, U; Ahmed, R; Kamat, S; Elkholy, K

2014-09-01

We present the unusual case of a woman presenting with an incarcerated umbilical hernia. Intraoperatively, the contents of the hernia were found to be an ovary. We outline the clinical presentation of our patient, investigations and management as well as a discussion on unusual contents of umbilical hernias. To our knowledge, this is the first case of a non-malignant ovary incarcerated in an umbilical hernia.

Microbial load of umbilical cord blood Ureaplasma species and Mycoplasma hominis in preterm prelabor rupture of membranes.

PubMed

Kacerovsky, Marian; Pliskova, Lenka; Menon, Ramkumar; Kutova, Radka; Musilova, Ivana; Maly, Jan; Andrys, Ctirad

2014-11-01

To evaluate Ureaplasma species and M. hominis DNA in the umbilical cord blood and its correlation with its microbial load in the amniotic fluid, as a measure of microbial burden in fetal inflammatory response and neonatal outcome in pregnancies complicated by preterm prelabor rupture of membranes (pPROM). A retrospective study of 158 women with singleton pregnancies complicated by pPROM between 24(0/7) and 36(6/7) weeks was conducted. Amniotic fluid was obtained from all women by transabdominal amniocentesis, and umbilical cord blood was obtained by venipuncture from umbilical cords immediately after the delivery of the neonates. The Ureaplasma species and M. hominis DNA was quantitated using absolute quantification techniques. Ureaplasma species and M. hominis DNA was identified in 9% of the umbilical cord blood samples. No correlation between the amniotic fluid and umbilical cord blood microbial load was observed. The presence of Ureaplasma species and M. hominis DNA in the umbilical cord blood had no impact on short-term neonatal morbidity. A high microbial load of genital mycoplasma Ureaplasma species DNA in the umbilical cord in pregnancies complicated by pPROM is not associated with a high fetal inflammatory response and is therefore not associated with serious neonatal morbidity.

Giant Ovarian Tumor Presenting as an Incarcerated Umbilical Hernia: A Case Report

PubMed Central

Aydın, Özgür; Onur, Erdal; Çelik, Nilufer Yiğit; Moray, Gökhan

2009-01-01

We report a rare case of a giant ovarian tumor presenting as an incarcerated umbilical hernia. A 61-yr-old woman was admitted to the hospital with severe abdominal pain, an umbilical mass, nausea and vomiting. On examination, a large, irreducible umbilical hernia was found. The woman underwent an urgent operation for a possible strangulated hernia. A large, multilocular tumor was found. The tumor was excised, and a total abdominal hysterectomy and bilateral salphingo-oophorectomy were performed. The woman was discharged 6 days after her admission. This is the first report of incarcerated umbilical hernia containing a giant ovarian tumor within the sac. PMID:19543424

Umbilical Hernia

MedlinePlus

... Prompt diagnosis and treatment can help prevent complications. Causes During pregnancy, the umbilical cord passes through a small opening ... abdominal pressure can cause an umbilical hernia. Possible causes in adults include: ... pregnancies Fluid in the abdominal cavity (ascites) Previous abdominal ...

ACOG committee opinion number 399, February 2008: umbilical cord blood banking.

PubMed

2008-02-01

Two types of banks have emerged for the collection and storage of umbilical cord blood--public banks and private banks. Public banks promote allogenic (related or unrelated) donation, analogous to the current collection of whole blood units in the United States. Private banks were initially developed to store stem cells from umbilical cord blood for autologous use (taken from an individual for subsequent use by the same individual) by a child if the child develops disease later in life. If a patient requests information on umbilical cord blood banking, balanced and accurate information regarding the advantages and disadvantages of public versus private banking should be provided. The remote chance of an autologous unit of umbilical cord blood being used for a child or a family member (approximately 1 in 2,700 individuals) should be disclosed. The collection should not alter routine practice for the timing of umbilical cord clamping. Physicians or other professionals who recruit pregnant women and their families for for-profit umbilical cord blood banking should disclose any financial interests or other potential conflicts of interest.

[Pathophysiological changes of umbilical vessels in intrauterine growth restriction].

PubMed

Jakó, Mária; Surányi, Andrea; Kaiser, László; Domokos, Dóra; Gáspár, Róbert; Bártfai, György

2014-12-14

The prevalence of intrauterine growth restriction is 4-5000/100,000 births, and they give the majority of perinatal morbidity. The aim of the authors was to compare the pathomorphologic data and vasoreactivity of umbilical vessels and placenta of small for date newborns to that of the normal pregnancies. Samples of the umbilical cord and placenta were divided into case and control groups. Two 10 cm long segments were cut of the umbilical cord at placental insertion. Tissue bath experiment was performed on umbilical vessels and pathomorphologic data were collected according to the Royal College of Pathologists' protocol. After the development of basal tone, oxytocin and desmopressin did not enhance the vascular contraction, but the pathomorphological and ultrasonographic data were significantly different in the two groups. The results indicate that umbilical vessels might not have oxytocin or vasopressin receptors. The pathomorphologic and flowmetric differences could be the causes of small birth weight.

Properties of self-assembled diluted magnetic semiconductor nanostructures =

NASA Astrophysics Data System (ADS)

Ankiewicz, Amelia Olga Goncalves

Este trabalho centra-se na investigacao da possibilidade de se conseguir um semicondutor magnetico diluido (SMD) baseado em ZnO. Foi levado a cabo um estudo detalhado das propriedades magneticas e estruturais de estruturas de ZnO, nomeadamente nanofios (NFs), nanocristais (NCs) e filmes finos, dopadas com metais de transicao (MTs). Foram usadas varias tecnicas experimentais para caracterizar estas estruturas, designadamente difraccao de raios-X, microscopia electronica de varrimento, ressonancia magnetica, SQUID, e medidas de transporte. Foram incorporados substitucionalmente nos sitios do Zn ioes de Mn2+ e Co2+ em ambos os NFs e NCs de ZnO. Revelou-se para ambos os ioes dopantes, que a incorporacao e heterogenea, uma vez que parte do sinal de ressonancia paramagnetica electronica (RPE) vem de ioes de MTs em ambientes distorcidos ou enriquecidos com MTs. A partir das intensidades relativas dos espectros de RPE e de modificacoes da superficie, demonstra-se ainda que os NCs exibem uma estrutura core-shell. Os resultados, evidenciam que, com o aumento da concentracao de MTs, a dimensao dos NCs diminui e aumentam as distorcoes da rede. Finalmente, no caso dos NCs dopados com Mn, obteve-se o resultado singular de que a espessura da shell e da ordem de 0.3 nm e de que existe uma acumulacao de Mn na mesma. Com o objectivo de esclarecer o papel dos portadores de carga na medicao das interaccoes ferromagneticas, foram co-dopados filmes de ZnO com Mn e Al ou com Co e Al. Os filmes dopados com Mn, revelaram-se simplesmente paramagneticos, com os ioes de Mn substitucionais nos sitios do Zn. Por outro lado, os filmes dopados com Co exibem ferromagnetismo fraco nao intrinseco, provavelmente devido a decomposicao spinodal. Foram ainda efectuados estudos comparativos com filmes de ligas de Zn1-xFexO. Como era de esperar, detectaram-se segundas fases de espinela e de oxido de ferro nestas ligas; todas as amostras exibiam curvas de histerese a 300 K. Estes resultados suportam a hipotese de que as segundas fases sao responsaveis pelo comportamento magnetico observado em muitos sistemas baseados em ZnO. Nao se observou nenhuma evidencia de ferromagnetismo mediado por portadores de carga. As experiencias mostram que a analise de RPE permite demonstrar directamente se e onde estao incorporados os ioes de MTs e evidenciam a importancia dos efeitos de superficie para dimensoes menores que 15 nm, para as quais se formam estruturas core-shell. As investigacoes realizadas no ambito desta tese demonstram que nenhuma das amostras de ZnO estudadas exibiram propriedades de um SMD intrinseco e que, no futuro, sao necessarios estudos teoricos e experimentais detalhados das interaccoes de troca entre os ioes de MTs e os atomos do ZnO para determinar a origem das propriedades magneticas observadas.

Gross umbilical cord complications are associated with placental lesions of circulatory stasis and fetal hypoxia.

PubMed

Chan, Joanna S Y; Baergen, Rebecca N

2012-01-01

Umbilical cord complications (UCC), such as true knots (TK), velamentous (VEL) insertion, marginal umbilical cord (MUC) insertion, umbilical cord entanglement (UCE) (both nuchal and non-nuchal), excessively long umbilical cord (ELUC), and excessively twisted umbilical cord (ETUC), can lead to decreased UC blood flow and have been associated with adverse fetal outcome and intrauterine fetal demise (IUFD). Few large series exist that correlate UCC with specific pathologic findings of the placenta. We present the largest series of UCC at this time. Eight hundred forty-one 3rd-trimester placentas with UCC were identified, as well as 858 randomly selected gestational age-matched placentas with grossly unremarkable UC. Lesions associated with circulatory stasis and thrombosis, including villous capillary congestion (VC), umbilical vessel distension (UVD), chorionic plate vessel distension (CPD), umbilical vessel thrombosis (UVT), fetal vascular thrombosis (FVT), intimal fibrin cushions (IFC), and avascular villi (AV), were noted, as well as other pathologic lesions. Data were analyzed by analysis of variance and Fisher exact tests, with P < 0.05 statistically significant. Umbilical cord complications as a group was associated with a significant increase in placental circulatory stasis lesions. Lesions associated with hypoxia, namely nucleated red blood cells and chorangiosis, were also increased. Finally, the presence of any UCC was significantly associated with IUFD. We also found that multiple UCC are associated with nonreassuring fetal heart rate and chorangiosis but that the presence of a single UCC was not. This indicates that UCC may lead to intrauterine hypoxia and subsequent adverse fetal outcome and that multiple UCC may be cumulative in effect.

Low risk, but not no risk, of umbilical hernia complications requiring acute surgery in childhood.

PubMed

Ireland, Amanda; Gollow, Ian; Gera, Parshotam

2014-04-01

Umbilical hernias are a common finding in the paediatric community, with a preponderance to affect Afro-Caribbean and premature children. The rate of incarceration varies greatly between populations. Therefore, it is valuable to obtain some Australian data on this topic. We undertook a retrospective study of the records of all patients who underwent umbilical hernia repair over a 12-year period of between October 1999 and May 2012 at Princess Margaret Hospital. From this group, all patients that had an umbilical hernia repair for reason of acute complication were identified and analysed for age, ethnicity and co-morbidities. Between October 1999 and May 2012, 433 umbilical hernias were repaired at Princess Margaret Hospital, five of which were as the direct result of an acutely complicated umbilical hernia. The mean age of hernia repair was 5 years old, and the mean age of acute complication was 5 years old. Out of the patients with acutely complicated umbilical hernia, there were no Afro-Caribbean patients, and one was premature complicated by hyaline membrane disease and broncho-pulmonary dysplasia. Western Australia has an incidence of acutely complicated umbilical hernia requiring operative intervention of 1:3000 to 1:11,000. On an international scale, this is low, and studies with similar incidence do not advocate for immediate repair of all identified umbilical hernias. The authors believe repair should be guided by patient and guardian, but if there is an episode of incarceration, acute repair is advised. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Concomitant Abdominoplasty and Laparoscopic Umbilical Hernia Repair.

PubMed

van Schalkwyk, Constant P; Dusseldorp, Joseph R; Liang, Derek G; Keshava, Anil; Gilmore, Andrew J; Merten, Steve

2018-04-20

Umbilical hernia is a common finding in patients undergoing abdominoplasty, especially those who are post-partum with rectus divarication. Concurrent surgical treatment of the umbilical hernia at abdominoplasty presents a "vascular challenge" due to the disruption of dermal blood supply to the umbilicus, leaving the stalk as the sole axis of perfusion. To date, there have been no surgical techniques described to adequately address large umbilical herniae during abdominoplasty. To present an effective and safe technique that can address large umbilical herniae during abdominoplasty. A prospective series of 10 consecutive patients, undergoing concurrent abdominoplasty and laparoscopic umbilical hernia repair between 2014 and 2017 were included in the study. All procedures were performed by the same general surgeon and plastic surgeon at the Macquarie University Hospital in North Ryde, NSW, Australia. Data was collected with approval of our ethics committee. At 12-month follow-up there were no instances of umbilical necrosis, wound complications, seroma or recurrent hernia. The mean body mass index was 23.8 kg/m2 (range, 16.1-30.1 kg/m2). Rectus divarication ranged from 35-80 mm (mean, 53.5 mm). Umbilical hernia repair took a mean of 25.9 minutes to complete (range, 18-35 minutes). We present a technique that avoids incision of the rectus fascia minimizes dissection of the umbilical stalk and is able to provide a gold standard hernia repair with mesh. This procedure is particularly suited to post-partum patients with large herniae (>3-4 cm diameter) and wide rectus divarication, where mesh repair with adequate overlap is the recommended treatment.

Core Stage Inter-Tank Umbilical (CSITU) Lift at ML

NASA Image and Video Library

2017-10-11

A heavy-lift crane and rigging are used to lift the Core Stage Inter-tank Umbilical (CSITU) up to about the 140-foot level of the mobile launcher (ML) tower at NASA's Kennedy Space Center in Florida. The CSITU is moved into place for a fit check of the attachment hardware. The umbilical will then be lowered down and installed permanently on the ML at a later date. The CSITU is a swing-arm umbilical that will connect to the Space Launch System core stage inter-tank. It will provide conditioned air, pressurized gases and power and data connection to the core stage. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Mobile Launcher

NASA Image and Video Library

2017-05-30

A view of the mobile launcher (ML) taken from the "eyebrow" of the nearby Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. The ML tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The Orion Service Module Umbilical and Core State Forward Skirt Umbilical were recently installed on the ML. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Spontaneous evisceration of bowel through an umbilical hernia in a patient with refractory ascites

PubMed Central

Ogu, Uchechukwu Stanley; Valko, Janice; Wilhelm, Jakub; Dy, Victor

2013-01-01

Umbilical hernia in the cirrhotic patient is frequently seen in the setting of refractory ascites. This article reports a rare case of spontaneous rupture of a recurrent umbilical hernia in a patient with persistent ascites, following an acute increase in intra-abdominal pressure, leading to bowel evisceration. This case highlights a potentially fatal complication of umbilical hernia in the setting of chronic ascites, which was successfully managed with prompt surgical intervention. PMID:24964319

The relation between umbilical cord characteristics and the outcome of external cephalic version.

PubMed

Kuppens, Simone M I; Waerenburgh, Evelyne R; Kooistra, Libbe; van der Donk, Riet W P; Hasaart, Tom H M; Pop, Victor J M

2011-05-01

Umbilical cords of fetuses in breech presentation differ in length and coiling from their cephalic counterparts and it might be hypothesised that these cord characteristics may in turn affect ECV outcome. To investigate the relation between umbilical cord characteristics and the outcome of external cephalic version (ECV). Prospective cohort study. Women (>35 weeks gestation) with a singleton fetus in breech presentation, suitable for external cephalic version. Demographic, lifestyle and obstetrical parameters were assessed at intake. ECV success was based on cephalic presentation on ultrasound post-ECV. Umbilical cord length (UCL) and umbilical coiling index (UCI) were measured after birth. The relation between umbilical cord characteristics (cord length and coiling) and the success of external cephalic version. ECV success rate was overall 79/146 (54%), for multiparas 37/46(80%) and for nulliparas 42/100 (42%). Multiple logistic regression showed that UCL (OR: 1.04, CI: 1.01-1.07), nulliparity (OR: 0.20, CI: 0.08-0.51), frank breech (OR: 0.37, 95% CI: 0.15-0.90), body mass index (OR: 0.85, CI: 0.76-0.95), placenta anterior (OR: 0.27, CI: 0.12-0.63) and birth weight (OR: 1.002, CI: 1.001-1.003) were all independently related to ECV success. Umbilical cord length is independently related to the outcome of ECV, whereas umbilical coiling index is not. Copyright © 2011 Elsevier Ltd. All rights reserved.

56. DETAIL OF PAYLOAD ELECTRICAL AND AIRCONDITIONING UMBILICAL CONNECTIONS ON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

56. DETAIL OF PAYLOAD ELECTRICAL AND AIR-CONDITIONING UMBILICAL CONNECTIONS ON NORTH FACE OF SLC-3W UMBILICAL MAST - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Ethical issues relating the the banking of umbilical cord blood in Mexico.

PubMed

Serrano-Delgado, V Moises; Novello-Garza, Barbara; Valdez-Martinez, Edith

2009-08-14

Umbilical cord banks are a central component, as umbilical cord tissue providers, in both medical treatment and scientific research with stem cells. But, whereas the creation of umbilical cord banks is seen as successful practice, it is perceived as a risky style of play by others. This article examines and discusses the ethical, medical and legal considerations that arise from the operation of umbilical cord banks in Mexico. A number of experts have stated that the use of umbilical cord goes beyond the mere utilization of human tissues for the purpose of treatment. This tissue is also used in research studies: genetic studies, studies to evaluate the effectiveness of new antibiotics, studies to identify new proteins, etc. Meanwhile, others claim that the law and other norms for the functioning of cord banks are not consistent and are poorly defined. Some of these critics point out that the confidentiality of donor information is handled differently in different places. The fact that private cord banks offer their services as "biological insurance" in order to obtain informed consent by promising the parents that the tissue that will be stored insures the health of their child in the future raises the issue of whether the consent is freely given or given under coercion. Another consideration that must be made in relation to privately owned cord banks has to do with the ownership of the stored umbilical cord. Conflicts between moral principles and economic interests (non-moral principles) cause dilemmas in the clinical practice of umbilical cord blood storage and use especially in privately owned banks. This article presents a reflection and some of the guidelines that must be followed by umbilical cord banks in order to deal with these conflicts. This reflection is based on the fundamental notions of ethics and public health and seeks to be a contribution towards the improvement of umbilical cord banks' performance.

Ethical issues relating to the banking of umbilical cord blood in Mexico

PubMed Central

2009-01-01

Background Umbilical cord banks are a central component, as umbilical cord tissue providers, in both medical treatment and scientific research with stem cells. But, whereas the creation of umbilical cord banks is seen as successful practice, it is perceived as a risky style of play by others. This article examines and discusses the ethical, medical and legal considerations that arise from the operation of umbilical cord banks in Mexico. Discussion A number of experts have stated that the use of umbilical cord goes beyond the mere utilization of human tissues for the purpose of treatment. This tissue is also used in research studies: genetic studies, studies to evaluate the effectiveness of new antibiotics, studies to identify new proteins, etc. Meanwhile, others claim that the law and other norms for the functioning of cord banks are not consistent and are poorly defined. Some of these critics point out that the confidentiality of donor information is handled differently in different places. The fact that private cord banks offer their services as "biological insurance" in order to obtain informed consent by promising the parents that the tissue that will be stored insures the health of their child in the future raises the issue of whether the consent is freely given or given under coercion. Another consideration that must be made in relation to privately owned cord banks has to do with the ownership of the stored umbilical cord. Summary Conflicts between moral principles and economic interests (non-moral principles) cause dilemmas in the clinical practice of umbilical cord blood storage and use especially in privately owned banks. This article presents a reflection and some of the guidelines that must be followed by umbilical cord banks in order to deal with these conflicts. This reflection is based on the fundamental notions of ethics and public health and seeks to be a contribution towards the improvement of umbilical cord banks' performance. PMID:19678958

Placental passage of antiepileptic drugs at delivery and neonatal outcomes

PubMed Central

Bank, Anna M.; Stowe, Zachary N.; Newport, D. Jeffrey; Ritchie, James C.; Pennell, Page B.

2017-01-01

Summary Children of women treated with antiepileptic drugs (AEDs) are at increased risk for adverse outcomes detectable in the neonatal period, which may be associated with the amount of AED in the fetal circulation. Placental passage of AEDs can be measured by calculating the ratio of umbilical cord to maternal AED concentrations collected at delivery. The aims of this study were to determine the umbilical cord concentrations and umbilical to maternal ratios for AEDs, and to determine whether higher cord concentrations are associated with increased risk of neonatal complications. AED cord and maternal blood concentrations from 70 mother-newborn dyads and neonatal complications were recorded. Logistic regressions were performed to determine the association between AED concentrations and complications. Mean umbilical to maternal ratios for total concentrations ranged from 0.79 for carbamazepine to 1.20 for valproic acid, and mean umbilical to maternal ratios for free concentrations ranged from 0.86 for valproic acid to 1.42 for carbamazepine, indicating complete placental passage. Neither umbilical cord concentrations nor umbilical to maternal ratios were associated with adverse neonatal outcomes. Additional investigations are warranted to delineate the relationship between quantified fetal AED exposure and neonatal complications. PMID:28387929

Robotic-assisted laparoscopic prostatectomy in umbilical hernia patients: University of California, Irvine, technique for port placement and repair.

PubMed

Kim, William; Abdelshehid, Corollos; Lee, Hak J; Ahlering, Thomas

2012-06-01

To discuss a technique currently used at our institution for the management of umbilical hernias during robot-assisted laparoscopic prostatectomy. As more patients undergo robot-assisted radical prostatectomy, there will be an increase in patients who qualify for robotic surgery with comorbidities. This technique has been utilized in clinically localized prostate cancer patients with umbilical hernias using the da Vinci Surgical System and standard laparoscopic instrumentation. Port placements and closures were performed by a resident assistant and a nurse at the operating table. The prostatectomy was performed by a single experienced surgeon at the console. Currently, no data are available regarding patients with umbilical hernias undergoing robotic prostatectomy. We reviewed our technique of port placement for patients with a pre-existing umbilical hernia undergoing robot-assisted laparoscopic prostatectomy. This technique allows for a reduction of the umbilical hernia, the use of the fascial defect as a robotic port, and the removal of the prostate by way of transverse incision and transverse repair. In our experience, this technique is feasible and reproducible for any small or large umbilical hernia. Copyright © 2012 Elsevier Inc. All rights reserved.

Patent omphalomesenteric duct of the vermiform appendix in a neonate: congenital appendicoumbilical fistula.

PubMed

Crankson, S J; Ahmed, G S; Palkar, V

1998-12-01

Umbilical anomalies arise from fetal structures such as the omphalomesenteric duct (OMD) or urachus or from failure of closure of the umbilical fascial ring. Persistence of the OMD may lead to several anomalies including umbilical sinus, umbilical cyst, Meckel's diverticulum, or patent OMD (POMD). A POMD is usually associated with the ileum, but rarely may be with the caecum or appendix. We describe a POMD of the vermiform appendix and discuss the possible pathogenesis and management.

Hepatic laceration as a life-threatening complication of umbilical venous catheterization.

PubMed

Gülcan, Hande; Hanta, Deniz; Törer, Birgin; Temiz, Adbülkerim; Demir, Senay

2011-01-01

Umbilical venous catheterization is an intravenous infusion route for maintenance fluids, medications, blood products, and parenteral nutrition in preterm neonates. However, this procedure may be associated with several complications, such as infection, thrombosis, vessel perforation, and cardiac and hepatic injuries. Hepatic laceration is a rare but life-threatening complication of umbilical venous catheterization that is a result of direct injury through the liver parenchyma. Here, we present a preterm newborn with hepatic laceration as a rare and serious complication of umbilical venous catheterization.

Rupture of Umbilical Hernia with Evisceration in a Newborn - A Case Report.

PubMed

Kittur, Dinesh H; Bhandarkar, Kailas P; Patil, Santosh V; Jadhav, Sudhakar S

2017-01-01

Most umbilical hernias in infants do not need surgery and the ring will eventually close. Occasionally few complications can arise and incarceration is most common. Spontaneous rupture of the hernia and eventual evisceration is a rarely seen complication. A 3-week-old neonate having umbilical hernia presented with rupture of the sac with evisceration of bowel within a few days of first visit. No underlying cause like umbilical sepsis was found. The baby had emergency repair of the hernia with an uneventful recovery.

Incarceration of umbilical hernia after radiological insertion of a Denver peritoneovenous shunt.

PubMed

Ohta, Kengo; Shimohira, Masashi; Hashizume, Takuya; Kawai, Tatsuya; Kurosaka, Kenichiro; Suzuki, Kazushi; Watanabe, Kenichi; Shibamoto, Yuta

2013-03-01

We report a rare complication of incarceration of an umbilical hernia after Denver peritoneovenous shunt placement. A 50-year-old man presented with refractory ascites from liver cirrhosis. He also had an umbilical hernia. Because the ascites became uncontrollable, Denver peritoneovenous shunting was performed. The operation was successful and the ascites decreased. Ten days later, however, incarceration of the umbilical hernia occurred. A surgical repair was performed, but he died 2 days later. The cause of death was considered to be sepsis.

Comparative studies of mesenchymal stem cells derived from different cord tissue compartments - The influence of cryopreservation and growth media.

PubMed

Dulugiac, Magda; Moldovan, Lucia; Zarnescu, Otilia

2015-10-01

We have identified some critical aspects concerning umbilical cord tissue mesenchymal stem cells: the lack of standards for cell isolation, expansion and cryopreservation, the lack of unanimous opinions upon their multilineage differentiation potential and the existence of very few results related to the functional characterization of the cells isolated from cryopreserved umbilical cord tissue. Umbilical cord tissue cryopreservation appears to be the optimal solution for umbilical cord tissue mesenchymal stem cells storage for future clinical use. Umbilical cord tissue cryopreservation allows mesenchymal stem cells isolation before expected use, according with the specific clinical applications, by different customized isolation and expansion protocols agreed by cell therapy institutions. Using an optimized protocol for umbilical cord tissue cryopreservation in autologous cord blood plasma, isolation explant method and growth media supplemented with FBS or human serum, we performed comparative studies with respect to the characteristics of mesenchymal stem cells (MSC) isolated from different compartments of the same umbilical cord tissue such as Wharton's jelly, vein, arteries, before cryopreservation (pre freeze) and after cryopreservation (post thaw). Expression of histochemical and immunohistochemical markers as well as electron microscopy observations revealed similar adipogenic, chondrogenic and osteogenic differentiation capacity for cells isolated from pre freeze and corresponding post thaw tissue fragments of Wharton's jelly, vein or arteries of the same umbilical cord tissue, regardless growth media used for cells isolation and expansion. Our efficient umbilical cord tissue cryopreservation protocol is reliable for clinical applicability of mesenchymal stem cells that could next be isolated and expanded in compliance with future accepted standards. Copyright © 2015 Elsevier Ltd. All rights reserved.

Umbilical cord blood: a guide for primary care physicians.

PubMed

Martin, Paul L; Kurtzberg, Joanne; Hesse, Brett

2011-09-15

Umbilical cord blood stem cell transplants are used to treat a variety of oncologic, genetic, hematologic, and immunodeficiency disorders. Physicians have an important role in educating, counseling, and offering umbilical cord blood donation and storage options to patients. Parents may donate their infant's cord blood to a public bank, pay to store it in a private bank, or have it discarded. The federal government and many state governments have passed laws and issued regulations regarding umbilical cord blood, and some states require physicians to discuss cord blood options with pregnant women. Five prominent medical organizations have published recommendations about cord blood donation and storage. Current guidelines recommend donation of umbilical cord blood to public banks when possible, or storage through the Related Donor Cord Blood Program when a sibling has a disease that may require a stem cell transplant. Experts do not currently recommend private banking for unidentified possible future use. Step-by-step guidance and electronic resources are available to physicians whose patients are considering saving or donating their infant's umbilical cord blood.

Evidence-based pathology: umbilical cord coiling.

PubMed

Khong, T Y

2010-12-01

The generation of a pathology test result must be based on criteria that are proven to be acceptably reproducible and clinically relevant to be evidence-based. This review de-constructs the umbilical cord coiling index to illustrate how it can stray from being evidence-based. Publications related to umbilical cord coiling were retrieved and analysed with regard to how the umbilical coiling index was calculated, abnormal coiling was defined and reference ranges were constructed. Errors and other influences that can occur with the measurement of the length of the umbilical cord or of the number of coils can compromise the generation of the coiling index. Definitions of abnormal coiling are not consistent in the literature. Reference ranges defining hypocoiling or hypercoiling have not taken those potential errors or the possible effect of gestational age into account. Even the way numerical test results in anatomical pathology are generated, as illustrated by the umbilical coiling index, warrants a critical analysis into its evidence base to ensure that they are reproducible or free from errors.

Concomitant abdominoplasty and umbilical hernia repair using the Ventralex hernia patch.

PubMed

Neinstein, Ryan M; Matarasso, Alan; Abramson, David L

2015-04-01

Patients requesting abdominoplasty often have concomitant umbilical hernias and may request simultaneous treatment. The vascularity of the umbilicus is potentially at risk during these combined procedures. In this study, the authors present a technique for treating umbilical hernias at the time of abdominoplasty surgery using the Ventralex hernia patch. A total of 11 female patients with a mean age of 39.4 years (range, 28 to 51 years) undergoing abdominoplasty with umbilical hernia repair with the Ventralex patch were included. The mean body mass index was 27.6 kg/m (range, 20 to 34 kg/m). No vascular compromise of the umbilicus was seen. The hernia repair did not alter the abdominoplasty results. One patient had transient umbilical swelling postoperatively that resolved within 6 months postoperatively. The authors present a series of umbilical hernia repairs in abdominoplasty patients using a minimal access incision by means of the rectus fascia and the Ventralex patch that is fast and reliable and preserves the blood supply to the umbilicus.

[Umbilical Hernia Complicated by Gastrointestinal Stromal Tumor of the Small Intestine - A Case Report].

PubMed

Tsukada, Manabu; Ozaki, Akihiko; Ohira, Hiromichi; Sawano, Toyoaki; Nemoto, Tsuyoshi; Kanazawa, Yukio

2016-11-01

Intraabdominal tumors can cause umbilical hernia and may lead to serious consequences, such as incarcerated or necrotized intestine. However, little information is available concerning how the location and characteristics of tumors may affect the process of umbilical hernia development. A 46-year-old Japanese man presented at the department of surgery with abdominal pain and abdominal retention, which appeared on the day of presentation and 4 years before the presentation, respectively. Abdominal computed tomography revealed a suspected gastrointestinal stromal tumor(GIST)and an umbilical hernia close to the tumor, both of which were clinically diagnosed. Surgical tumor resection and hernia repair were conducted successfully. The patient was pathologically diagnosed with high-risk GIST. Adjuvant therapy with imatinib was administered with no recurrence as of 1 year post-surgery. This is a case of GIST complicated by umbilical hernia. Small solid tumors may cause umbilical hernia if they are in close proximity to vulnerable parts of the abdominal wall.

Umbilical Hernia in Peritoneal Dialysis Patients: Surgical Treatment and Risk Factors.

PubMed

Banshodani, Masataka; Kawanishi, Hideki; Moriishi, Misaki; Shintaku, Sadanori; Ago, Rika; Hashimoto, Shinji; Nishihara, Masahiro; Tsuchiya, Shinichiro

2015-12-01

No previous reports have focused on surgical treatments and risk factors of umbilical hernia alone in peritoneal dialysis (PD) patients. Herein, we evaluated the treatments and risk factors. A total of 411 PD patients were enrolled. Of the 15 patients with umbilical hernia (3.6%), six underwent hernioplasty. There was no recurrence in five patients treated with tension-free hernioplasty. The mean PD vintage after onset of hernia in the hernioplasty group tended to be longer than that in the non-hernioplasty group. An incarcerated hernia occurred in one non-hernioplasty patient. Although the incidence was significantly higher among women (P = 0.02), female sex was not a risk factor for umbilical hernia (P = 0.08). Our findings suggest that umbilical hernias should be repaired for continuing PD. Furthermore, there were no significant risk factors for umbilical hernia in PD patients. Future studies with larger sample groups are required to elucidate these risk factors. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

Anatomical description of the umbilical arteries and impact of their ligation on pelvic and perineal vascular supply after cystectomy in women.

PubMed

Chantalat, E; Vaysse, C; Delchier, M C; Bordier, B; Game, X; Chaynes, P; Cavaignac, E; Roumiguié, M

2018-03-27

In radical cystectomy, the surgeon generally ligates the umbilical artery at its origin. This artery may give rise to several arteries that supply the sexual organs. Our aim was to evaluate pelvic and perineal devascularisation in women after total cystectomy. We carried out a prospective anatomical and radiological study. We performed bilateral pelvic dissections of fresh adult female cadavers to identify the dividing branches of the umbilical artery. In parallel, we examined and compared the pre- and postoperative imaging investigations [magnetic resonance imaging (MRI) angiography] in patients undergoing cystectomy for benign disease to quantify the loss of pelvic vascularisation on the postoperative images by identifying the occluded arteries. The anatomical study together with the radiological study visualised 35 umbilical arteries (n = 70) with their branching patterns and collateral arteries. The uterine artery originated from the umbilical artery in more than 75% of cases (n = 54) of the internal pudendal artery in 34% (n = 24) and the vaginal artery in 43% (n = 30). The postoperative MRI angiograms showed pelvic devascularisation in four patients. Devascularisation was dependent on the level of surgical ligation. In the four patients with loss of pelvic vascular supply, the umbilical artery had been ligated at its origin. The umbilical artery gives rise to various branches that supply the pelvis and perineum. If the surgeon ligates the umbilical artery at its origin during total cystectomy, there is a significant risk of pelvic and perineal devascularisation.

Treatment of umbilical hernia and recti muscles diastasis without a periumbilical incision.

PubMed

Kulhanek, J; Mestak, O

2013-08-01

Postpartum rectus diastasis eventually combined with umbilical hernia is a condition that is frequently treated by plastic surgeons and general surgeons. Standard treatment of this condition is abdominoplasty with a periumbilical incision, which often results in an umbilical incision or an inverted-T scar. Limited incision abdominoplasty differs from traditional abdominoplasty by disconnecting the umbilical stalk from the abdominal wall during flap dissection, thus allowing the resection of excess skin above and under the umbilicus without causing periumbilical scarring. We conducted a retrospective cohort study of women undergoing a limited scar abdominoplasty without a periumbilical incision for the treatment of a separation of the recti muscles and/or an umbilical hernia. We recorded the postoperative complications and patient satisfaction with the results of the treatment. We operated on 50 patients from 2002 to 2010. We followed the patients for 2-8 years. The most common complication, as with other abdominoplasty procedures, was minor dehiscention in the middle part of the wound, which occurred in 16 % (n = 8) of the patients. All of these complications were treated conservatively. No recurrence of diastasis or umbilical hernia was observed. Extended miniabdominoplasty with a low suprapubic incision and umbilical caudalization for treating the diastasis of the abdominal rectus muscles and/or an umbilical hernia is an excellent method that results in a small, hidden scar. This method is especially beneficial for young, slim women with an abdominal wall deformity after pregnancy.

126. REDUNDANCY SYSTEM CONTROLS FOR UMBILICAL MAST RETRACTION AT LOWER ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

126. REDUNDANCY SYSTEM CONTROLS FOR UMBILICAL MAST RETRACTION AT LOWER LEFT SIDE OF HYDRAULIC CONTROL PANEL IN UMBILICAL MAST PUMP ROOM (209), LSB (BLDG. 751) - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

109. REDUNDANCY SYSTEM CONTROLS FOR UMBILICAL MAST RETRACTION AT LOWER ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

109. REDUNDANCY SYSTEM CONTROLS FOR UMBILICAL MAST RETRACTION AT LOWER LEFT SIDE OF HYDRAULIC CONTROL PANEL IN UMBILICAL MAST PUMP ROOM (109), LSB (BLDG. 770) - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Doppler ultrasound of the placenta and maternal and fetal vessels during normal gestation in captive agoutis (Dasyprocta prymnolopha, Wagler, 1831).

PubMed

Sousa, Francisco C A; Pessoa, Gerson T; Moura, Laecio S; Rodrigues, Renan P S; Diniz, Anaemilia N; Souza, André B; Silva, Elzivânia G; Sanches, Marina P; Silva-Filho, Osmar F; Guerra, Porfirio C; Sousa, João M; Neves, Willams C; Alves, Flávio R

2016-11-01

The use of ultrasound for pregnancy monitoring is critical for the evaluation of hemodynamic parameters essential to fetal viability. In the present study, using B-mode and Doppler ultrasound, we characterized the placenta, subplacenta, maternal, and fetal vessels during normal gestation of healthy agoutis raised in captivity. In total, 30 agoutis were obtained from the Center for the Study and Preservation of Wild Animals, Center of Agricultural Sciences, Federal University of Piauí (Núcleo de Estudos e Preservação de Animais Silvestres-NEPAS, Centro de Ciências Agrárias-CCA, Universidade Federal do Piauí-UFPI). These animals were subjected to B-mode and Doppler ultrasound examinations to evaluate their maternal and fetal hemodynamic profiles. The placenta was located in the mesometrial region and had a discoid, ellipsoid, or globular aspect. With spectral Doppler, characteristic systolic and diastolic flow was observed in the umbilical artery. This flow increased during pregnancy. A cross-sectional view revealed a goblet-shaped placenta. The uteroplacental blood flow was characterized by a marked increase in systolic peak velocity during pregnancy, the presence of a rapid deceleration ramp, and a relatively high diastolic speed. The fetal aortic vascular flow was predominantly systolic and diastolic. The caudal vena cava blood flow was characterized by a systolic peak followed by a decreased diastolic wave throughout pregnancy. In the present study, we characterized the morphologic and hemodynamic interactions of the placenta/subplacenta with maternal and fetal vessels in agoutis at 30, 45, 60, 75, and 90 days gestation using B-mode and Doppler ultrasound. We determined the approximation and separation of the blood flow values of the umbilical artery, subplacental flow, uteroplacental artery, fetal aorta, and fetal vena cava. We believe these values may contribute to an understanding of the gestational biology and aid delivery prediction in this species. Copyright © 2016 Elsevier Inc. All rights reserved.

127. HYDRAULIC CONTROLS AND GAUGES FOR THE UMBILICAL MAST ON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

127. HYDRAULIC CONTROLS AND GAUGES FOR THE UMBILICAL MAST ON UPPER RIGHT SIDE OF HYDRAULIC CONTROL PANEL IN UMBILICAL MAST PUMP ROOM (209), LSB (BLDG. 751) - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

123. UMBILICAL MAST PUMP ROOM (209), LSB (BLDG. 751). PUMP ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

123. UMBILICAL MAST PUMP ROOM (209), LSB (BLDG. 751). PUMP ON LEFT; HYDRAULIC CONTROL PANEL FOR UMBILICAL MAST AND TRENCH DOORS IN CENTER OF ROOM, FACING WEST. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

The conception, birth, and growth of a missile umbilical system

NASA Technical Reports Server (NTRS)

Nordman, G. W.

1977-01-01

The design development of the Sprint 2 and the Improved Sprint 2 Missile System umbilical system is reviewed. Unique system requirements, umbilical designs considered to meet the requirements, and the problems encountered and solutions derived during the design and development testing of the selected systems are described.

42. VIEW OF UMBILICAL MAST AND LAUNCH PAD FROM MST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

42. VIEW OF UMBILICAL MAST AND LAUNCH PAD FROM MST BASE. LAUNCHER IS BEHIND UMBILICAL MAST AND RAIL SYSTEM IS PARALLEL TO MAST ON RIGHT AND LEFT. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Obstructed Umbilical Hernia: A Normal Presentation with Abnormal Contents.

PubMed

P Agrawal, Vijay; S Shetty, Nikhil; Narasimhaprasad, Ashwin

2015-01-01

Umbilical hernia is a common problem encountered in children. The rarity of finding cecum and appendix is probably due to the fact that the appendix is seldom found in the proximity of the umbilicus. It would, therefore, appear worthwhile to report the occurrence of cecum and an inflamed appendix with Ladd's bands in an umbilical hernia of a child. The last case with similar presentation was presented in 1950s. Agrawal VP, Shetty NS, Narasimhaprasad A. Obstructed Umbilical Hernia: A Normal Presentation with Abnormal Contents. Euroasian J Hepato-Gastroenterol 2015;5(2):110-111.

Concentrations of amino acids in plasma from 45- to 47-week gestation mares and foetuses (Equus caballus).

PubMed

Zicker, S C; Vivrette, S; Rogers, Q R

1994-06-01

Concentrations of 16 of 24 amino acids in plasma of foetuses were significantly higher, while four of 24 were lower, than their concentration in maternal plasma. The higher foetal concentrations of amino acids in plasma are similar to other species, with some exceptions, and suggest that equine placenta actively transports and concentrates amino acids into the umbilical circulation. Concentrations of nine of 24 amino acids were significantly lower in plasma from the umbilical artery compared to plasma from the umbilical vein, while no significant differences were present between maternal artery and vein plasma. The umbilical venous-arterial difference in concentrations of amino acids in plasma suggests the foetus extracts amino acids from the umbilical circulation for catabolism or protein synthesis, as in other species.

The crying sign: the winking umbilical cord

PubMed Central

Smith, Aisling M; Healy, David B; Ryan, C Anthony; Dempsey, Eugene M

2015-01-01

A preterm baby girl, born at 34 weeks gestation, with features of Beckwith-Wiedemann syndrome was noted to have a relatively large umbilical stump. No fetal abnormalities had been detected on anatomy scan at 28 weeks and only mild polyhydramnios and macrosomia were noted on a 32-week ultrasound scan. Although there was no obvious omphalocoele, clinical assessment of the umbilical cord revealed an abdominal wall defect through which bowel would protrude into the umbilicus when the infant was crying. In keeping with an abdominal wall defect α-fetoprotein was found to be elevated. Surgical consultation advised conservative management. Subsequently, detachment of the umbilical cord occurred 1 week postdischarge and a large umbilical hernia persists. Genetic analysis confirmed a diagnosis of Beckwith-Wiedemann syndrome. PMID:25820111

A "Kane's Dynamics" Model for the Active Rack Isolation System. Part 3; Addition of Umbilicals to the Nonlinear Model

NASA Technical Reports Server (NTRS)

Rupert, J. K.; Hampton, R. D.; Beech, G. S.

2005-01-01

In the late 1980s, microgravity researchers began to voice their concern that umbilical-transmitted energy could significantly degrade the acceleration environment of microgravity space science experiments onboard manned spacecraft. Since umbilicals are necessary for many experiments, control designers began to seek ways to compensate for these "indirect" disturbances. Hampton, et al., used the Kane s method to develop a model of the active rack isolation system (ARIS) that includes (1) actuator control forces, (2) direct disturbance forces, and (3) indirect, actuator-transmitted disturbances. Their model does not, however, include the indirect, umbilical-transmitted disturbances. Since the umbilical stiffnesses are not negligible, these indirect disturbances must be included in the model. Until the umbilicals have been appropriately included, the model will be incomplete. This Technical Memorandum presents a nonlinear model of ARIS with umbilicals included. Model verification was achieved by utilizing two commercial-off-the-shelf software tools. Various forces and moments were applied to the model to yield simulated responses of the system. Plots of the simulation results show how various critical points on an ARIS-outfitted international standard payload rack behave under the application of direct disturbances, indirect disturbances, and control forces. Simulations also show system response to a variety of initial conditions.

Umbilical hernia: Influence of adhesive strapping on outcome.

PubMed

Hayashida, Makoto; Shimozono, Takashi; Meiri, Satoru; Kurogi, Jun; Yamashita, Naoto; Ifuku, Toshinobu; Yamamura, Yoshiko; Tanaka, Etsuko; Ishii, Shigeki; Shimonodan, Hidemi; Mihara, Yuka; Kono, Keiichiro; Nakatani, Keigo; Nishiguchi, Toshihiro

2017-12-01

Adhesive strapping for umbilical hernia has been re-evaluated as a promising treatment. We evaluated the influence of adhesive strapping on the outcome of umbilical hernia. We retrospectively evaluated patients with umbilical hernia referred to the present institution from April 2011 to December 2015. Patients who were treated with adhesive strapping were compared with an observation alone group. The adhesive strapping group was also subdivided into two groups: the cure group and the treatment failure group. A total of 212 patients with umbilical hernia were referred to the present institution. Eighty-nine patients were treated with adhesive strapping, while 27 had observation only. The cure rate in the adhesive strapping group was significantly higher than that in the observation group. The duration of treatment of the adhesive strapping group was significantly shorter than that of the observation group. In the adhesive strapping group, the patients in the cure group were treated significantly earlier than those in the treatment failure group (P < 0.001). Furthermore, even in cases of umbilical hernia non-closure, surgical repair was easier after adhesive strapping. Adhesive strapping represents a promising treatment for umbilical hernia. To achieve the best results, adhesive strapping should be initiated as early as possible. © 2017 Japan Pediatric Society.

Umbilical Hernia Repair: Analysis After 934 Procedures.

PubMed

Porrero, José L; Cano-Valderrama, Oscar; Marcos, Alberto; Bonachia, Oscar; Ramos, Beatriz; Alcaide, Benito; Villar, Sol; Sánchez-Cabezudo, Carlos; Quirós, Esther; Alonso, María T; Castillo, María J

2015-09-01

There is a lack of consensus about the surgical management of umbilical hernias. The aim of this study is to analyze the medium-term results of 934 umbilical hernia repairs. In this study, 934 patients with an umbilical hernia underwent surgery between 2004 and 2010, 599 (64.1%) of which were evaluated at least one year after the surgery. Complications, recurrence, and the reoperation rate were analyzed. Complications were observed in 5.7 per cent of the patients. With a mean follow-up time of 35.5 months, recurrence and reoperation rates were 3.8 per cent and 4.7 per cent, respectively. A higher percentage of female patients (60.9 % vs 29 %, P = 0.001) and a longer follow-up time (47.4 vs 35 months, P = 0.037) were observed in patients who developed a recurrence. No significant differences were observed between complications and the reoperation rate in patients who underwent Ventralex(®) preperitoneal mesh reinforcement and suture repair; however, a trend toward a higher recurrence rate was observed in patients with suture repair (6.5 % vs 3.2 %, P = 0.082). Suture repair had lower recurrence and reoperation rates in patients with umbilical hernias less than 1 cm. Suture repair is an appropriate procedure for small umbilical hernias; however, for larger umbilical hernias, mesh reinforcement should be considered.

Short communication: The effect of 4 antiseptic compounds on umbilical cord healing and infection rates in the first 24 hours in dairy calves from a commercial herd.

PubMed

Robinson, A L; Timms, L L; Stalder, K J; Tyler, H D

2015-08-01

The objective of this study was to compare the effect of 4 antiseptic compounds on the healing rate and incidence of infection of umbilical cords in newborn calves (n=60). Late gestation Jersey cows were monitored at a commercial farm (Sioux Jersey, Salix, IA) and newborn purebred (n=30) and crossbred (n=30) calves were obtained within 30min after birth. Calves were alternately assigned by birth order to 4 treatment groups: 7% tincture of iodine, 0.1% chlorine created using a novel chlorine disinfectant technology, chlorohexidine gluconate 4.0% wt/vol, and 10% trisodium citrate. Prior to dipping (within 30min of birth), diameter of the umbilical cords (as an indicator of cord drying and healing) were determined using digital calipers. In addition, as an indicator of umbilical infections, surface temperature of the umbilical stump (along with a reference point at the midpoint of the sternum) was determined using a dual-laser infrared thermometer. These measurements were all repeated at 24±1 h of age. All data were analyzed using mixed model methods. All models included fixed effects of breed (Jersey or Jersey cross), sex (bull or heifer), and treatment. Fixed effect interactions were not included in the statistical model due to the relatively small sample size. No treatment differences were noted for healing rate of umbilical cords. Initially, mean umbilical cord diameter was 22.84±3.89mm and cords healed to a mean diameter of 7.64±4.12mm at 24 h of age. No umbilical infections were noted for calves on any treatment during the course of this study. Mean surface temperature of the umbilical stump was 33.1±2.2°C at birth (1.5±1.6°C higher than the sternal reference temperature), and at 24±1 h of age the mean temperature of the umbilical stump was 33.0±4.3°C (0.5±1.8°C lower than the sternal reference temperature). These data suggest that these antiseptic compounds are equally effective for preventing infections and permitting healing of the umbilical cord when used within 30min of birth. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Incarcerated umbilical hernia in children.

PubMed

Chirdan, L B; Uba, A F; Kidmas, A T

2006-02-01

Umbilical hernia is common in children. Complications from umbilical hernias are thought to be rare and the natural history is spontaneous closure within 5 years. A retrospective analysis was performed of the medical records of a series of 23 children who presented with incarcerated umbilical hernias at our institution over an 8-year period. Fifty-two children with umbilical hernias were seen in the hospital over the period. Twenty-three (44.2%) had incarceration. Seventeen (32.7%) had acute incarceration while 6 (11.5%) had recurrent incarceration. There were 16 girls and 7 boys. The ages of the children with acute incarceration ranged from 3 weeks to 12 years (median 4 years), while the ages of those with recurrent incarceration ranged from 3-15 years (median 8.5 years). Incarceration occurred in hernias of more than 1.5 cm in diameter (in those whose defect size was measured). Twenty-one children (15 with acute and all six with recurrent incarceration) underwent repair of the umbilical hernia using standard methods. The parents of two children with acute incarceration declined surgery after spontaneous reduction of the hernia in one and taxis in the other. One boy had gangrenous bowel containing Meckel's diverticulum inside the sac, for which bowel resection with end-to-end anastomosis was done. Operation led to disappearance of pain in all 6 children with recurrent incarceration. Superficial wound infection occurred in one child. There was no mortality. Incarcerated umbilical hernia is not as uncommon as thought. Active observation of children with umbilical hernia is necessary to prevent morbidity from incarceration.

Predicting intrapartum fetal compromise using the fetal cerebro-umbilical ratio.

PubMed

Sabdia, S; Greer, R M; Prior, T; Kumar, S

2015-05-01

The aim of this study was to explore the association between the cerebro-umbilical ratio measured at 35-37 weeks and intrapartum fetal compromise. This retrospective cross sectional study was conducted at the Mater Mothers' Hospital in Brisbane, Australia. Maternal demographics and fetal Doppler indices at 35-37 weeks gestation for 1381 women were correlated with intrapartum and neonatal outcomes. Babies born by caesarean section or instrumental delivery for fetal compromise had the lowest median cerebro-umbilical ratio 1.60 (IQR 1.22-2.08) compared to all other delivery groups (vaginal delivery, emergency delivery for failure to progress, emergency caesarean section for other reasons or elective caesarean section). The percentage of infants with a cerebro-umbilical ratio <10th centile that required emergency delivery (caesarean section or instrumental delivery) for fetal compromise was 22%, whereas only 7.3% of infants with a cerebro-umbilical ratio between the 10th-90th centile and 9.6% of infants with a cerebro-umbilical ratio > 90th centile required delivery for the same indication (p < 0.001). A lower cerebro-umbilical ratio was associated with an increased risk of emergency delivery for fetal compromise, OR 2.03 (95% CI 1.41-2.92), p < 0.0001. This study suggests that a low fetal cerebro-umbilical ratio measured at 35-37 weeks is associated with a greater risk of intrapartum compromise. This is a relatively simple technique which could be used to risk stratify women in diverse healthcare settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Endothelial cell expression of adhesion molecules is induced by fetal plasma from pregnancies with umbilical placental vascular disease.

PubMed

Wang, Xin; Athayde, Neil; Trudinger, Brian

2002-07-01

To test the hypothesis that local production with spill into the fetal circulation of factor(s) injurious to endothelium is responsible for the vascular pathology present when the umbilical artery Doppler study is abnormal. Expression of adhesion molecules is a feature of endothelial cell activation. Case-control study. University teaching hospital. Fetal plasma was collected from 27 normal pregnancies, 39 pregnancies with umbilical placental vascular disease defined by abnormal umbilical artery Doppler and 11 pregnancies with pre-eclampsia and normal umbilical artery Doppler. Isolated and cultured human umbilical vein endothelial cells from normal pregnancies were incubated with fetal plasma from three study groups. mRNA expression of intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and platelet-endothelial cell adhesion molecule-1 (PECAM-1) were assessed by reverse transcription-polymerase chain reaction. To confirm the occurrence of this in vivo, we measured the levels of soluble fractions of sICAM-1, sVCAM-1 and sPECAM-1 in the fetal circulation in the fetal plasma used for endothelial cell incubation. The mRNA expression of ICAM-1 [median 1.1 (interquartile range 0.5-1.9) vs 0.7 (0.3-1.2), P < 0.05] and PECAM-1 [2.1 (1.2-3.0) vs 1.5 (0.7-2.1), P < 0.05] was significantly higher following incubation with fetal plasma from umbilical placental vascular disease compared with the normal group. There was no difference in the expression of VCAM-1 [1.2 (0.9-1.8) vs 1.1 (0.8-1.6), ns]. The group with maternal pre-eclampsia and normal umbilical artery Doppler did not differ from the normal group. In the umbilical placental vascular disease group, the results were similar in the presence or absence of pre-eclampsia. For soluble fractions of the adhesion molecules released into the fetal circulation, we found the levels (ng/mL) of sICAM- I [median 248.5 (interquartile range 197.3-315.7) vs 174.2 (144.5-212.9), P < 0.05] and sPECAM-1 [9.3 (6.2-11.1) vs 6.1 (5.4-7.7), P < 0.05] in fetal plasma to be significantly increased in the presence of umbilical placental vascular disease compared with the normal. Vascular disease in the fetal umbilical placental circulation is associated with an elevation in mRNA expression by endothelial cells of ICAM-1 and PECAM-1. Our study provides evidence for endothelial cell activation and dysfunction in umbilical placental vascular disease. We speculate that the plasma factor(s) affecting the vessels of the umbilical villous tree is locally released by the trophoblast. The occurrence of the maternal syndrome of pre-eclampsia appears to be independent of this.

Mucinous cystadenoma of the appendix presenting as an umbilical hernia: A case report.

PubMed

Ren, Bingbing; Meng, Xiangchao; Cao, Z I; Guo, Chunli; Zhang, Zili

2016-06-01

Mucinous cystadenoma of the appendix is a rare condition that develops as a result of proliferation of mucin-secreting cells in an occluded appendix. Mucinous cystadenoma of the appendix presenting as an umbilical hernia is a rare clinical entity. The most common causes of this condition are known to be ascites, hepatitis and cirrhosis; however, the patient in the present study, was diagnosed as hepatitis- and cirrhosis-negative, with no history of chronic coughing or constipation. The aim of the present study was to report a rare case of mucinous cystadenoma of the appendix presenting as an umbilical hernia in a 66-year-old female patient. The patient had a 6-month history of a reducible mass in the umbilical region and was diagnosed with umbilical hernia. Computed tomography and ultrasonography were performed and revealed massive ascites. Ultimately, a laparoscopic appendectomy was performed and borderline mucinous appendiceal cystadenoma of low malignant potential was confirmed. In addition, the present study discussed the association between mucinous cystadenoma of the appendix and umbilical hernia, as well as the diagnostic process and treatment strategies.

Mucinous cystadenoma of the appendix presenting as an umbilical hernia: A case report

PubMed Central

REN, BINGBING; MENG, XIANGCHAO; CAO, ZI; GUO, CHUNLI; ZHANG, ZILI

2016-01-01

Mucinous cystadenoma of the appendix is a rare condition that develops as a result of proliferation of mucin-secreting cells in an occluded appendix. Mucinous cystadenoma of the appendix presenting as an umbilical hernia is a rare clinical entity. The most common causes of this condition are known to be ascites, hepatitis and cirrhosis; however, the patient in the present study, was diagnosed as hepatitis- and cirrhosis-negative, with no history of chronic coughing or constipation. The aim of the present study was to report a rare case of mucinous cystadenoma of the appendix presenting as an umbilical hernia in a 66-year-old female patient. The patient had a 6-month history of a reducible mass in the umbilical region and was diagnosed with umbilical hernia. Computed tomography and ultrasonography were performed and revealed massive ascites. Ultimately, a laparoscopic appendectomy was performed and borderline mucinous appendiceal cystadenoma of low malignant potential was confirmed. In addition, the present study discussed the association between mucinous cystadenoma of the appendix and umbilical hernia, as well as the diagnostic process and treatment strategies. PMID:27313766

Mercury in the Umbilical Cord: Implications for Risk Assessment for Minamata Disease.

PubMed Central

Dalgard, C; Grandjean, P; Jorgensen, PJ; Weihe, P

1994-01-01

Umbilical cord tissue was obtained from 50 births in the Faroe Islands, where high mercury intake is due to ingestion of pilot whale meat. The mercury concentration correlated significantly with the frequency of maternal whale meat dinners during pregnancy and with mercury concentrations in umbilical cord blood and in maternal hair. The results were compared with published values for mercury in umbilical cord tissue from 12 infants diagnosed with congenital methylmercury poisoning in Minamata, Japan. From the regression coefficients obtained in the Faroese samples, the median umbilical cord mercury concentration of 4.95 nmol/g dry weight in Minamata would correspond to 668 nmol/l cord blood and 114 nmol/g maternal hair. These levels agree well with other evidence of susceptibility of the fetus to increased exposure to methylmercury. Images Figure 1. Figure 2. PMID:9679113

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Construction workers assist as a crane lifts the Core Stage Forward Skirt Umbilical up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Cranes and rigging are being used to lift up the Core Stage Forward Skirt Umbilical (CSFSU) for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

A construction worker welds a metal part during installation of the Core Stage Forward Skirt Umbilical on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Construction workers assist as a crane lifts the Core Stage Forward Skirt Umbilical into position for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Spacecraft automatic umbilical system

NASA Technical Reports Server (NTRS)

Goldin, R. W.; Jacquemin, G. G.; Johnson, W. H.

1981-01-01

An umbilical system design is described that incorporates all the features specified for a power system to payload interconnect capability. A proof-of-concept prototype of the umbilical system was built to determine experimentally the suitability of the threading characteristics of the ram mechanism and to verify freedom from cross threading. It is concluded that Berthing systems that utilize remote manipulator systems (RMS) can be simplified by using RMS targets, closed circuit TV cameras, tie into the RMS control system, and grapple-fixture and end-effector-like capture and secure mechanisms. To effect a remotely controlled umbilical interconnect in proximity with a manned spacecraft and to provide for extravehicular activity backup and maintenance capabilities, 18 different mechanisms are found to be necessary. The weight impact of proving for maintenance capability in a large multiple connector umbilical system was found to be in the order of +60 percent.

Generation of mesenchymal stromal cells in the presence of platelet lysate: a phenotypic and functional comparison of umbilical cord blood- and bone marrow-derived progenitors

PubMed Central

Avanzini, Maria Antonietta; Bernardo, Maria Ester; Cometa, Angela Maria; Perotti, Cesare; Zaffaroni, Nadia; Novara, Francesca; Visai, Livia; Moretta, Antonia; Del Fante, Claudia; Villa, Raffaella; Ball, Lynne M.; Fibbe, Willem E.; Maccario, Rita; Locatelli, Franco

2009-01-01

Background Mesenchymal stromal cells are employed in various different clinical settings in order to modulate immune response. However, relatively little is known about the mechanisms responsible for their immunomodulatory effects, which could be influenced by both the cell source and culture conditions. Design and Methods We tested the ability of a 5% platelet lysate-supplemented medium to support isolation and ex vivo expansion of mesenchymal stromal cells from full-term umbilical-cord blood. We also investigated the biological/functional properties of umbilical cord blood mesenchymal stromal cells, in comparison with platelet lysate-expanded bone marrow mesenchymal stromal cells. Results The success rate of isolation of mesenchymal stromal cells from umbilical cord blood was in the order of 20%. These cells exhibited typical morphology, immunophenotype and differentiation capacity. Although they have a low clonogenic efficiency, umbilical cord blood mesenchymal stromal cells may possess high proliferative potential. The genetic stability of these cells from umbilical cord blood was demonstrated by a normal molecular karyotype; in addition, these cells do not express hTERT and telomerase activity, do express p16ink4a protein and do not show anchorage-independent cell growth. Concerning alloantigen-specific immune responses, umbilical cord blood mesenchymal stromal cells were able to: (i) suppress T- and NK-lymphocyte proliferation, (ii) decrease cytotoxic activity and (iii) only slightly increase interleukin-10, while decreasing interferon-γ secretion, in mixed lymphocyte culture supernatants. While an indoleamine 2,3-dioxygenase-specific inhibitor did not reverse mesenchymal stromal cell-induced suppressive effects, a prostaglandin E2-specific inhibitor hampered the suppressive effect of both umbilical cord blood- and bone marrow-mesenchymal stromal cells on alloantigen-induced cytotoxic activity. Mesenchymal stromal cells from both sources expressed HLA-G. Conclusions Umbilical cord blood- and bone marrow-mesenchymal stromal cells may differ in terms of clonogenic efficiency, proliferative capacity and immunomodulatory properties; these differences may be relevant for clinical applications. PMID:19773264

Attitudes of Swiss mothers toward unrelated umbilical cord blood banking 6 months after donation.

PubMed

Danzer, Enrico; Holzgreve, Wolfgang; Troeger, Carolyn; Kostka, Ulrike; Steimann, Sabine; Bitzer, Johanes; Gratwohl, Alois; Tichelli, André; Seelmann, Kurt; Surbek, Daniel V

2003-05-01

During the past decade, the use of umbilical cord blood (CB) as a source of transplantable hematopoietic stem cells has been increasing. Little is known about the psychosocial consequences that later affect parents after unrelated CB donation. The objective of this study was to evaluate the attitudes of mothers toward unrelated donation of umbilical CB for transplantation 6 months after giving birth. A prospective study was performed with a standardized, anonymous questionnaire distributed to 131 women 6 months after CB donation. The questionnaire included topics concerning views about the ethical accuracy of having donated CB, emotional responses after donation, concerns about genetic testing and research with CB samples, attitude toward anonymity between her child and possible unrelated CB recipient, and willingness to repeatedly donate umbilical CB in a next pregnancy. The vast majority (96.1%) stated that they would donate umbilical CB again, and all respondents were certain that their decision to have donated umbilical CB was ethical. With regard to the potential risks of genetic testing and "experimentation" of umbilical CB, a significant correlation (p = 0.01) was found between negative attitudes and the decision not to donate umbilical CB again. Additionally, it was observed that women who had a negative experience concerning the donation of CB would not donate again (p = 0.004). This study shows a high degree of satisfaction of unrelated umbilical CB donation for banking in women 6 months after delivery. Despite a well-performed and detailed informed consent procedure, one of the ongoing issues for the donators in CB banking involves the concern regarding of improper use of the cells, such as genetic testing or experimentation. Accurate and detailed counseling of pregnant women and their partners therefore maximizes the likelihood that they will donate CB for unrelated banking. These data provide a basis for the improvement of donor selection procedures and public education regarding the use of CB for banking and transplantation.

[Rare umbilical anomalies].

PubMed

Kysucan, J; Malý, T; Neoral, C

2010-12-01

Umbilicus is a scar, which is the place of the previous merger of the fetus with the umbilical cord. After birth, it has no known function, however, unless the umbilical annulus is completely closed, umbilical hernia may occur. Umbilical scar is also an area where may occur a number of anomalies that may be present alone or together with umbilical hernia. Failure of involution leads to persistence of omphalomesenteric duct and urachal remnants. These embryonic remnants may cause more or less significant clinical problems, or may be completely asymptomatic and may be diagnosed at random. The authors present their own group of patients who were diagnosed and dealt with the defect omphalomesenteric duct or urachus. In past 7 years we observed 35 children with these abnormalities. A large group of patients represents incidental findings during elective surgery for umbilical hernia. Another large group are patients with symptomatic or asymptomatic Meckel's diverticulum. The anatomical observations, clinical manifestations, complications and treatment of these anomalies are mentioned. A total of 35 children were found with these birth defects. In 23 cases we observed omphalomesenteric duct disorders and 12 urachal remnants were reported. Of these, 12 abnormalities were found incidentally during elative procedure for umbilical hernia. Asymptomatic or symptomatic Meckel's diverticulum appeared in 16 cases. Surgical treatment included resection or exstirpation, if urachal anomaly was accompanied then partial resection of the bladder vertex was added. Postoperative complications emerged in 4 cases, three times it was ileus from adhesions 6 months after surgery, once postoperative cystitis appeared and was treated conservatively. Birth abnormalities of the umbilicus are relatively rare diseases that may occur in the pediatric population. Omfalomesenteric duct and urachal anomalies constitute a major group of these congenital disorders and are often associated with umbilical hernia. They can be diagnosed soon after birth or later in life. Surgical treatment involves excision or radical exstirpation to prevent early or late complications (urachal carcinoma in adulthood).

Profile of paediatric umbilical hernias managed at Federal Medical Centre Umuahia.

PubMed

Ezomike, U O; Ituen, M A; Ekpemo, S C; Eke, C B; Eke, B C

2012-01-01

Umbilical hernias are common in children but many resolve spontaneously within the first five years of life. Most umbilical herniorrhaphies in our environment are due to symptomatic hernias which constitute a small percentage of all umbilical hernias. A retrospective review of all pediatric patients with UH treated at Federal Medical Centre Umuahia, Abia State from February 2001 to February 2011. There were 22 patients but only 20 of the folders were found and analyzed. They were made up of 11 males and 9 females with a mean age of 6.19 +/- 0.83 years and median age of 6 years. Nine(7 males and 2 females) had acute incarcerations, nine (3 males and 6 females) had recurrent umbilical pains without incarceration and two (1 male and 1 female) had recurrent incarcerations. Age range for acute incarceration was 2-8 years (mean: 4.69 years, median: 4 years); recurrent umbilical pains was 4 months -15 years (mean: 7.7 years, median: 8 years) and for recurrent incarceration 2-10 years (mean: 6 years). All had standard umbilical hernia repairs except one whose parents declined surgery after reduction of acute incarceration. One patient with acute incarceration had gangrenous bowel with hernia sac abscess and was offered bowel resection with end-to-end anastomosis. On short-term follow-up, the symptoms resolved in all the patients following surgery. Five patients had six complications: 1 exuberant granulation tissue, 2 stitch reactions, 2 superficial wound dehiscence and one superficial wound infection. There were no mortalities and no recurrence on short-term follow-up. Only one patient (5%) registered under the National Health Insurance Scheme (NHIS). Active observation of all umbilical hernias at all ages will ensure early detection of complications and prompt treatment. Elective repair of umbilical hernias in patientsabove five years with fascia defect greater than 1.5cm is encouraged. Comprehensive NHIS will ensure early presentation and reduced complications.

Umbilical cord rupture: a case report and review of literature.

PubMed

Naidu, Madhusudhan; Nama, Vivek; Karoshi, Mahantesh; Kakumani, Vijayasri; Worth, Richard

2007-01-01

The umbilical cord acts as a mechanical conduit between the fetus and placenta, allowing movement of water and nutrient substances between the fetal circulation and the amniotic fluid. Complications can occur antenatally or intranatally and are usually acute events that require immediate delivery to prevent intrauterine death. Even though the majority of the cord complications are unpreventable, significant improvement in perinatal mortality and morbidity can be achieved if such an event can be predicted. Umbilical cord rupture is not uncommon, but significantly underreported. We present an unusual cause of umbilical cord rupture and a review of literature.

Engraftment of gene-modified umbilical cord blood cells in neonates with adenosine deaminase deficiency

PubMed Central

Kohn, Donald B.; Weinberg, Kenneth I.; Nolta, Jan A.; Heiss, Linda N.; Lenarsky, Carl; Crooks, Gay M.; Hanley, Mary E.; Annett, Geralyn; Brooks, Judith S.; El-Khoureiy, Anthony; Lawrence, Kim; Wells, Susie; Moen, Robert C.; Bastian, John; Williams-Herman, Debora E.; Elder, Melissa; Wara, Diane; Bowen, Thomas; Hershfield, Michael S.; Mullen, Craig A.; Blaese, R. Michael; Parkman, Robertson

2010-01-01

Haematopoietic stem cells in umbilical cord blood are an attractive target for gene therapy of inborn errors of metabolism. Three neonates with severe combined immunodeficiency were treated by retroviral-mediated transduction of the CD34+ cells from their umbilical cord blood with a normal human adenosine deaminase complementary DNA followed by autologous transplantation. The continued presence and expression of the introduced gene in leukocytes from bone marrow and peripheral blood for 18 months demonstrates that umbilical cord blood cells may be genetically modified with retroviral vectors and engrafted in neonates for gene therapy. PMID:7489356

Umbilical Hernia Repair: Overview of Approaches and Review of Literature.

PubMed

Appleby, Paul W; Martin, Tasha A; Hope, William W

2018-06-01

Umbilical hernias are ubiquitous, and surgery is indicated in symptomatic patients. Umbilical hernia defects can range from small (<1 cm) to very large/complex hernias, and treatment options should be tailored to the clinical situation. Open, laparoscopic, and robotic options exist for repair, with each having its advantages and disadvantages. In general, mesh should be used for repair, because it has been shown to decrease recurrence rates, even in small hernias. Although outcomes are generally favorable after umbilical hernia repairs, some patients have chronic complaints that are mostly related to recurrences. Copyright © 2018 Elsevier Inc. All rights reserved.

Obstructed Umbilical Hernia: A Normal Presentation with Abnormal Contents

PubMed Central

P Agrawal, Vijay; Narasimhaprasad, Ashwin

2015-01-01

Umbilical hernia is a common problem encountered in children. The rarity of finding cecum and appendix is probably due to the fact that the appendix is seldom found in the proximity of the umbilicus. It would, therefore, appear worthwhile to report the occurrence of cecum and an inflamed appendix with Ladd’s bands in an umbilical hernia of a child. The last case with similar presentation was presented in 1950s. How to cite this article Agrawal VP, Shetty NS, Narasimhaprasad A. Obstructed Umbilical Hernia: A Normal Presentation with Abnormal Contents. Euroasian J Hepato-Gastroenterol 2015;5(2):110-111. PMID:29201704

[Umbilical cord collision in the first trimester in a monoamniotic twin pregnancy--does it really matter?].

PubMed

Ropacka-Lesiak, Mariola; Lebioda, Anna; Breborowicz, Grzegorz

2012-09-01

A case of an umbilical cord collision diagnosed in the first trimester of a monochorionic monoamniotic twin pregnancy is presented. An intensive surveillance included ultrasound monitoring with color and spectral Doppler and fetal echocardiography. The first signs of fetal distress were observed at 31 weeks of gestation. The brain sparing effect as well as a periodic appearance of the "notch" in the wave forms obtained from the umbilical artery from the collision region were observed. In the first ultrasound scan there were no abnormalities in twin I. In contrast, in twin II a vascular resistance in the umbilical artery was at the upper limit for the gestational age. Five days later, decreased vascular resistance in the middle cerebral artery, which fluctuated at the lower limit, was noticed in twin II. After the next four days, PI in the middle cerebral artery decreased below the lower limit and tricuspid regurgitation appeared. In twin I the vascular resistance in the umbilical artery increased and remained at the upper limit of the reference ranges. Cardiotocographic records did not reveal signs of fetal distress. After a week the signs of brain sparing effect were visible in both fetuses. However, twin II showed features of umbilical cord clamping in the form of abnormal blood flow waveforms in the umbilical artery ("notch"). Therefore, despite the absence of signs of fetal distress in CTG in monochorionic monoamniotic twins with growth discordance of 20% and exponents of periodical clamping of the umbilical cord in twin II at 34 weeks, the decision to perform a caesarean section was made. The patient gave birth to two daughters (twin I: weight 1780g, Ap 10, pH 7.39, 7.40, BE -3.0, -2.6, and twin II: weight 1860g, Ap 10, pH 7.29, 7.35, BE -1.4, -2.4). During the delivery the umbilical cords collision was found at the region close to the body of twins. This case presents the possibility of using ultrasound and Doppler in the early diagnosis, monitoring and surveillance of pregnancies complicated by umbilical cords collision in monochorionic monoamniotic twins from the first trimester. Application of these methods allowed a safe monitoring of the fetuses and the identification of the onset of the cords collision. This in turn allowed the achievement of fetal maturity at 34 weeks, when both the risk of death and neonatal morbidity are significantly minimized. The use of Doppler blood flow velocimetry allowed the diagnosis of umbilical cords tightening before there were any signs of cardiac dysfunction in the CTG. This enabled to determine the most favorable, earlier time for delivery. The paper presents diagnostic management and surveillance in monochorionic monoamniotic pregnancy complicated by umbilical cord collision since the early pregnancy.

Infection of internal umbilical remnant in foals by Clostridium sordellii.

PubMed

Ortega, J; Daft, B; Assis, R A; Kinde, H; Anthenill, L; Odani, J; Uzal, F A

2007-05-01

Omphalitis and the resulting septicemia contribute to perinatal mortality in several animal species. In foals, the most important causes of omphalitis are Escherichia coli and Streptococcus zooepidemicus. However to date, no information has been published about the role of Clostridium sordellii in these infections. In this paper, we describe 8 cases of perinatal mortality in foals associated with internal umbilical remnant infection by C. sordellii. The foals studied were between 12 and 21 days old at the time of death, and various breeds were represented in the group. Five of the foals were male and 3 were female. The diagnosis was established on the basis of the detection of C. sordellii by 3 methods (culture, fluorescent antibody test, and immunohistochemistry) and on gross and histopathologic findings. All foals had acute peritonitis, and the internal umbilical remnant was thickened by edema, hemorrhage, and fibrosis. A moderate amount of serosanguinous fluid with fibrin strands was present in the pericardial sac and pleural cavity. Histopathologically, the urachus and umbilical arterial walls were thickened by edema and exhibited hemorrhage, fibrin, and leukocytic infiltration. Gram-positive bacterial rods were observed in subepithelial areas of the urachus, the adventicia of umbilical arteries, and interstitium of the internal umbilical remnant. On the basis of these findings, we suggest that C. sordellii should be considered in the differential diagnosis for infections of the internal umbilical remnant in foals.

PP043. Oxidative stress in the maternal body also affects the fetus in preeclamptic women with fetal growth restriction.

PubMed

Watanabe, Kazushi; Iwasaki, Ai; Mori, Toshitaka; Kimura, Chiharu; Matsushita, Hiroshi; Shinohara, Koichi; Wakatsuki, Akihiko

2013-04-01

The purpose of the present study was to determine whether oxidative stress occurring in the maternal body also affects the fetus in preeclamptic women with FGR. We ∥@consecutively recruited 17 preeclamptic women with FGR, 16 preeclamptic women without FGR, and 16 healthy pregnant women with uncomplicated pregnancy. We measured concentrations of derivatives of reactive oxygen metabolites (d-ROMs) as a marker of oxygen free radicals in a maternal vein, umbilical artery, and umbilical vein. ∥@Maternal d-ROM levels were higher in preeclamptic groups compared to the control group. Umbilical artery and vein d-ROM levels were elevated in preeclamptic women with FGR compared to the control group. Umbilical artery d-ROM levels were significantly higher than in the vein in preeclamptic women with FGR, but not in those without FGR. Umbilical arterial blood pH was significantly lower in preeclamptic women with FGR. The partial pressure of oxygen (PaO2) in umbilical arterial blood tended to be lower in preeclamptic women with FGR (p=0.08). The partial pressure of carbon dioxide (PaCO2) in umbilical arterial blood was significantly higher in preeclamptic women with FGR. These results indicate that oxidative stress occurring in the maternal body also affects the fetus in preeclamptic women with FGR. Copyright © 2013. Published by Elsevier B.V.

Abnormal umbilical cord Doppler sonograms may predict impending demise in fetuses with sacrococcygeal teratoma. A report of two cases.

PubMed

Olutoye, Oluyinka O; Johnson, Mark P; Coleman, Beverly G; Crombleholme, Timothy M; Adzick, N Scott; Flake, Alan W

2004-01-01

To identify factors predictive of fetal demise in fetuses with sacrococcygeal teratoma (SCT). The recent management of monochorionic twins discordant for a large SCT and a singleton with a large SCT was reviewed. Serial fetal echocardiography and ultrasonography with Doppler flow measurements documented rapid growth of the SCT in both cases with a relatively modest increase in combined cardiac output. No placentomegaly or hydrops was observed at any time. In both fetuses with SCT, evolution of abnormal umbilical artery waveforms was observed with the ultimate development of reversed end-diastolic umbilical arterial flow that was followed by sudden fetal demise. Death in these 2 fetuses with large SCTs in the absence of placentomegaly/hydrops or hemodynamic changes suggestive of evolving high-output failure suggests a previously unrecognized mechanism of death in fetuses with large rapidly growing SCTs. In these cases, fetal demise may only be heralded by abnormal umbilical artery waveforms that progress to the premorbid observation of reversed diastolic umbilical artery blood flow. Umbilical artery waveform analysis should be closely monitored with other hemodynamic parameters in fetuses with large SCTs. In such fetuses, depending on the gestational age, abnormalities in umbilical artery waveform should be considered indications for early delivery or in utero intervention to prevent fetal demise. Copyright 2004 S. Karger AG, Basel

Abnormal umbilical cord Dopplers may predict impending demise in fetuses with sacrococcygeal teratoma. A report of 2 cases.

PubMed

Olutoye, Oluyinka O; Johnson, Mark P; Coleman, Beverly G; Crombleholme, Timothy M; Adzick, N Scott; Flake, Alan W

2003-01-01

To identify factors predictive of fetal demise in fetuses with sacrococcygeal teratoma (SCT). The recent management of monochorionic twins discordant for a large SCT and a singleton with a large SCT were reviewed. Serial fetal echocardiography and ultrasonography with Doppler flow measurements documented rapid growth of the SCT in both cases with a relatively modest increase in combined cardiac output. No placentomegaly or hydrops was observed at any time. In both fetuses with SCT, evolution of abnormal umbilical artery waveforms was observed with the ultimate development of reversed end-diastolic umbilical arterial flow that was followed by sudden fetal demise. Death in these 2 fetuses with large SCTs in the absence of placentomegaly/hydrops or hemodynamic changes suggestive of evolving high-output failure suggests a previously unrecognized mechanism of death in fetuses with large rapidly growing SCTs. In these cases, fetal demise may only be heralded by abnormal umbilical artery waveforms that progress to the premorbid observation of reversed diastolic umbilical artery blood flow. Umbilical artery waveform analysis should be closely monitored with other hemodynamic parameters in fetuses with large SCTs. In such fetuses, depending on the gestational age, abnormalities in umbilical artery waveform should be considered indications for early delivery or in utero intervention to prevent fetal demise. Copyright 2003 S. Karger AG, Basel

Umbilical hernias and anterior fontanelle size in Jamaican children.

PubMed

Cohen, I P

1989-06-01

This cross-sectional study documents the frequent occurrence of umbilical hernias among Jamaican children and suggests, for the first time, that the presence of an umbilical hernia may be associated with larger anterior fontanelle dimensions. It also demonstrates that data about the people a community health officer serves can be recorded during a busy clinic schedule.

The Effect of Prophylactic Phenylephrine and Ephedrine Infusions on Umbilical Artery Blood pH in Women With Preeclampsia Undergoing Cesarean Delivery With Spinal Anesthesia: A Randomized, Double-Blind Trial.

PubMed

Higgins, Nicole; Fitzgerald, Paul C; van Dyk, Dominique; Dyer, Robert A; Rodriguez, Natalie; McCarthy, Robert J; Wong, Cynthia A

2018-06-01

Spinal anesthesia for cesarean delivery is associated with a high incidence of hypotension. Phenylephrine results in higher umbilical artery pH than ephedrine when used to prevent or treat hypotension in healthy women. We hypothesized that phenylephrine compared to ephedrine would result in higher umbilical artery pH in women with preeclampsia undergoing cesarean delivery with spinal anesthesia. This study was a randomized double-blind clinical trial. Nonlaboring women with preeclampsia scheduled for cesarean delivery with spinal anesthesia at Prentice Women's Hospital of Northwestern Medicine were randomized to receive prophylactic infusions of phenylephrine or ephedrine titrated to maintain systolic blood pressure >80% of baseline. Spinal anesthesia consisted of hyperbaric 0.75% bupivacaine 12 mg, fentanyl 15 µg, and morphine 150 µg. The primary outcome was umbilical arterial blood pH and the secondary outcome was umbilical artery base excess. One hundred ten women were enrolled in the study and 54 per group were included in the analysis. There were 74 and 72 infants delivered in the ephedrine and phenylephrine groups, respectively. The phenylephrine:ephedrine ratio for umbilical artery pH was 1.002 (95% confidence interval [CI], 0.997-1.007). Mean [standard deviation] umbilical artery pH was not different between the ephedrine 7.20 [0.10] and phenylephrine 7.22 [0.07] groups (mean difference -0.02, 95% CI of the difference -0.06 to 0.07; P = .38). Median (first, third quartiles) umbilical artery base excess was -3.4 mEq/L (-5.7 to -2.0 mEq/L) in the ephedrine group and -2.8 mEq/L (-4.6 to -2.2mEq/L) in the phenylephrine group (difference -0.6 mEq/L, 95% CI of the difference -1.6 to 0.3 mEq/L; P = .10). When adjusted for gestational age and infant gender, umbilical artery pH did not differ between groups. There were also no differences in the umbilical artery pH stratified by magnesium therapy or by the severity of preeclampsia. We were unable to demonstrate a beneficial effect of phenylephrine on umbilical artery pH compared with ephedrine. Our findings suggest that phenylephrine may not have a clinically important advantage compared with ephedrine with regard to improved neonatal acid-base status when used to prevent spinal anesthesia-induced hypotension in women with preeclampsia undergoing cesarean delivery.

Umbilical necrosis rates after abdominal-based microsurgical breast reconstruction.

PubMed

Ricci, Joseph A; Kamali, Parisa; Becherer, Babette E; Curiel, Daniel; Wu, Winona; Tobias, Adam M; Lin, Samuel J; Lee, Bernard T

2017-07-01

Umbilical stalk necrosis represents a rare, yet important complication after abdominal-based microsurgical breast reconstruction, which is both underrecognized and understudied in the literature. Once identified, umbilical reconstruction can be an extremely challenging problem. All consecutive breast free flaps at a single institution from February 2004 to February 2016 were reviewed, excluding non-abdominal-based flaps. Patients were divided based on the development of umbilical necrosis postoperatively. Demographics, surgical characteristics, and other complications were compared between the groups. A total of 918 patients met the inclusion criteria, with 29 developing umbilical necrosis identified (3.2%). Patients developing necrosis tended to be older (49.4 yrs versus 52.9 yrs; P < 0.01); have higher BMI (31.3 versus 27.8; P < 0.01); and were more likely to be smokers (27.5% versus 11.6%; P = 0.01). Umbilical necrosis was also associated with increased flap weight (830 g versus 656 g; P < 0.01), decreased time of perforator dissection (151 min versus 169 min; P = 0.02); bilateral cases (68.9% versus 44.7%; P < 0.01), and increased number of perforators per flap (2.5 versus 2.2; P = 0.03). There was no association with flap type (deep inferior epigastric perforator, superficial inferior epigastric artery, or free TRAM), diabetes, previous abdominal surgery, or use of preoperative imaging. Umbilical necrosis was not associated with any concomitant complications. Umbilical stalk necrosis was found to occur in 3.2% of patients and was associated with several preoperative comorbidities and intraoperative characteristics. This information should help influence intraoperative decision-making to prevent the development of this undesirable complication. Copyright © 2017 Elsevier Inc. All rights reserved.

Efficacy of intra-umbilical oxytocin in the management of retained placenta: a randomized controlled trial.

PubMed

Samanta, Ajanta; Roy, Samir Ghosh; Mistri, Pallab Kumar; Mitra, Anirban; Pal, Ranjan; Naskar, Animesh; Bhattacharya, Sanjay Kumar; Pal, Partha Pratim; Pande, Arindam

2013-01-01

Retained placenta is an important cause of maternal mortality. The present study was aimed to determine the efficacy of umbilical injection of oxytocin as a treatment modality in this condition. This was a single-center randomized controlled trial incorporating 58 women with retained placenta of more than 30 min, equally distributed into two study arms of intra-umbilical injection of oxytocin (50 IU oxytocin diluted with normal saline [NS] to a total volume 30 mL) and intra-umbilical injection of NS (30 mL). Primary outcome was expulsion of the placenta within 30 min following intervention. All the data were analyzed on an intention-to-treat basis. The success rate in the intra-umbilical oxytocin group was 51.72% compared to 20.69% in the control arm. This difference in the primary outcome was statistically significant with a P-value<0.05 (P=0.014) favoring intra-umbilical oxytocin infusion with an efficacy rate of 1.5 and a number-needed-to-treat of 3. The peripartum bleeding complications were more in the NS group with a statistically higher (P<0.001) requirement of extra oxytocin to control post-partum bleeding. There were no differences between the two groups in respect to other secondary outcomes, such as post-partum fever, antibiotic requirement and hospital stay.   Umbilical vein injection of 50IU oxytocin in 30mL of NS delivered effectively via the umbilical cord with milking in cases of retained placenta seems a simple and promising technique to reduce the incidence of a potentially morbid procedure and other complications. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

Release from quiescence of CD34+ CD38- human umbilical cord blood cells reveals their potentiality to engraft adults.

PubMed Central

Cardoso, A A; Li, M L; Batard, P; Hatzfeld, A; Brown, E L; Levesque, J P; Sookdeo, H; Panterne, B; Sansilvestri, P; Clark, S C

1993-01-01

Using optimal culture conditions in which the transforming growth factor beta 1 (TGF-beta 1) inhibitory loop has been interrupted by antisense TGF-beta 1 oligonucleotides or anti-TGF-beta serum, we have compared the proliferative capacities and the abilities of the CD34+ CD38- cell populations from bone marrow and umbilical cord blood to generate early progenitors in long-term cultures. The CD34+ CD38- fraction of umbilical cord blood accounts for 4% of the CD34+ fraction compared to only 1% in bone marrow, indicating that umbilical cord blood may be relatively enriched in stem cells. We estimate that the CD34+ CD38- cells from a typical umbilical cord blood sample produce equivalent numbers of colony-forming units (CFU)-granulocyte/erythrocyte/macrophage/megakaryocyte, twice as many CFU-granulocyte/macrophage (GM) and 3 times as many burst-forming units-erythroid as the same population from an average bone marrow sample used in adult transplantation. In addition, the colonies resulting from the umbilical cord blood samples were significantly larger than those from bone marrow, indicating a greater growth potential. However, the content of later progenitors, which may be important for short-term reconstitution, was less in umbilical cord blood-derived than in bone marrow-derived cell preparations, as estimated by a 4-fold lower production of CFU-GM in long-term cultures of CD34+ CD38+ cells. This deficit is partially compensated by the higher growth capacity of the resulting CFU-GM. These studies suggest that umbilical cord blood is a suitable source of cells for adult transplantation. PMID:7690969

Intrauterine growth restriction is associated with structural alterations in human umbilical cord and decreased nitric oxide-induced relaxation of umbilical vein.

PubMed

Peyter, A-C; Delhaes, F; Baud, D; Vial, Y; Diaceri, G; Menétrey, S; Hohlfeld, P; Tolsa, J-F

2014-11-01

Intrauterine growth restriction (IUGR) affects ∼8% of all pregnancies and is associated with major perinatal mortality and morbidity, and with an increased risk to develop cardiovascular diseases in adulthood. Despite identification of several risk factors, the mechanisms implicated in the development of IUGR remain poorly understood. In case of placental insufficiency, reduced delivery of oxygen and/or nutrients to the fetus could be associated with alterations in the umbilical circulation, contributing further to the impairment of maternal-fetal exchanges. We compared the structural and functional properties of umbilical cords from growth-restricted and appropriate for gestational age (AGA) term newborns, with particular attention to the umbilical vein (UV). Human umbilical cords were collected at delivery. Morphological changes were investigated by histomorphometry, and UV's reactivity by pharmacological studies. Growth-restricted newborns displayed significantly lower growth parameters, placental weight and umbilical cord diameter than AGA controls. Total cross-section and smooth muscle areas were significantly smaller in UV of growth-restricted neonates than in controls. Maximal vasoconstriction achieved in isolated UV was lower in growth-restricted boys than in controls, whereas nitric oxide-induced relaxation was significantly reduced in UV of growth-restricted girls compared to controls. IUGR is associated with structural alterations of the UV in both genders, and with a decreased nitric oxide-induced relaxation in UV of newborn girls, whereas boys display impaired vasoconstriction. Further investigations will allow to better understand the regulation of umbilical circulation in growth-restricted neonates, which could contribute to devise potential novel therapeutic strategies to prevent or limit the development of IUGR. Copyright © 2014 Elsevier Ltd. All rights reserved.

Transplacental Distribution of Lidocaine and Its Metabolite in Peridural Anesthesia Administered to Patients With Gestational Diabetes Mellitus

PubMed Central

Duarte, Luciana de Barros; Cavalli, Ricardo de Carvalho; Carvalho, Daniela Miarelli; Filgueira, Gabriela Campos de Oliveira; Marques, Maria Paula; Lanchote, Vera Lucia; Duarte, Geraldo

2015-01-01

Background: Neonatal effects of drugs administered to mothers before delivery depend on the quantity that crosses the placental barrier, which is determined by the pharmacokinetics of the drug in the mother, fetus, and placenta. Diabetes mellitus can alter the kinetic disposition and the metabolism of drugs. This study investigated the placental transfer of lidocaine and its metabolite monoethylglycinexylidide (MEGX) in pregnant women with gestational diabetes mellitus (GDM) submitted to peridural anesthesia. Patients and Methods: A total of 10 normal pregnant women (group 1) and 6 pregnant women with GDM (group 2) were studied, all at term. The patients received 200 mg 2% lidocaine hydrochloride by the peridural locoregional route. Maternal blood samples were collected at the time of delivery and, after placental expulsion, blood samples were collected from the intervillous space, umbilical artery, and vein for determination of lidocaine and MEGX concentrations and analysis of the placental transfer of the drug. Results: The following respective lidocaine ratios between the maternal and the fetal compartments were obtained for groups 1 and 2: umbilical vein/maternal peripheral blood, 0.60 and 0.46; intervillous space/maternal blood, 1.01 and 0.88; umbilical artery/umbilical vein, 0.77 and 0.91; and umbilical vein/intervillous space, 0.53 and 0.51. The following MEGX ratios for groups 1 and 2 were, respectively, fetal/maternal, 0.43 and 0.97; intervillous space/maternal blood, 0.64 and 0.90; umbilical artery/umbilical vein, 1.09 and 0.99; and umbilical vein/intervillous space, 0.55 and 0.78. Conclusion: Gestational diabetes mellitus did not affect the transplacental transfer of lidocaine but interfered with the transfer of MEGX, acting as a mechanism facilitating the transport of the metabolite. PMID:25563756

Transplacental Distribution of Lidocaine and Its Metabolite in Peridural Anesthesia Administered to Patients With Gestational Diabetes Mellitus.

PubMed

Moises, Elaine Christine Dantas; Duarte, Luciana de Barros; Cavalli, Ricardo de Carvalho; Carvalho, Daniela Miarelli; Filgueira, Gabriela Campos de Oliveira; Marques, Maria Paula; Lanchote, Vera Lucia; Duarte, Geraldo

2015-07-01

Neonatal effects of drugs administered to mothers before delivery depend on the quantity that crosses the placental barrier, which is determined by the pharmacokinetics of the drug in the mother, fetus, and placenta. Diabetes mellitus can alter the kinetic disposition and the metabolism of drugs. This study investigated the placental transfer of lidocaine and its metabolite monoethylglycinexylidide (MEGX) in pregnant women with gestational diabetes mellitus (GDM) submitted to peridural anesthesia. A total of 10 normal pregnant women (group 1) and 6 pregnant women with GDM (group 2) were studied, all at term. The patients received 200 mg 2% lidocaine hydrochloride by the peridural locoregional route. Maternal blood samples were collected at the time of delivery and, after placental expulsion, blood samples were collected from the intervillous space, umbilical artery, and vein for determination of lidocaine and MEGX concentrations and analysis of the placental transfer of the drug. The following respective lidocaine ratios between the maternal and the fetal compartments were obtained for groups 1 and 2: umbilical vein/maternal peripheral blood, 0.60 and 0.46; intervillous space/maternal blood, 1.01 and 0.88; umbilical artery/umbilical vein, 0.77 and 0.91; and umbilical vein/intervillous space, 0.53 and 0.51. The following MEGX ratios for groups 1 and 2 were, respectively, fetal/maternal, 0.43 and 0.97; intervillous space/maternal blood, 0.64 and 0.90; umbilical artery/umbilical vein, 1.09 and 0.99; and umbilical vein/intervillous space, 0.55 and 0.78. Gestational diabetes mellitus did not affect the transplacental transfer of lidocaine but interfered with the transfer of MEGX, acting as a mechanism facilitating the transport of the metabolite. © The Author(s) 2015.

Comparison of umbilical cord ghrelin concentrations in full-term pregnant women with or without gestational diabetes.

PubMed

Karakulak, Murat; Saygili, Uğur; Temur, Muzaffer; Yilmaz, Özgür; Özün Özbay, Pelin; Calan, Mehmet; Coşar, Hese

2017-05-01

Ghrelin is a potent orexigenic peptide hormone secreted from the gastrointestinal tract that plays a crucial role in the regulation of lipids and glucose metabolism. Ghrelin also has links with fetal development and growth. Gestational diabetes mellitus (GDM) causes fetal macrosomia, but there is no available evidence of a relationship between ghrelin levels and birth weight in women with GDM. The purpose of this study is to investigate whether umbilical cord ghrelin concentrations are altered in full-term pregnant women with GDM compared to women without GDM and whether birth weight is correlated with ghrelin levels. Sixty pregnant women with GDM and 64 healthy pregnant women without GDM were included in this cross-sectional study. Blood samples were drawn from the umbilical vein following birth. Ghrelin concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Umbilical vein ghrelin levels were decreased in women with GDM (879.6 ± 256.1 vs. 972.2 ± 233.6 pg/ml in women without GDM, p=0.033), whereas birth weights were higher for babies in the GDM than in the non-GDM group (3448 ± 410 vs. 3308 ± 365 gr, respectively, p=0.046). Umbilical ghrelin levels were inversely correlated with birth weight (r=-0.765, p<0.001). Multiple regression analysis revealed that birth weight was independently and negatively associated with umbilical ghrelin levels (β= -2.077, 95% CI=-2.652 to -1.492, p=0.002). Umbilical ghrelin levels were lower in GDM women. Birth weight was inversely associated with umbilical ghrelin levels. This association may be explained by a negative feedback mechanism between ghrelin and birth weight.

Evaluating a switch from meconium to umbilical cord tissue for newborn drug testing: A retrospective study at an academic medical center.

PubMed

Palmer, Kendra L; Wood, Kelly E; Krasowski, Matthew D

2017-04-01

The objective of this study was to compare detection rates of newborn drug exposure at an academic medical center transitioning from meconium to umbilical cord tissue toxicology testing. We performed an Institutional Review Board-approved retrospective chart review on all newborns (n=2072) for whom newborn drug testing was ordered at our academic medical center between June 2012 and August 2015 (in August 2013, umbilical cord tissue became the preferred specimen). Meconium toxicology testing was positive for at least one compound in 221 cases (21.3% of 1037 total specimens), with non-medical drug use identified in 85 cases (8.2%). Umbilical cord tissue toxicology testing was positive for at least one compound in 302 cases (29.2%), with non-medical drug use identified in 107 cases (10.3%). Of the cases involving non-medical drug use, the most common compounds detected were tetrahydrocannabinol and amphetamines. Non-medical drug use did not differ significantly between meconium and umbilical cord tissue, either as a total or for classes of drugs such as amphetamines, cannabinoids, and opiates. Maternal non-medical use of tramadol (not tested for in meconium) was identified in 5 cases (0.4%). There were significant differences in rate of detection of iatrogenic medications. Specifically, morphine, lorazepam, phenobarbital, and codeine were more commonly detected in meconium, while oxycodone was more commonly detected in umbilical cord tissue. Umbilical cord tissue toxicology testing yielded a similar detection rate compared to meconium testing. The use of umbilical cord tissue avoids detection of medications given to the neonate prior to meconium collection. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Genome-wide association study reveals a QTL and strong candidate genes for umbilical hernia in pigs on SSC14.

PubMed

Grindflek, Eli; Hansen, Marianne H S; Lien, Sigbjørn; van Son, Maren

2018-05-29

Umbilical hernia is one of the most prevalent congenital defect in pigs, causing economic losses and substantial animal welfare problems. Identification and implementation of genomic regions controlling umbilical hernia in breeding is of great interest to reduce incidences of hernia in commercial pig production. The aim of this study was to identify such regions and possibly identify causative variation affecting umbilical hernia in pigs. A case/control material consisting of 739 Norwegian Landrace pigs was collected and applied in a GWAS study with a genome-wide distributed panel of 60 K SNPs. Additionally candidate genes were sequenced to detect additional polymorphisms that were used for single SNP and haplotype association analyses in 453 of the pigs. The GWAS in this report detected a highly significant region affecting umbilical hernia around 50 Mb on SSC14 (P < 0.0001) explaining up to 8.6% of the phenotypic variance of the trait. The region is rather broad and includes 62 significant SNPs in high linkage disequilibrium with each other. Targeted sequencing of candidate genes within the region revealed polymorphisms within the Leukemia inhibitory factor (LIF) and Oncostatin M (OSM) that were significantly associated with umbilical hernia (P < 0.001). A highly significant QTL for umbilical hernia in Norwegian Landrace pigs was detected around 50 Mb on SSC14. Resequencing of candidate genes within the region revealed SNPs within LIF and OSM highly associated with the trait. However, because of extended LD within the region, studies in other populations and functional studies are needed to determine whether these variants are causal or not. Still without this knowledge, SNPs within the region can be used as genetic markers to reduce incidences of umbilical hernia in Norwegian Landrace pigs.

Ultrasound-guided rectus sheath block in children with umbilical hernia: Case series.

PubMed

Alsaeed, Abdul Hamid; Thallaj, Ahmed; Khalil, Nancy; Almutaq, Nada; Aljazaeri, Ayman

2013-10-01

Umbilical hernia repair, a common day-case surgery procedure in children, is associated with a significant postoperative pain. The most popular peripheral nerve blocks used in umbilical hernia repair are rectus sheath infiltration and caudal block. The rectus sheath block may offer improved pain relief following umbilical hernia repair with no undesired effects such as lower limb motor weakness or urinary retention seen with caudal block which might delay discharge from the hospital. Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks. The aim of this case series is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery. Twenty two (22) children (age range: 1.5-8 years) scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz 50 mm linear probe. An ultrasound-guided posterior rectus sheath block of both rectus abdominis muscles (RMs) was performed (total of 44 punctures). An in-plain technique using Stimuplex A insulated facet tip needle 22G 50mm. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia by means of the modified CHEOPS scale were evaluated. ultrasonograghic visualization of the posterior sheath was possible in all patients. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one patient who postoperatively required morphine 0.1 mg/kg intravenously. There were no complications. Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia. Use of the Stimuplex A insulated facet tip needle 22G 50mm provides easy, less traumatic skin and rectus muscle penetration and satisfactory needle visualiza.

Vitellointestinal Duct Anomalies in Infancy

PubMed Central

Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

2016-01-01

Background: Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5–9 of intrauterine life. Methods: This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Results: Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: patent VID in 9 (56.25%) patients, umbilical cyst in 2(12.25%), umbilical granuloma in 2 (12.25%), and Meckel diverticulum as content of hernia sac in obstructed umbilical hernia in 1 (6.25%) patient. Two patients with umbilical fistula had severe electrolyte disturbance and died without surgical intervention. Conclusion: Persistent VID may have varied presentations in infancy. High output umbilical fistula and excessive bowel prolapse demand urgent surgical intervention to avoid morbidity and mortality. PMID:27433448

Vitellointestinal Duct Anomalies in Infancy.

PubMed

Kadian, Yogender Singh; Verma, Anjali; Rattan, Kamal Nain; Kajal, Pardeep

2016-01-01

Vitellointestinal duct (VID) or omphalomesenteric duct anomalies are secondary to the persistence of the embryonic vitelline duct, which normally obliterates by weeks 5-9 of intrauterine life. This is a retrospective analysis of a total of 16 patients of symptomatic remnants of vitellointestinal duct from period of Jan 2009 to May 2013. Male to female ratio (M:F) was 4.3:1 and mean age of presentation was 2 months and their mode of presentation was: patent VID in 9 (56.25%) patients, umbilical cyst in 2(12.25%), umbilical granuloma in 2 (12.25%), and Meckel diverticulum as content of hernia sac in obstructed umbilical hernia in 1 (6.25%) patient. Two patients with umbilical fistula had severe electrolyte disturbance and died without surgical intervention. Persistent VID may have varied presentations in infancy. High output umbilical fistula and excessive bowel prolapse demand urgent surgical intervention to avoid morbidity and mortality.

Active Vibration Isolation of Microgravity Experiments with Spring Umbilicals Using an Electrodynamic Actuator

NASA Technical Reports Server (NTRS)

Banerjee, B. B.; Allaire, P. E.; Grodsinsky, C. M.

1996-01-01

Microgravity experiments will require active vibration isolation in the low to mid frequency range of 0.1 Hz to 10 Hz. Approximately two orders of acceleration reduction (40 dB) will be required. Previous works have reported results for accelerations transmitted through the umbilical. This paper describes experimental and theoretical results for vibration isolation in one dimension (horizontal) where the simulated experiment is connected to the spacecraft by a spring umbilical. The experiment consisted of a spacecraft (shaker), experiment (mass), umbilical, accelerometer, control electronics, and Lorentz actuator. The experiment mass was supported in magnetic bearings to avoid any stiction problems. Acceleration feedback control was employed to obtain the vibration isolation. Three different spring umbilicals were employed. Acceleration reductions on the order of 40 dB were obtained over the frequency range of 0.1 Hz to 10 Hz. Good agreement was obtained between theory and experiment.

[Persistent neonatal hypoglycaemia caused by arterial positioning of the umbilical venous catheter].

PubMed

Peters, P A G; Brus, F; Noordam, C; Smorenburg, M K; van Setten, P A

2007-10-06

Two neonates, a girl born at 40 2/7 weeks weighing 4165 g and a boy born at 37 6/7 weeks weighing 4040 g, received umbilical venous catheters to help manage hypoglycaemia. The catheter was ineffective or only effective when high doses of glucose were used, due to what later appeared to be arterial positioning of the catheter. Both patients recovered without consequences. Persistent hypoglycaemia is a common problem in newborns and can cause severe neurological sequelae. A relatively uncommon cause is malpositioning of the umbilical catheter. Positioning in an artery leads to direct infusion of glucose into the pancreas, which causes hyperinsulinaemia and can lead to potentially dangerous nonketotic hypoglycaemia. Arterial positioning of the umbilical catheter should be ruled out at an early stage. Correct catheter positioning can be determined using careful inspection of the umbilical veins, radiological examination of the catheter position, blood gas analysis or vascular pulsation.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

A crane has been attached to the Core Stage Forward Skirt Umbilical (CSFSU) to lift it up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Cranes and rigging are being used to lift the Core Stage Forward Skirt Umbilical (CSFSU) into position for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System (SLS) rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-05-25

Seeming to hang in midair, the Core Stage Forward Skirt Umbilical (CSFSU) is lifted high up by crane for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The CSFSU will be located at about the 180-foot level on the tower, above the liquid oxygen tank. The CSFSU is an umbilical that will swing into position to provide connections to the core stage forward skirt of the SLS rocket, and then swing away before launch. Its main purpose is to provide conditioned air/GN2 to the SLS core stage forward skirt cavity. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Eviscerated urinary bladder via ruptured umbilical hernia: a rare occurrence.

PubMed

Pandey, A; Kumar, V; Gangopadhyay, A N; Upadhyaya, V D

2008-06-01

Umbilical hernia is a common problem encountered in children. Rupture and evisceration are very rare phenomena, and the usual content that is eviscerated is the bowel. We present an infant who had a ruptured umbilical hernia with eviscerated urinary bladder dome. As this is the first case of its kind, it is being reported with a brief review of literature.

Persistent Umbilical Discharge from an Omphalomesenteric Duct Cyst Containing Gastric Mucosa

PubMed Central

Tamilselvan, Kanimozhi; Mohan, Arunodaya; Cheslyn-Curtis, Sarah; Eisenhut, Michael

2012-01-01

Umbilical discharge in infancy is often attributed to infection or an umbilical granuloma. It is important to investigate if such a discharge is due to an underlying congenital abnormality because corrective surgical intervention may then be required. We present the first case of an infant with a persistent umbilical discharge from an omphalomesenteric duct cyst. The discharge was associated with periumbilical dermatitis. The dermatitis was most likely due to irritation of the skin by gastric acid produced by the ectopic gastric mucosa contained in the omphalomesenteric duct cyst. Both discharge and dermatitis resolved after surgical removal of the cyst. PMID:22693676

Assessment of umbilical artery flow and fetal heart rate to predict delivery time in bitches.

PubMed

Giannico, Amália Turner; Garcia, Daniela Aparecida Ayres; Gil, Elaine Mayumi Ueno; Sousa, Marlos Gonçalves; Froes, Tilde Rodrigues

2016-10-15

The aim of this study was to quantitatively investigate the oscillation of the fetal heart rate (HR) in advance of normal delivery and whether this index could be used to indicate impending delivery. In addition, fetal HR oscillation and umbilical artery resistive index (RI) were correlated to determine if the combination of these parameters provided a more accurate prediction of the time of delivery. Sonographic evaluation was performed in 11 pregnant bitches to evaluate the fetal HR and umbilical artery RI at the following antepartum times: 120 to 96 hours, 72 to 48 hours, 24 to 12 hours, and 12 to 1 hours. Statistical analysis indicated a correlation between the oscillation of fetal HR and the umbilical artery RI. As delivery approached a considerable reduction in the umbilical artery RI was documented and greater oscillations between maximum and minimum HRs occurred. We conclude that the quantitative analysis of fetal HR oscillations may be used to predict the time of delivery in bitches. The combination of fetal HR and umbilical artery RI together may provide more accurate predictions of time of delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

A "Kane's Dynamics" Model for the Active Rack Isolation System

NASA Astrophysics Data System (ADS)

Rupert, J. K.; Hampton, R. D.; Beech, G. S.

2005-02-01

In the late 1980s, microgravity researchers began to voice their concern that umbilical-transmitted energy could significantly degrade the acceleration environment of microgravity space science experiments onboard manned spacecraft. Since umbilicals are necessary for many experiments, control designers began to seek ways to compensate for these "indirect" disturbances. Hampton, et al., used the Kane s method to develop a model of the active rack isolation system (ARIS) that includes (1) actuator control forces, (2) direct disturbance forces, and (3) indirect, actuator-transmitted disturbances. Their model does not, however, include the indirect, umbilical-transmitted disturbances. Since the umbilical stiffnesses are not negligible, these indirect disturbances must be included in the model. Until the umbilicals have been appropriately included, the model will be incomplete. This Technical Memorandum presents a nonlinear model of ARIS with umbilicals included. Model verification was achieved by utilizing two commercial-off-the-shelf software tools. Various forces and moments were applied to the model to yield simulated responses of the system. Plots of the simulation results show how various critical points on an ARIS-outfitted international standard payload rack behave under the application of direct disturbances, indirect disturbances, and control forces. Simulations also show system response to a variety of initial conditions.

Design of the Core Stage Inter-Tank Umbilical {CSITU) Compliance Mechanism

NASA Technical Reports Server (NTRS)

Smith, Kurt R.

2013-01-01

Project Goals: a) Design the compliance mechanism for the CSITU system to a 30% level -3D models completed in Pro/Engineer -Relevant design analysis b) Must meet all system requirements and establish basis for proceeding with detailed design. Tasks to be completed: A design that meets requirements for the 30% design review, 01/16/2013. Umbilical arms provide commodities to the launch vehicle prior to T-0. Commodities can range anywhere from hydraulics, pneumatics, cryogenic, electrical, ECS, etc ... Umbilicals commonly employ truss structures to deliver commodities to vehicle. Common configurations include: -Tilt-up -Swing Arm -Hose Drape -Drop Arm Umbilical arms will be mounted to Mobile Launch Platform. SLS currently has 9 T-0 umbilical arms. The compliance refers to the ability of the umbilical to adjust to minor changes in vehicle location. The compliance mechanism refers to the mechanism on the ground support equipment {GSE) that compensates for these changes. For the CSITU, these minor changes, or vehicle excursions, can be up to +4 in. Excursions refer to movements of the vehicle caused by wind loads and thermal expansion. It is ideal to have significant vertical compliance so a passive secondary release mechanism may be implemented.

Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

PubMed Central

2011-01-01

Introduction The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia. Case presentation An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum. Conclusion We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure. PMID:21539740

The Perfect Mate for Safe Fueling

NASA Technical Reports Server (NTRS)

2004-01-01

Referred to as the "lifeline for any space launch vehicle" by NASA Space Launch Initiative Program Manager Warren Wiley, an umbilical is a large device that transports power, communications, instrument readings, and fluids such as propellants, pressurization gases, and coolants from one source to another. Numerous launch vehicles, planetary systems, and rovers require umbilical "mating". This process is a driving factor for dependable and affordable space access. With future-generation space vehicles in mind, NASA recently designed a smart, automated method for quickly and reliably mating and demating electrical and fluid umbilical connectors. The new umbilical concept is expected to replace NASA s traditional umbilical systems that release at vehicle lift-off (T-0). The idea is to increase safety by automatically performing hazardous tasks, thus reducing potential failure modes and the time and labor hours necessary to prepare for launch. The new system will also be used as a test bed for quick disconnect development and for advance control and leak detection. It incorporates concepts such as a secondary mate plate, robotic machine vision, and compliant motor motion control, and is destined to advance usage of automated umbilicals in a variety of aerospace and commercial applications.

Cryopreserved, Xeno-Free Human Umbilical Cord Mesenchymal Stromal Cells Reduce Lung Injury Severity and Bacterial Burden in Rodent Escherichia coli-Induced Acute Respiratory Distress Syndrome.

PubMed

Curley, Gerard F; Jerkic, Mirjana; Dixon, Steve; Hogan, Grace; Masterson, Claire; O'Toole, Daniel; Devaney, James; Laffey, John G

2017-02-01

Although mesenchymal stem/stromal cells represent a promising therapeutic strategy for acute respiratory distress syndrome, clinical translation faces challenges, including scarcity of bone marrow donors, and reliance on bovine serum during mesenchymal stem/stromal cell proliferation. We wished to compare mesenchymal stem/stromal cells from human umbilical cord, grown in xeno-free conditions, with mesenchymal stem/stromal cells from human bone marrow, in a rat model of Escherichia coli pneumonia. In addition, we wished to determine the potential for umbilical cord-mesenchymal stem/stromal cells to reduce E. coli-induced oxidant injury. Randomized animal study. University research laboratory. Male Sprague-Dawley rats. Acute respiratory distress syndrome was induced in rats by intratracheal instillation of E. coli (1.5-2 × 10 CFU/kg). "Series 1" compared the effects of freshly thawed cryopreserved umbilical cord-mesenchymal stem/stromal cells with bone marrow-mesenchymal stem/stromal cells on physiologic indices of lung injury, cellular infiltration, and E. coli colony counts in bronchoalveolar lavage. "Series 2" examined the effects of cryopreserved umbilical cord-mesenchymal stem/stromal cells on survival, as well as measures of injury, inflammation and oxidant stress, including production of reactive oxidative species, reactive oxidative species scavenging by superoxide dismutase-1 and superoxide dismutase-2. In "Series 1," animals subjected to E. coli pneumonia who received umbilical cord-mesenchymal stem/stromal cells had improvements in oxygenation, respiratory static compliance, and wet-to-dry ratios comparable to bone marrow-mesenchymal stem/stromal cell treatment. E. coli colony-forming units in bronchoalveolar lavage were reduced in both cell therapy groups, despite a reduction in bronchoalveolar lavage neutrophils. In series 2, umbilical cord-mesenchymal stem/stromal cells enhanced animal survival and decreased alveolar protein and proinflammatory cytokine concentrations, whereas increasing interleukin-10 concentrations. Umbilical cord-mesenchymal stem/stromal cell therapy decreased nicotinamide adenine dinucleotide phosphate-oxidase 2 and inducible nitric oxide synthase and enhanced lung concentrations of superoxide dismutase-2, thereby reducing lung tissue reactive oxidative species concentrations. Our results demonstrate that freshly thawed cryopreserved xeno-free human umbilical cord-mesenchymal stem/stromal cells reduce the severity of rodent E. coli-induced acute respiratory distress syndrome. Umbilical cord-mesenchymal stem/stromal cells, therefore, represent an attractive option for future clinical trials in acute respiratory distress syndrome.

Newborns' temperature submitted to radiant heat and to the Top Maternal device at birth.

PubMed

Albuquerque, Rosemeire Sartori de; Mariani, Corintio; Bersusa, Ana Aparecida Sanches; Dias, Vanessa Macedo; Silva, Maria Izabel Mota da

2016-08-08

to compare the axillar temperatures of newborns that are put immediately after birth in skin-to-skin contact under the Top Maternal device, as compared to those in a radiant heat crib. comparatives observational study of the case-control type about temperature of 60 babies born at the Obstetric Center and Normal Delivery Center of a public hospital of the municipality of Sao Paulo, being them: 29 receiving assistance in heated crib and 31 in skin-to skin contact, shielded by a cotton tissue placed on mother's thorax, called Top Maternal. the temperature of the babies of the skin-to-skin contact group presented higher values in a larger share of the time measures verified, as compared to those that were placed in radiant heat crib, independently from the place of birth. Differences between the two groups were not statistically significant. the study contributes to generate new knowledge, supporting the idea of keeping babies with their mothers immediately after birth protected with the Maternal Top, without harming their wellbeing, as it keeps the axillar temperature in recommendable levels. comparar a temperatura axilar dos recém-nascidos acomodados - imediatamente após o nascimento - em contato pele a pele, sob o Top Maternal, em berço de calor radiante. estudo comparativo observacional do tipo Caso-Controle sobre a temperatura de 60 bebês nascidos no Centro Obstétrico e Centro de Parto Normal de um hospital público do município de São Paulo, sendo: 29 assistidos em berço aquecido e 31 em contato pele a pele, protegidos por uma malha de algodão colocada sobre o tórax da mãe, denominada Top Maternal. a temperatura dos bebês do grupo de contato pele a pele teve maior valor na maioria dos tempos verificados comparada à dos que foram colocados em berço de calor radiante, independentemente do local de nascimento. A diferença entre os grupos não foi estatisticamente significante. o estudo contribui com a geração de um novo conhecimento que sustenta a manutenção dos bebês com suas mães imediatamente após o nascimento por meio do contato pele a pele protegidos pelo Top Maternal, sem prejuízos ao seu bem-estar, uma vez que a temperatura axilar se manteve em níveis recomendáveis. comparar la temperatura axilar de los recién nacidos (Rn) acomodados, inmediatamente después del nacimiento, en contacto piel con piel, bajo el Top Maternal, en cuna de calor radiante. estudio comparativo observacional del tipo Caso Control sobre la temperatura de 60 bebés nacidos en el Centro Obstétrico y Centro de Parto Normal de un hospital público del municipio de Sao Paulo, siendo: 29 asistidos en cuna calentada y 31 en contacto piel con piel, protegidos por un tejido de algodón colocado sobre el tórax de la madre, denominado Top Maternal. la temperatura de los bebés del grupo de contacto piel con piel fue más alta en la mayoría de los tiempos verificados, ello comparado con los que fueron colocados en cuna de calor radiante, independientemente del local de nacimiento. La diferencia entre los grupos no fue estadísticamente significativa. el estudio contribuye con la generación de un nuevo conocimiento que sustenta que se debe mantener a los bebés con sus madres inmediatamente después del nacimiento por medio del contacto piel con piel protegidos por el Top Maternal, sin perjuicios a su bienestar, una vez que la temperatura axilar se mantuvo en niveles recomendables.

Clinical accuracy of non-contact infrared thermometer from umbilical region in children: A new side.

PubMed

Apa, Hurşit; Gözmen, Salih; Keskin-Gözmen, Şükran; Aslan, Fatma; Bayram, Nuri; Devrim, İlker

2016-01-01

Measurement from axillary site with digital thermometer has been accepted as the most accurate method. But this method is time consuming. Tympanic and forehead measurements are often used but don't always seem to be more appropriate. Another site, umbilical region, could be an alternative site. This study aims to compare the measurements with axillary digital thermometer and non-contact infrared thermometers at sites from umbilicus and forehead to determine whether umbilical site could be used accurately in children. For each method, 2,048 measurements in total were performed. Using axillary method as gold standard, with a cut-off temperature of 38oC, the sensitivities and specificities, positive and negative predictive values of umbilical and forehead temperatures and area under the ROC curve were determined in non obese children. There was a significant positive correlation between axillary and umbilical temperatures with a correlation coefficient of 0.78. The average difference between the mean of both axillary and umbilical temperatures was -0.47 ± 0.65°C. The Bland-Altman plot showed good accuracy with only 2.5 % of the readings falling outside the 95% level of confidence. Umbilical measurements showed sensitivity of 71.7% and specificity of 95.8%. The area under the ROC curve was 0.93. The easy application may lead noncontact measurements from umbilicus site to be the preferable method for health care providers, but agreement limits mentioned in this study should be considered.

[Umbilical blood-gas status at cesarean section for breech presentation: a comparison with vertex presentation].

PubMed

Haruta, M; Saeki, N; Naka, Y; Funato, T; Ohtsuki, Y

1989-10-01

Umbilical blood-gas status at elective cesarean section with oxygen inhalation for breech presentation (25 cases) was compared with that for vertex presentation (25 cases), so as to confirm the security of full-term breech fetuses delivered by cesarean section under spinal anesthesia. Umbilical arterial oxygen levels were significantly lower in the breech group (Mean PO2:18.9 mmHg; SO2:37.3%; Oxygen content:7.6 ml/dl). The number of hypoxemic fetuses was significantly higher in the breech group (the breech: 7; the vertex; 0). The other umbilical blood-gas values revealed no significant differences between the breech and vertex groups, and were within normal limits in both groups. Oxygen extraction in the breech (Mean: 49.0%) was higher than that in the vertex (32.9%). Therefore decreased umbilical blood flow in the breech was suggested. The incidence of depression at 1 minute after delivery in the breech infants (24%) was significantly higher than that in the vertex infants (0%). It became obvious in the breech that as the interval between the uterine incision and delivery increased, umbilical arterial blood tended to acidosis and the 1 minute Apgar score decreased. Cesarean section for breech presentation requires sufficient and optimal incisions of the abdominal wall and uterus as well as a skillful manual delivery technique, because the fetus or neonate should be protected against asphyxia resulting from umbilical compression and prolonged delivery interval.

Umbilical artery histomorphometry: a link between the intrauterine environment and kidney development.

PubMed

DeFreitas, M J; Mathur, D; Seeherunvong, W; Cano, T; Katsoufis, C P; Duara, S; Yasin, S; Zilleruelo, G; Rodriguez, M M; Abitbol, C L

2017-06-01

Prematurity is a risk factor for hypertension, vascular stiffness, nephron deficit and adult onset cardiorenal disease. The vascular tree and kidneys share morphogenic drivers that promote maturation in utero before 36 weeks of gestation. Vascular elastin accrual terminates after birth leaving collagen to promote vascular stiffness. Our objective was to determine if the histomorphometry of the umbilical artery, an extension of the aorta, parallels nephron mass across gestational age groups. From a cohort of 54 newborns, 32 umbilical cord specimens were adequate for evaluation. The umbilical cord was sectioned, stained with trichrome, and digitalized. Muscular and collagenous areas of the umbilical artery were measured in pixels using the Image J 1.48q software. Total kidney volume was measured by ultrasound and factored by body surface area (TKV/BSA). The umbilical artery total area was significantly greater in term v. preterm infants (9.3±1.3 v. 7.0±2.0 mm2; P<0.05) and increased with gestational age; while the percent muscular and collagen areas were independent of gestational age (R 2=0.04; P=ns). Percent muscular area correlated positively with TKV/BSA (r=0.53; P=0.002); while an increase in collagen correlated inversely with kidney mass (r=-0.53; P=0.002). In conclusion, an enhanced % muscular area and presumed vascular elasticity was associated with increased renal mass in all infants. Umbilical artery histomorphometry provides a link between the intrauterine environment, vascular and kidney development.

A new approach to umbilical hernia repair: the circular suture technique for defects less than 2 cm.

PubMed

Yıldız, Ihsan; Koca, Yavuz Savas

2017-01-01

Umbilical hernia, unlike other abdominal wall hernias, occurs when the umbilical ring opens and expands. Its' symptoms and complications show similarities with other hernias. Although there are various repair techniques, there is not a standard technique yet. This paper investigated the outcomes of double layer circular suture technique as a new approach in the repair of umbilical hernia. A total number of 282 patients comprised of 102 males and 180 females with an age range of 18-89 whose umbilical hernias were repaired between 2002 and 2013, retrospectively studied in two groups group 1 (circular suture technique) and group 2 (open primary suture). The subjects were investigated with regards to age, sex, body mass index (BMI), accompanying disease, anesthesia method, surgical complications, hospital stay, total costs, mortality and recurrence. The study participants were 282 patients with an age average of 49, 09 ± 16, 62 including 182 patients in group 1 (male/female ratio 76/106) and 100 patients in group 2 (26/74). There was a significant difference between the groups in terms of time and recurrence. During the follow-up period, 9 patients in group 1 (4.94%) and 16 patients in group 2 (16%) had a recurrence. This result was statistically significant (p=0.014) CONCLUSION: We believe that the double layer circular suture technique is practical, inexpensive and effective in the repair of umbilical hernia defects, which are smaller than 2 cm diameter. Key words: Hernia, Repair, Umbilical hernia.

Factors Associated With Long-term Outcomes of Umbilical Hernia Repair.

PubMed

Shankar, Divya A; Itani, Kamal M F; O'Brien, William J; Sanchez, Vivian M

2017-05-01

Umbilical hernia repair is one of the most commonly performed general surgical procedures. However, there is little consensus about the factors that lead to umbilical hernia recurrence. To better understand the factors associated with long-term umbilical hernia recurrence. A retrospective cohort of 332 military veteran patients who underwent umbilical hernia repair was studied between January 1, 1998, and December 31, 2008, at the VA Boston Healthcare System. Recurrence and mortality outcomes were tracked from that period until June 1, 2014. Data were collected on patient characteristics, operative, and postoperative factors and univariate and multivariable analyses were used to assess which factors were significantly associated with umbilical hernia recurrence and mortality. All patients with primary umbilical hernia repair, with or without a concurrent unrelated procedure, were included in the study. Patients excluded were those who underwent umbilical hernia repair as a part of another major planned procedure with abdominal incisions. Data were collected from June 1, 2014, to November 1, 2015. Statistical analysis was performed from November 2, 2015, to April 1, 2016. The primary study outcomes were umbilical hernia recurrence and death. Of the 332 patients in this study, 321 (96.7%) were male, mean age was 58.4 years, and mean (SD) time of follow-up was 8.5 (4.1) years. The hernia recurrence rate was 6.0% (n = 20) at a mean 3.1 years after index repair (median, 1.0-year; range, 0.33-13 years). The primary suture repair recurrence rate was 9.8% (16 of 163 patients), and the mesh repair recurrence rate was 2.4% (4 of 169 patients). On univariate analysis, ascites (P = .02), liver disease (P = .02), diabetes (P = .04), and primary suture (nonmesh) repairs (P = .04) were significantly associated with increased recurrence rates. Patients who had a history of hernias (125 [39%]) were less likely to have umbilical hernia recurrences (χ21 = 4.65, P = .03). On multivariable regression analysis, obesity and ascites were associated with significantly increased odds ratios of recurrence of 3.3 (95% CI, 1.0-10.1) and 8.0 (95% CI, 1.8-34.4), respectively. Mesh repair was seen to decrease recurrence with odds of 0.28 (95% CI, 0.08-0.95). There was no significant difference in complication rates between mesh repair and primary suture repair. The survival rate was 73% (n = 242) at the end of the study. Factors associated with mortality were older age, smoking, liver disease, ascites, emergency or semiurgent repair, and need for intraoperative bowel resection. Ascites, liver disease, diabetes, obesity, and primary suture repair without mesh are associated with increased umbilical hernia recurrence rates. Elective umbilical hernia repair with mesh should be considered in patients with multiple comorbidities given that the use of mesh offers protection from recurrence without major morbidity.

Factors Associated With Long-term Outcomes of Umbilical Hernia Repair

PubMed Central

Shankar, Divya A.; Itani, Kamal M. F.; O’Brien, William J.

2017-01-01

Importance Umbilical hernia repair is one of the most commonly performed general surgical procedures. However, there is little consensus about the factors that lead to umbilical hernia recurrence. Objective To better understand the factors associated with long-term umbilical hernia recurrence. Design, Setting, and Participants A retrospective cohort of 332 military veteran patients who underwent umbilical hernia repair was studied between January 1, 1998, and December 31, 2008, at the VA Boston Healthcare System. Recurrence and mortality outcomes were tracked from that period until June 1, 2014. Data were collected on patient characteristics, operative, and postoperative factors and univariate and multivariable analyses were used to assess which factors were significantly associated with umbilical hernia recurrence and mortality. All patients with primary umbilical hernia repair, with or without a concurrent unrelated procedure, were included in the study. Patients excluded were those who underwent umbilical hernia repair as a part of another major planned procedure with abdominal incisions. Data were collected from June 1, 2014, to November 1, 2015. Statistical analysis was performed from November 2, 2015, to April 1, 2016. Main Outcomes and Measures The primary study outcomes were umbilical hernia recurrence and death. Results Of the 332 patients in this study, 321 (96.7%) were male, mean age was 58.4 years, and mean (SD) time of follow-up was 8.5 (4.1) years. The hernia recurrence rate was 6.0% (n = 20) at a mean 3.1 years after index repair (median, 1.0-year; range, 0.33-13 years). The primary suture repair recurrence rate was 9.8% (16 of 163 patients), and the mesh repair recurrence rate was 2.4% (4 of 169 patients). On univariate analysis, ascites (P = .02), liver disease (P = .02), diabetes (P = .04), and primary suture (nonmesh) repairs (P = .04) were significantly associated with increased recurrence rates. Patients who had a history of hernias (125 [39%]) were less likely to have umbilical hernia recurrences (χ21 = 4.65, P = .03). On multivariable regression analysis, obesity and ascites were associated with significantly increased odds ratios of recurrence of 3.3 (95% CI, 1.0-10.1) and 8.0 (95% CI, 1.8-34.4), respectively. Mesh repair was seen to decrease recurrence with odds of 0.28 (95% CI, 0.08-0.95). There was no significant difference in complication rates between mesh repair and primary suture repair. The survival rate was 73% (n = 242) at the end of the study. Factors associated with mortality were older age, smoking, liver disease, ascites, emergency or semiurgent repair, and need for intraoperative bowel resection. Conclusions and Relevance Ascites, liver disease, diabetes, obesity, and primary suture repair without mesh are associated with increased umbilical hernia recurrence rates. Elective umbilical hernia repair with mesh should be considered in patients with multiple comorbidities given that the use of mesh offers protection from recurrence without major morbidity. PMID:28122076

44. VIEW OF UMBILICAL MAST AND LAUNCH PAD FROM SOUTHWEST. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

44. VIEW OF UMBILICAL MAST AND LAUNCH PAD FROM SOUTHWEST. DOORS FOR THE UMBILICAL MAST TRENCH RAISED FOR MAINTENANCE POSITION OF 10 DEGREES. LAUNCHER IS RIGHT OF MAST; RAILS PARALLEL TO MAST. CONTROL PANELS LEFT TO RIGHT: ELECTRICAL PANEL, COMMUNICATIONS PANEL, AND MAST CONTROL PANEL. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Term Neonate with Atypical Hypoxic-Ischemic Encephalopathy Presentation: A Case Report

PubMed Central

Townley, Nick; McNellis, Emily; Sampath, Venkatesh

2017-01-01

We describe a case of atypical hypoxic-ischemic encephalopathy (HIE) in a neonate following a normal pregnancy and delivery who was found to have an umbilical vein thrombosis. The infant arrived to our center with continuous bicycling movement of her lower extremities. She had a continuous electroencephalogram that showed burst suppression and magnetic resonance imaging of the brain showed diffusely abnormal cerebral cortical/subcortical diffusion restriction which may be secondary hypoxic-ischemic injury. Interestingly, a pathology report noted a focal umbilical vein thrombosis appearing to have compressed an umbilical artery with associated arterial dissection and hematoma. Our case illustrates how umbilical venous or arterial thrombosis may be associated with HIE and refractory seizures. PMID:28852582

Term Neonate with Atypical Hypoxic-Ischemic Encephalopathy Presentation: A Case Report.

PubMed

Townley, Nick; McNellis, Emily; Sampath, Venkatesh

2017-07-01

We describe a case of atypical hypoxic-ischemic encephalopathy (HIE) in a neonate following a normal pregnancy and delivery who was found to have an umbilical vein thrombosis. The infant arrived to our center with continuous bicycling movement of her lower extremities. She had a continuous electroencephalogram that showed burst suppression and magnetic resonance imaging of the brain showed diffusely abnormal cerebral cortical/subcortical diffusion restriction which may be secondary hypoxic-ischemic injury. Interestingly, a pathology report noted a focal umbilical vein thrombosis appearing to have compressed an umbilical artery with associated arterial dissection and hematoma. Our case illustrates how umbilical venous or arterial thrombosis may be associated with HIE and refractory seizures.

Nurses' guide to early detection of umbilical arterial catheter complications in infants.

PubMed

Furdon, Susan Arana; Horgan, Michael J; Bradshaw, Wanda Todd; Clark, David A

2006-10-01

Umbilical arterial catheters (UAC) are routinely used in the care of critically ill newborns. Complications related to UACs include vascular compromise, hemorrhage, complications related to malposition, severance of the catheter itself, and infection. This article is Part II in a series dedicated to assessing infants with an umbilical catheter. Part I focused on infants with umbilical venous catheters; this article will focus on the physical assessment relevant to infants with an UAC. Complications related to UACs can occur during any phase of treatment: insertion, while indwelling, or after discontinuing the catheter. Review of clinical signs of complications along with clinical photographs, will assist caregivers in promptly recognizing UAC-related complications.

[Hernia surgery in urology: part 1: inguinal, femoral and umbilical hernias - fundamentals of clinical diagnostics and treatment].

PubMed

Franz, T; Schwalenberg, T; Dietrich, A; Müller, J; Stolzenburg, J-U

2013-05-01

Hernias are a common occurrence with correspondingly huge clinical and economic impacts on the healthcare system. The most common forms of hernia which need to be diagnosed and treated in routine urological work are inguinal and umbilical hernias. With the objective of reconstructing and stabilizing the inguinal canal there are the possibilities of open and minimally invasive surgery and both methods can be performed with suture or mesh repair. Indications for surgery of umbilical hernias are infrequent although this is possible with little effort under local anesthesia. This article presents an overview of the epidemiology, pathogenesis, clinical symptoms, diagnostics and therapy of inguinal, femoral and umbilical hernias.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

A crane lifts the Orion Service Module Umbilical (OSMU) high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Umbilical cord blood transplants: treatment for selected hematologic and oncologic diseases.

PubMed

Stevens, K

1997-12-01

Umbilical cord blood transplantation is a rapidly growing form of treatment for many types of cancer and hematologic disorders. The concepts behind the use of umbilical cord blood transplantation are based on information gained from experience in bone marrow transplantation. Previously discarded as human waste, the blood in the umbilical cord remnant and the placenta has been observed to be rich in hematopoietic stem cells. Techniques for collecting these stem cells from the placenta may vary among the institutions, physicians, and other health care providers, including midwives and nurse practitioners, involved with this procedure. This source of hematopoietic stem cells in transplantation has many advantages, disadvantages, and controversies associated with its use.

Simultaneous Umbilical Hernia Repair with Transumbilical Ventriculoperitoneal Shunt Placement.

PubMed

Montalbano, Michael J; Loukas, Marios; Oakes, W Jerry; Tubbs, R Shane

2017-01-01

Recently, placement of a ventriculoperitoneal shunt via a transumbilical approach has been reported. Herein, we report the repair of an umbilical hernia via the same incision and introduction of the distal end of a ventricultoperitoneal shunt into the peritoneal cavity in 3 patients. A case illustration is included. Both hernia repair and placement of the distal end of the ventriculoperitoneal shunt were uncomplicated in our small case series. To our knowledge, simultaneous repair of an umbilical hernia followed by transumbilical shunt placement has not been reported. As umbilical hernias are so common in infants, this finding, based on our experience, should not exclude placement of peritoneal tubing in the same setting. © 2017 S. Karger AG, Basel.

Umbilical Connect Techniques Improvement-Technology Study

NASA Technical Reports Server (NTRS)

Valkema, Donald C.

1972-01-01

The objective of this study was to develop concepts, specifications, designs, techniques, and procedures capable of significantly reducing the time required to connect and verify umbilicals for ground services to the space shuttle. The desired goal was to reduce the current time requirement of several shifts for the Saturn 5/Apollo to an elapsed time of less than one hour to connect and verify all of the space shuttle ground service umbilicals. The study was conducted in four phases: (1) literature and hardware examination, (2) concept development, (3) concept evaluation and tradeoff analysis, and (4) selected concept design. The final product of this study was a detail design of a rise-off disconnect panel prototype test specimen for a LO2/LH2 booster (or an external oxygen/hydrogen tank for an orbiter), a detail design of a swing-arm mounted preflight umbilical carrier prototype test specimen, and a part 1 specification for the umbilical connect and verification design for the vehicles as defined in the space shuttle program.

Umbilical Stiffness Matrix Characterization and Testing for Microgravity Science Payloads

NASA Technical Reports Server (NTRS)

Engberg, Robert C.

2003-01-01

This paper describes efforts of testing and analysis of various candidate cables and umbilicals for International Space Station microgravity science payloads. The effects of looping, large vs. small displacements, and umbilical mounting configurations were assessed. A 3-DOF stepper motor driven fixture was used to excite the umbilicals. Forces and moments were directly measured in all three axes with a 6-DOF load cell in order to derive suitable stiffness matrices for design and analysis of vibration isolation controllers. Data obtained from these tests were used to help determine the optimum type and configuration of umbilical cables for the International Space Station microgravity science glovebox (MSG) vibration isolation platform. The data and procedures can also be implemented into control algorithm simulations to assist in validation of actively controlled vibration isolation systems. The experimental results of this work are specific in support of the Glovebox Integrated Microgravity Isolation Technology (g-LIMIT) isolation platform, to be located in the microgravity science glovebox aboard the U.S. Destiny Laboratory Module.

Cardiac tamponade due to umbilical venous catheter in the new born

PubMed Central

Abdellatif, Mohamed; Ahmed, Ashfag; Alsenaidi, Khalfan

2012-01-01

With more and more extreme premature and very low-birth weight babies being resuscitated, umbilical central venous catheterisation is now being used more frequently in neonatal intensive care. The authors present a case of cardiac tamponade following umbilical venous catheterisation in a neonate, an uncommon, yet potentially fatal complication. The patient was diagnosed at the appropriate time by echocardiography and urgent pericardiocentesis proved lifesaving. PMID:22802560

The effects of compound danshen dripping pills and human umbilical cord blood mononuclear cell transplant after acute myocardial infarction.

PubMed

Jun, Yi; Chunju, Yuan; Qi, Ai; Liuxia, Deng; Guolong, Yu

2014-04-01

The low frequency of survival of stem cells implanted in the myocardium after acute myocardial infarction may be caused by inflammation and oxidative stress in the myocardial microenvironment. We evaluated the effects of a traditional Chinese medicine, Compound Danshen Dripping Pills, on the cardiac microenvironment and cardiac function when used alone or in combination with human umbilical cord blood mononuclear cell transplant after acute myocardial infarction. After surgically induced acute myocardial infarction, rabbits were treated with Compound Danshen Dripping Pills alone or in combination with human umbilical cord blood mononuclear cell transplant. Evaluation included histology, measurement of left ventricular ejection fraction and fractional shortening, leukocyte count, count of green fluorescent protein positive cells, superoxide dismutase activity, and malondialdehyde content. Combination treatment with Compound Danshen Dripping Pills and human umbilical cord blood mononuclear cell transplant significantly increased the survival of implanted cells, inhibited cardiac cell apoptosis, decreased oxidative stress, decreased the inflammatory response, and improved cardiac function. Rabbits treated with either Compound Danshen Dripping Pills or human umbilical cord blood mononuclear cells alone had improvement in these effects compared with untreated control rabbits. Combination therapy with Compound Danshen Dripping Pills and human umbilical cord blood mononuclear cells may improve cardiac function and morphology after acute myocardial infarction.

Hypoxic ischemic encephalopathy in newborns linked to placental and umbilical cord abnormalities.

PubMed

Nasiell, Josefine; Papadogiannakis, Nikos; Löf, Erika; Elofsson, Fanny; Hallberg, Boubou

2016-03-01

Birth asphyxia and hypoxic ischemic encephalopathy (HIE) of the newborn remain serious complications. We present a study investigating if placental or umbilical cord abnormalities in newborns at term are associated with HIE. A prospective cohort study of the placenta and umbilical cord of infants treated with hypothermia (HT) due to hypoxic brain injury and follow-up at 12 months of age has been carried out. The study population included 41 infants treated for HT whose placentas were submitted for histopathological analysis. Main outcome measures were infant development at 12 months, classified as normal, cerebral palsy, or death. A healthy group of 100 infants without HIE and normal follow-up at 12 months of age were used as controls. A velamentous or marginal umbilical cord insertion and histological abruption was associated with the risk of severe HIE, OR = 5.63, p = 0.006, respectively, OR = 20.3, p = 0.01 (multiple-logistic regression). Velamentous or marginal umbilical cord insertion was found in 39% among HIE cases compared to 7% in controls. Placental and umbilical cord abnormalities have a profound association with HIE. A prompt examination of the placentas of newborns suffering from asphyxia can provide important information on the pathogenesis behind the incident and contribute to make a better early prognosis.

Umbilical Negative Pressure Dressing for Transumbilical Appendectomy in Childern.

PubMed

Seifarth, Federico G; Kundu, Neilendu; Guerron, Alfredo D; Garland, Mary M; Gaffley, Michaela W G; Worley, Sarah; Knight, Colin G

2016-01-01

Transumbilical laparoscopic-assisted appendectomy (TULAA) carries a high risk for surgical site infection. We investigated the effect of a bio-occlusive umbilical vacuum dressing on wound infection rates after TULAA for patients with acute appendicitis and compared to it with a conventional 3-port appendectomy with a nonvacuum dressing. This study was a retrospective chart review of 1377 patients (2-20 years) undergoing laparoscopic appendectomy for acute appendicitis in 2 tertiary care referral centers from January 2007 through December 2012. Twenty-two different operative technique/dressing variations were documented. The 6 technique/dressing groups with >50 patients were assessed, including a total of 1283 patients. The surgical site infection rate of the 220 patients treated with TULAA and application of an umbilical vacuum dressing with dry gauze is 1.8% (95% CI, 0.0-10.3%). This compares to an infection rate of 4.1% (95% CI, 1.3-10.5%) in 97 patients with dry dressing without vacuum. In the 395 patients who received an umbilical vacuum dressing with gauze and bacitracin, the surgical site infection rate was found to be 4.3% (95% CI, 2.7-6.8%). Application of an umbilical negative-pressure dressing with dry gauze lowers the rate of umbilical site infections in patients undergoing transumbilical laparoscopic-assisted appendectomy for acute appendicitis.

Outcome of sublay mesh repair in non-complicated umbilical hernia with liver cirrhosis and ascites.

PubMed

Hassan, Ahmed Mohamed Abdelaziz; Salama, Asaad Fayrouz; Hamdy, Hussam; Elsebae, Magdy Mohamed; Abdelaziz, Ayman Mohamed; Elzayat, Wessam Abdelrahman

2014-01-01

Umbilical hernia repair is often accompanied by complications in patients with liver cirrhosis and ascites. It appears that the early elective repair of umbilical hernias in these patients is safer and can be considered for selected patients. The objective of this study is to evaluate the feasibility, safety, complications and technical aspects of sublay mesh repair of umbilical hernia in cirrhotic patients with ascites. Between October 2010 and April 2013, 70 patients with non-complicated umbilical hernia, liver cirrhosis and ascites were enrolled in this study. All patients underwent sublay mesh repair. Demographic data, preoperative variables, peri-operative course, and postoperative complications were recorded and analyzed. A total of 38 women and 32 men underwent operation at an average age 51.24 years. The patients mean MELD score was 18 (range 12-25). The mean operative time was 67.45 min and the average hospital stay was 3.8 days. 2 patients had wound infection, 3 patients developed seroma and 1 patient had an ascitic fistula. Recurrence occurred in 1 (1.4%) patient and no mortality related to the procedure. elective sublay umbilical hernia mesh repair is a safe approach and feasible technique in selected non-complicated cirrhotic patients with ascites. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

The prevalence of umbilical and epigastric hernia repair: a nationwide epidemiologic study.

PubMed

Burcharth, J; Pedersen, M S; Pommergaard, H-C; Bisgaard, T; Pedersen, C B; Rosenberg, J

2015-10-01

Umbilical and epigastric hernia repair are common surgical procedures; however, the nationwide gender and age-specific prevalence of these repairs is unknown, and this knowledge could form the basis for new studies. A nationwide register-based study covering all people living in Denmark on December 31st, 2010 was performed. Within this population all umbilical and epigastric hernia repairs from January 1st, 2006 to December 31st, 2010 were identified using data from the Danish National Hospital Register, and 5-year prevalence estimates were calculated. The study population covered 5,639,885 persons (49 % males). A total of 10,107 patients (68 % males) were operated for an umbilical hernia and 2412 patients (55 % males) were operated for an epigastric hernia. The age-specific 5-year prevalence differed for both hernia types. The highest 5-year prevalence of umbilical hernia repairs was seen in males aged 60-70 years with a 5-year prevalence of 0.53 % (95 % CI 0.51-0.56 %) and the highest age-specific 5-year prevalence of epigastric hernia repair was seen in 40-50 year females with a 5-year prevalence of 0.086 % (95 % CI 0.077-0.095 %). The gender and age-specific 5-year prevalence of umbilical and epigastric hernia repair differed in a nationwide population.

Spontaneous endometriosis associated with an umbilical hernia: A case report and review of the literature.

PubMed

Ismael, Hishaam; Ragoza, Yury; Harden, Angela; Cox, Steven

2017-01-01

Umbilical endometriosis occurring in the presence of an underlying hernia is extremely rare and presents a diagnostic challenge for the general surgeon. We present an interesting case and perform a comprehensive review of the literature. Medline and PubMed were queried for all cases of spontaneous umbilical endometriosis associated with an umbilical hernia. Data was analyzed and is presented along with an interesting case. Only 7 cases have been reported in the literature. Median age was 38 years. Time to presentation was long (up to 5 years) and the majority had cyclical symptoms related to menstruation. All patients, including our case, were treated surgically. Spontaneous umbilical endometriosis with an underlying hernia is often missed preoperatively. Preoperative suspicion warrants axial imaging for better operative planning and patient counseling. Surgery consists of enbloc excision of the umbilicus, implant and the hernia sac to avoid residual disease and reduce recurrence. The hernia defect can be repaired primarily or using mesh and the umbilicus reconstructed using skin flaps if necessary. Surgery is the mainstay of therapy for umbilical endometriosis associated with an underlying hernia. Clinical suspicion warrants preoperative imaging, and follow-up with a gynecologist is essential to address any pelvic disease. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Umbilical Benz Incision for Reduced Port Surgery in Pediatric Patients

PubMed Central

Amano, Hizuru; Kawashima, Hiroshi; Deie, Kyoichi; Murase, Naruhiko; Makita, Satoshi; Yokota, Kazuki; Tanaka, Yujiro

2015-01-01

Background and Objectives: For reduced port surgery in pediatric patients, the initial umbilical incision plays an important role in both functional ability and cosmetic impact. Larger umbilical incisions enable better manipulation of forceps, extraction of larger surgical specimens, and easier exteriorization of the intestine for anastomosis. We have pursued an incision of the small pediatric umbilicus that allows for enlargement of the orifice of the abdominal opening with preservation of the natural umbilical profile. This article aims to present a new umbilical incision technique and describe the outcomes. Methods: We devised a new umbilical incision technique for reduced port surgery in pediatric patients. Our incision is made in an inverted Y shape (Benz incision), allowing for access port device insertion. The Benz incision technique was applied between November 2010 and May 2014 and was retrospectively studied. Results: Seventy-five patients underwent Benz incisions. The median age of all patients was 6 years 6 months (range, 26 days to 18 years), and the median body weight was 21.7 kg (range, 3.1–54.3 kg). Benz incisions were applied for various procedures, including reduced port surgery with hepaticojejunostomy for congenital biliary dilatation, portojejunostomy for biliary atresia, Meckel diverticulectomy, tumor resection, varicocelectomy, cholecystectomy, splenectomy, ileus surgery, ileocecal resection, and total colectomy. All patients were successfully treated, without a significant increase in operating time or severe complications. The cosmetic profile of the umbilicus was maintained after surgery. Conclusion: The Benz incision is a feasible, effective, and scarless approach for reduced port surgery in pediatric patients whose umbilical rings are too small for the conventional approach. PMID:25848185

Tacrolimus placental transfer at delivery and neonatal exposure through breast milk.

PubMed

Zheng, Songmao; Easterling, Thomas R; Hays, Karen; Umans, Jason G; Miodovnik, Menachem; Clark, Shannon; Calamia, Justina C; Thummel, Kenneth E; Shen, Danny D; Davis, Connie L; Hebert, Mary F

2013-12-01

The current investigation aims to provide new insights into fetal exposure to tacrolimus in utero by evaluating maternal and umbilical cord blood (venous and arterial), plasma and unbound concentrations at delivery. This study also presents a case report of tacrolimus excretion via breast milk. Maternal and umbilical cord (venous and arterial) samples were obtained at delivery from eight solid organ allograft recipients to measure tacrolimus and metabolite bound and unbound concentrations in blood and plasma. Tacrolimus pharmacokinetics in breast milk were assessed in one subject. Mean (±SD) tacrolimus concentrations at the time of delivery in umbilical cord venous blood (6.6 ± 1.8 ng ml(-1)) were 71 ± 18% (range 45-99%) of maternal concentrations (9.0 ± 3.4 ng ml(-1)). The mean umbilical cord venous plasma (0.09 ± 0.04 ng ml(-1)) and unbound drug concentrations (0.003 ± 0.001 ng ml(-1)) were approximately one fifth of the respective maternal concentrations. Arterial umbilical cord blood concentrations of tacrolimus were 100 ± 12% of umbilical venous concentrations. In addition, infant exposure to tacrolimus through the breast milk was less than 0.3% of the mother's weight-adjusted dose. Differences between maternal and umbilical cord tacrolimus concentrations may be explained in part by placental P-gp function, greater red blood cell partitioning and higher haematocrit levels in venous cord blood. The neonatal drug exposure to tacrolimus via breast milk is very low and likely does not represent a health risk to the breastfeeding infant. © 2013 The Authors. British Journal of Clinical Pharmacology © 2013 The British Pharmacological Society.

The feasibility of local anesthesia for the surgical treatment of umbilical hernia: a systematic review of the literature.

PubMed

Jairam, A P; Kaufmann, R; Muysoms, F; Jeekel, J; Lange, J F

2017-04-01

Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in groin hernia surgery. Local anesthesia might be useful in the treatment of umbilical hernia as well. However, convincing evidence is lacking. We have conducted a systematic review on safety, feasibility, and advantages of local anesthesia for umbilical hernia repair. A systematic review was conducted according to the PRISMA guidelines. Outcome parameters were duration of surgery, surgical site infection, perioperative and postoperative complications, postoperative pain, hernia recurrence, time before discharge, and patient satisfaction. The systematic review resulted in nine included articles. Various anesthetic agents were used, varying from short acting to longer acting agents. There was no consensus regarding the injection technique and no conversions to general anesthesia were described. The most common postoperative complication was surgical site infection, with an overall percentage of 3.4%. There were no postoperative deaths and no allergic reactions described for local anesthesia. The hernia recurrence rate varied from 2 to 7.4%. Almost 90% of umbilical hernia patients treated with local anesthesia were discharged within 24 h, compared with 47% of patients treated with general anesthesia. The overall patient satisfaction rate varied from 89 to 97%. Local anesthesia for umbilical hernia seems safe and feasible. However, the advantages of local anesthesia are not sufficiently demonstrated, due to the heterogeneity of included studies. We, therefore, propose a randomized controlled trial comparing general versus local anesthesia for umbilical hernia repair.

[Correlation analysis of the pre-pregnant body mass index, the gestational weight gain and umbilical cord blood C peptide].

PubMed

Chen, X L; Han, Y; Zhao, X M; Liu, Y; Lü, J J

2017-01-03

Objective: To explore the correlation among the pre-pregnant body mass index (BMI), gestational weight gain (GWG) and umbilical cord blood C peptide, and to investigate the influence of maternal weight management on the incidence of baby long-term metabolic syndrome. Methods: During May to Aug.2015, 485 pregnant women in Zhejiang Taizhou first people's hospital and Taizhou Huangyan maternal &child care service centre were selected in random and divided into four groups according to pre-pregnant BMI: low body mass, normal body mass, over body mass and obese group, and also divided into two groups for getting gestational diabetes mellitus (GDM) or not. According to the gestational weight gain (GWG), all the cases were divided into two groups: above the Institute Of Medicine (IMO) 2009 recommendations or not. According to the outcome, the GDM group which had received weight control treatment, was divided into successful treat group or not. At last, we tested the umbilical cord blood C peptide and birth weight of each newborn and compared the difference in all subgroups. The correlation between the umbilical cord blood C peptide and birth weight were analysed. Results: (1) In the pre-pregnant BMI groups, there were significant differences of incidence of GDM ( P <0.05). But, there were no significant differences of incidence of GWG in four groups ( P >0.05). (2) Newborn birth weight and the umbilical cord blood C peptide were positively correlated ( r =0.673, P <0.05). (3) Umbilical cord blood C peptide showed the correlation in all subgroups for different pre-pregnant BMI, GDM or not, overweight or not ( P <0.05), but only the GDM or not group had relation to newborn birth weight in all subgroups. (4) All groups showed correlations with neonatal umbilical cord blood C peptide, the GDM mostly (β=0.58), pre-pregnant BMI secondly (β: 0.36, 0.38) , and GWG weakly (β=0.17). (5) By stratification analysis, in GDM group, low body mass was negatively correlated with umbilical cord blood C peptide ( P <0.05, β=-1.41); in non-GDM group, over body mass group and obsess group were positively correlated with umbilical cord blood C peptide ( P <0.05, β=0.37, 0.46). Conclusion: There was direct correlation between the pre-pregnant body mass index, the gestational weight gain and umbilical cord blood C peptide. Suitable maternal weight control especially pre-pregnant body mass index control will lower the baby long-term metabolic syndrome incidence.

Umbilical metastasis or Sister Mary Joseph's nodule as a very early sign of an occult cecal adenocarcinoma.

PubMed

Salemis, Nikolaos S

2007-01-01

Umbilical metastasis (Sister Mary Joseph's nodule) is a rare occurrence and indicates, in most of the patients, an advanced intraabdominal malignancy. It may be the first sign of an underlying adenocarcinoma, originating mainly from the gastrointestinal or genitourinary tract. An extremely rare case of a Sister Mary Joseph's nodule is described herein, where the metastatic umbilical nodule was the first sign of a cecal adenocarcinoma and became evident 8 months before the onset of the disease. Diagnostic evaluation and surgical management are discussed along with a review of the literature. This case is presented in order to emphasize the need for thorough investigation of any umbilical lesion especially in elderly patients.

Orion Service Module Umbilical (OSMU) Installation on Mobile Launcher (ML)

NASA Image and Video Library

2017-03-13

Cranes and rigging are being used to lift the bracket for the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower. The tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

Preparations are underway to lift the bracket for the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

A crane and rigging are used to lift the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

Preparations are underway to lift the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

Seeming to hang in midair, the Orion Service Module Umbilical (OSMU) is lifted high up by crane for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

A crane and rigging are used to position the Orion Service Module Umbilical (OSMU) for installation high up on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

A crane positions the bracket for the Orion Service Module Umbilical (OSMU) for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

A crane and rigging are used to lift the Orion Service Module Umbilical (OSMU) high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

A crane lifts the bracket for the Orion Service Module Umbilical (OSMU) high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

ICPSU Install onto Mobile Launcher

NASA Image and Video Library

2018-03-16

A heavy-lift crane slowly lifts the Interim Cryogenic Propulsion Stage Umbilical (ICPSU) high up for installation on the tower of the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical is located at about the 240-foot-level of the mobile launcher and will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

ICPSU Install onto Mobile Launcher

NASA Image and Video Library

2018-03-16

A crane and rigging lines are used to install the Interim Cryogenic Propulsion Stage Umbilical (ICPSU) high up on the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical is located at about the 240-foot-level of the mobile launcher and will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

ICPSU Install onto Mobile Launcher - Preps for Lift

NASA Image and Video Library

2018-03-15

Construction workers with JP Donovan assist with preparations to lift and install the Interim Cryogenic Propulsion Stage Umbilical on the tower of the mobile launcher at NASA's Kennedy Space Center in Florida. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical is located at about the 240-foot-level of the mobile launcher and will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

ICPSU Install onto Mobile Launcher

NASA Image and Video Library

2018-03-16

Construction workers with JP Donovan install the Interim Cryogenic Propulsion Stage Umbilical (ICPSU) at about the 240-foot-level of the mobile launcher (ML) tower at NASA's Kennedy Space Center in Florida. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical is located at about the 240-foot-level of the mobile launcher and will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

ICPSU Install onto Mobile Launcher

NASA Image and Video Library

2018-03-16

A heavy-lift crane slowly lifts the Interim Cryogenic Propulsion Stage Umbilical (ICPSU) up for installation on the tower of the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical is located at about the 240-foot-level of the mobile launcher and will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

ICPSU Install onto Mobile Launcher - Preps for Lift

NASA Image and Video Library

2018-03-15

The mobile launcher (ML) tower is lit up before early morning sunrise at NASA's Kennedy Space Center in Florida. Preparations are underway to lift and install the Interim Cryogenic Propulsion Stage Umbilical (ICPSU) at about the 240-foot-level on the tower. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

Flood Syndrome: Spontaneous Umbilical Hernia Rupture Leaking Ascitic Fluid—A Case Report

PubMed Central

Nguyen, Emilie T; Tudtud-Hans, Leah A

2017-01-01

Introduction We report a rare case of Flood syndrome, which is a spontaneous rupture of an umbilical hernia. Case Presentation A 42-year-old man with decompensated hepatitis C and alcoholic cirrhosis complicated by ascites and esophageal varices presented with 1 day of ascitic fluid drainage after rupture of a preexisting umbilical hernia associated with diffuse abdominal pain and tenderness. A pigtail drain was placed in the right upper abdominal quadrant to decrease fluid drainage from the abdominal wall defect, allowing it to heal naturally. Discussion The spontaneous rupture of an umbilical hernia in our patient highlights a rare complication with high mortality rates and stresses the challenge of treatment that falls in the area between medical and surgical management. PMID:28678688

Flood Syndrome: Spontaneous Umbilical Hernia Rupture Leaking Ascitic Fluid-A Case Report.

PubMed

Nguyen, Emilie T; Tudtud-Hans, Leah A

2017-01-01

We report a rare case of Flood syndrome, which is a spontaneous rupture of an umbilical hernia. A 42-year-old man with decompensated hepatitis C and alcoholic cirrhosis complicated by ascites and esophageal varices presented with 1 day of ascitic fluid drainage after rupture of a preexisting umbilical hernia associated with diffuse abdominal pain and tenderness. A pigtail drain was placed in the right upper abdominal quadrant to decrease fluid drainage from the abdominal wall defect, allowing it to heal naturally. The spontaneous rupture of an umbilical hernia in our patient highlights a rare complication with high mortality rates and stresses the challenge of treatment that falls in the area between medical and surgical management.

The effect of umbilical cord cleansing with chlorhexidine on omphalitis and neonatal mortality in community settings in developing countries: a meta-analysis

PubMed Central

2013-01-01

Background There is an increased risk of serious neonatal infection arising through exposure of the umbilical cord to invasive pathogen in home and facility births where hygienic practices are difficult to achieve. The World Health Organization currently recommends ‘dry cord care’ because of insufficient data in favor of or against topical application of an antiseptic. The primary objective of this meta-analysis is to evaluate the effects of application of chlorhexidine (CHX) to the umbilical cord to children born in low income countries on cord infection (omphalitis) and neonatal mortality. Standardized guidelines of Child Health Epidemiology Reference Group (CHERG) were followed to generate estimates of effectiveness of topical chlorhexidine application to umbilical cord for prevention of sepsis specific mortality, for inclusion in the Lives Saved Tool (LiST). Methods Systematic review and meta-analysis. Data sources included Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, PubMed, CINHAL and WHO international clinical trials registry. Only randomized trials were included. Studies of children in hospital settings were excluded. The comparison group received no application to the umbilical cord (dry cord care), no intervention, or a non-CHX intervention. Primary outcomes were omphalitis and all-cause neonatal mortality. Results There were three cluster-randomised community trials (total participants 54,624) conducted in Nepal, Bangladesh and Pakistan that assessed impact of CHX application to the newborn umbilical cord for prevention of cord infection and mortality. Application of any CHX to the umbilical cord of the newborn led to a 23% reduction in all-cause neonatal mortality in the intervention group compared to control [RR 0.77, 95 % CI 0.63, 0.94; random effects model, I2=50 %]. The reduction in omphalitis ranged from 27 % to 56 % compared to control group depending on severity of infection. Based on CHERG rules, effect size for all-cause mortality was used for inclusion to LiST model as a proxy for sepsis specific mortality. Conclusions Application of CHX to newborn umbilical cord can significantly reduce incidence of umbilical cord infection and all-cause mortality among home births in community settings. This inexpensive and simple intervention can save a significant number of newborn lives in developing countries. PMID:24564621

Changes in Doppler flow velocity waveforms and fetal size at 20 weeks gestation among cigarette smokers.

PubMed

Kho, E M; North, R A; Chan, E; Stone, P R; Dekker, G A; McCowan, L M E

2009-09-01

To compare umbilical and uterine artery Doppler waveforms and fetal size at 20 weeks between smokers and nonsmokers. Prospective cohort study. Auckland, New Zealand and Adelaide, Australia. Nulliparous participants in the Screening for Pregnancy Endpoints (SCOPE) study. Self-reported smoking status was determined at 15 +/- 1 weeks' gestation. At the 20 +/- 1 week anatomy scan, uterine and umbilical Doppler resistance indices (RI) and fetal measurements were compared between smokers and nonsmokers. Umbilical and mean uterine artery Doppler RI values, abnormal umbilical and uterine Doppler (RI > 90th centile) and fetal biometry. Among the 2459 women, 248 (10%) were smokers. Smokers had higher umbilical RI [0.75 (SD 0.06) versus 0.73 (0.06), P < 0.0001] and mean uterine RI [0.59 (0.09) versus 0.56 (0.10), P < 0.0001]. They were twice as likely to have an abnormal umbilical Doppler at 20 weeks compared with nonsmokers [n = 35 (14.6%) versus n = 156 (7.2%), OR 2.21, 95% CI 1.49-3.27]. This effect remained significant after adjusting for age, ethnicity, marital status, employment and BMI (adjusted OR 1.62, 95% CI 1.03-2.54). Smokers were more likely to have an abnormal mean uterine RI [n = 33 (13.7%) versus n = 198 (9.2%), OR 1.57, 95% CI 1.06-2.33], but this association was not significant after adjusting for confounders. Fetuses of women who smoked had a small reduction in femur length and estimated weight compared with nonsmokers. At 20 weeks' gestation, women who smoke have higher umbilical artery RI, a surrogate measure for an abnormal placental villous vascular tree. This may contribute to later fetal growth restriction among smokers. Further research is needed to explore the clinical significance of these findings.

Carbetocin versus intra-umbilical oxytocin in the management of retained placenta: a randomized clinical study.

PubMed

Elfayomy, Amr K

2015-08-01

This study aimed to compare the hemodynamic profile and efficacy of carbetocin versus intra-umbilical oxytocin in the management of retained placenta following vaginal delivery. In this randomized clinical study, women with retained placenta for more than 30 min were assigned to receive either an i.v. bolus of 100-µg carbetocin (n = 38) or an intra-umbilical vein injection of 50 IU oxytocin in 30 mL saline (n = 40). The main parameters evaluated were the success rate for expulsion of the placenta and the effects of these drugs on maternal blood pressure. The success rate in the carbetocin group was 86.84% compared to 77.5% in the intra-umbilical oxytocin group. Notably, 57.7% of the participants had prior induction of labor or augmentation during labor. There were no significant differences between the two groups regarding the estimated blood loss, drop of hemoglobin within the first 48 h, additional uterotonic injection or the need for manual removal of the placenta. Systolic blood pressure was significantly lower in the intra-umbilical oxytocin group at 30 and 60 min after injection (P = 0.008, 0.026, respectively). Nonetheless, diastolic blood pressure was significantly lower in the intra-umbilical oxytocin group than in the carbetocin group at 30 min (P = 0.036). A single i.v. bolus of carbetocin and umbilical vein injection of 50 IU oxytocin are similarly effective in reducing the need for manual removal of the placenta. Carbetocin seems to have an acceptable hemodynamic safety profile and can be used as an alternative choice to the conventional oxytocic agents in the management of retained placenta. © 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

Evaluation of three high abundance protein depletion kits for umbilical cord serum proteomics

PubMed Central

2011-01-01

Background High abundance protein depletion is a major challenge in the study of serum/plasma proteomics. Prior to this study, most commercially available kits for depletion of highly abundant proteins had only been tested and evaluated in adult serum/plasma, while the depletion efficiency on umbilical cord serum/plasma had not been clarified. Structural differences between some adult and fetal proteins (such as albumin) make it likely that depletion approaches for adult and umbilical cord serum/plasma will be variable. Therefore, the primary purposes of the present study are to investigate the efficiencies of several commonly-used commercial kits during high abundance protein depletion from umbilical cord serum and to determine which kit yields the most effective and reproducible results for further proteomics research on umbilical cord serum. Results The immunoaffinity based kits (PROTIA-Sigma and 5185-Agilent) displayed higher depletion efficiency than the immobilized dye based kit (PROTBA-Sigma) in umbilical cord serum samples. Both the PROTIA-Sigma and 5185-Agilent kit maintained high depletion efficiency when used three consecutive times. Depletion by the PROTIA-Sigma Kit improved 2DE gel quality by reducing smeared bands produced by the presence of high abundance proteins and increasing the intensity of other protein spots. During image analysis using the identical detection parameters, 411 ± 18 spots were detected in crude serum gels, while 757 ± 43 spots were detected in depleted serum gels. Eight spots unique to depleted serum gels were identified by MALDI- TOF/TOF MS, seven of which were low abundance proteins. Conclusions The immunoaffinity based kits exceeded the immobilized dye based kit in high abundance protein depletion of umbilical cord serum samples and dramatically improved 2DE gel quality for detection of trace biomarkers. PMID:21554704

Umbilical cord CD71+ erythroid cells are reduced in neonates born to women in spontaneous preterm labor.

PubMed

Gomez-Lopez, Nardhy; Romero, Roberto; Xu, Yi; Miller, Derek; Unkel, Ronald; C MacKenzie, Tippi; Frascoli, Michela; Hassan, Sonia S

2016-10-01

Preterm neonates are highly susceptible to infection. Neonatal host defense against infection seems to be maintained by the temporal presence of immunosuppressive CD71+ erythroid cells. The aim of this study was to investigate whether umbilical cord CD71+ erythroid cells are reduced in neonates born to women who undergo spontaneous preterm labor/birth. Umbilical cord blood samples (n=155) were collected from neonates born to women who delivered preterm with (n=39) and without (n=12) spontaneous labor or at term with (n=82) and without (n=22) spontaneous labor. Time-matched maternal peripheral blood samples were also included (n=111). Mononuclear cells were isolated from these samples, and CD71+ erythroid cells were identified and quantified as CD3-CD235a+CD71+ cells by flow cytometry. (i) The proportion of CD71+ erythroid cells was 50-fold higher in cord blood than in maternal blood; (ii) a reduced number and frequency of umbilical cord CD71+ erythroid cells were found in neonates born to women who underwent spontaneous preterm labor compared to those born to women who delivered preterm without labor; (iii) umbilical cord CD71+ erythroid cells were fewer in neonates born to term pregnancies, regardless of the process of labor, than in those born to women who delivered preterm without labor; and (iv) no differences were seen in umbilical cord CD71+ erythroid cells between neonates born to women who underwent spontaneous preterm labor and those born to women who delivered at term with labor. Umbilical cord CD71+ erythroid cells are reduced in neonates born to women who had undergone spontaneous preterm labor. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Lower reoperation rate for recurrence after mesh versus sutured elective repair in small umbilical and epigastric hernias. A nationwide register study.

PubMed

Christoffersen, M W; Helgstrand, F; Rosenberg, J; Kehlet, H; Bisgaard, T

2013-11-01

Repair for a small (≤ 2 cm) umbilical and epigastric hernia is a minor surgical procedure. The most common surgical repair techniques are a sutured repair or a repair with mesh reinforcement. However, the optimal repair technique with regard to risk of reoperation for recurrence is not well documented. The aim of the present study was in a nationwide setup to investigate the reoperation rate for recurrence after small open umbilical and epigastric hernia repairs using either sutured or mesh repair. This was a prospective cohort study based on intraoperative registrations from the Danish Ventral Hernia Database (DVHD) of patients undergoing elective open mesh and sutured repair for small (≤ 2 cm) umbilical and epigastric hernias. Patients were included during a 4-year study period. A complete follow-up was obtained by combining intraoperative data from the DVHD with data from the Danish National Patient Register. The cumulative reoperation rates were obtained using cumulative incidence plot and compared with the log rank test. In total, 4,786 small (≤ 2 cm) elective open umbilical and epigastric hernia repairs were included. Age was median 48 years (range 18-95 years). Follow-up was 21 months (range 0-47 months). The cumulated reoperation rates for recurrence were 2.2 % for mesh reinforcement and 5.6 % for sutured repair (P = 0.001). The overall cumulated reoperation rate for sutured and mesh repairs was 4.8 %. In conclusion, reoperation rate for recurrence for small umbilical and epigastric hernias was significantly lower after mesh repair compared with sutured repair. Mesh reinforcement should be routine in even small umbilical or epigastric hernias to lower the risk of reoperation for recurrence avoid recurrence.

An umbilical polyp in an infant.

PubMed

Swanson, David L; Pakzad, Betty

2005-10-01

The persistence at birth of the omphalomesenteric (vitelline) duct may result in life-threatening consequences. Early identification of this congenital anomaly is essential for prompt surgical treatment to eliminate the risk of prolapse and herniation. A neonatal umbilical polyp may indicate the presence of an omphalomesenteric duct remnant. We describe the diagnosis and surgical treatment of an infant with an umbilical polyp. We also present an overview of the diagnosis and treatment of vitelline duct remnants and their associated anomalies.

Simultaneous isolation of vascular endothelial cells and mesenchymal stem cells from the human umbilical cord.

PubMed

Kadam, Sachin S; Tiwari, Shubha; Bhonde, Ramesh R

2009-01-01

The umbilical cord represents the link between mother and fetus during pregnancy. This cord is usually discarded as a biological waste after the child's birth; however, its importance as a "store house" of stem cells has been explored recently. We developed a method of simultaneous isolation of endothelial cells (ECs) from the vein and mesenchymal stem cells from umbilical cord Wharton's jelly of the same cord. The isolation protocol has been simplified, modified, and improvised with respect to choice of enzyme and enzyme mixture, digestion time, cell yield, cell growth, and culture medium. Isolated human umbilical vascular ECs (hUVECs) were positive for von-Willibrand factor, a classical endothelial marker, and could form capillary-like structures when seeded on Matrigel, thus proving their functionality. The isolated human umbilical cord mesenchymal stem cells (hUCMSCs) were found positive for CD44, CD90, CD 73, and CD117 and were found negative for CD33, CD34, CD45, and CD105 surface markers; they were also positive for cytoskeleton markers of smooth muscle actin and vimentin. The hUCMSCs showed multilineage differentiation potential and differentiated into adipogenic, chondrogenic, osteogenic, and neuronal lineages under influence of lineage specific differentiation medium. Thus, isolating endothelial cells as well as mesenchymal cells from the same umbilical cord could lead to complete utilization of the available tissue for the tissue engineering and cell therapy.

Double half-cone flap umbilicoplasty for proboscoid umbilical hernia in a 2 years old child with satisfactory results 2 years later.

PubMed

Ashu, Eseme Ebai; Leroy, Guifo Marc; Aristide, Bang Guy; Joss, Bitang Mafok Louis; Bonaventure, Jemea; Patrick, Savom Eric; Myriam, Fotso Guegne

2015-01-01

Surgical repair of large umbilical hernias may present a challenging surgical problem; standard surgical techniques have proven to be inadequate for both closing the fascial defect of the umbilicus and providing a satisfactory cosmetic result. We describe here a case of double half-cone flap umbilicoplasty that was performed in a 2 years old boy. The case of a 2 years old child with proboscoid umbilical hernia. The protruding umbilical skin was excised sharply by two V-shaped cuts leaving two half cones, a short cephalic (0.5cm) and a long caudal (1cm). A classic herniotomy was carried out, with repair of the facial defect. The caudal half cone was sutured from its apex till half it's length upon itself with interrupted sutures and it was anchored deeply to the fascia. Then we inverted the cephalic half cone which was sutured to the caudal cone to form the new umbilicus. The early result was excellent with no complications and the result after 2years revealed a cosmetically satisfactory shape of the umbilicus. this technique provides a good solution for reconstruction of the protruding umbilical skin and it is easy to learn, easy to be taught and perform in surgical environments and may be applicable for any kind of umbilical reconstruction.

Umbilical cord sparing technique for repair of congenital hernia into the cord and small omphalocele.

PubMed

Ceccanti, Silvia; Falconi, Ilaria; Frediani, Simone; Boscarelli, Alessandro; Musleh, Layla; Cozzi, Denis A

2017-01-01

Current repair of small omphaloceles and hernias into the umbilical cord is a straightforward procedure, whose repair may result in a suboptimal cosmetic outcome. We describe a novel repair technique retaining the umbilical cord elements in an attempt to improve the cosmetic appearance of the umbilicus. Eight neonates were consecutively treated more than a ten-year period. Size of the fascial defects ranged 1 to 3cm (median, 2). Present technique entails incision of the amniotic sac without its detachment from the skin, reduction of the extruded contents under direct vision, and closure of the abdominal wall defect by circumferential suturing of peritoneum and fascia around the base of the amniotic sac. The amniotic sac is then re-approximated and folded to create an umbilical stump, which is trimmed and left to shed naturally. All patients achieved a scarless abdomen with a normal appearing umbilicus in 6. The remaining 2 patients are awaiting surgery for persisting umbilical hernia repair and umbilicoplasty, respectively. Poor esthetic outcome was significantly associated with initial fascial defect ≥2.5cm in size (p=0.03). Present technique is a simple and cosmetically appealing repair for umbilical cord hernias and small omphaloceles, especially effective when the size of the fascial defect is less than 2.5cm. IV (Treatment Study). Copyright © 2017 Elsevier Inc. All rights reserved.

Double half-cone flap umbilicoplasty for proboscoid umbilical hernia in a 2 years old child with satisfactory results 2 years later

PubMed Central

Ashu, Eseme Ebai; Leroy, Guifo Marc; Aristide, Bang Guy; Joss, Bitang Mafok Louis; Bonaventure, Jemea; Patrick, Savom Eric; Myriam, Fotso Guegne

2015-01-01

Surgical repair of large umbilical hernias may present a challenging surgical problem; standard surgical techniques have proven to be inadequate for both closing the fascial defect of the umbilicus and providing a satisfactory cosmetic result. We describe here a case of double half-cone flap umbilicoplasty that was performed in a 2 years old boy. The case of a 2 years old child with proboscoid umbilical hernia. The protruding umbilical skin was excised sharply by two V-shaped cuts leaving two half cones, a short cephalic (0.5cm) and a long caudal (1cm). A classic herniotomy was carried out, with repair of the facial defect. The caudal half cone was sutured from its apex till half it's length upon itself with interrupted sutures and it was anchored deeply to the fascia. Then we inverted the cephalic half cone which was sutured to the caudal cone to form the new umbilicus. The early result was excellent with no complications and the result after 2years revealed a cosmetically satisfactory shape of the umbilicus. this technique provides a good solution for reconstruction of the protruding umbilical skin and it is easy to learn, easy to be taught and perform in surgical environments and may be applicable for any kind of umbilical reconstruction. PMID:26664545

Optimization of informed consent for umbilical cord blood banking.

PubMed

Sugarman, Jeremy; Kurtzberg, Joanne; Box, Tamara L; Horner, Ronnie D

2002-12-01

The purpose of this project was to evaluate the informed consent process for donation to a public umbilical cord blood bank. Telephone interviews were conducted with 170 women who had given consent to donate their newborn infants' umbilical cord blood. Of the 170 women who were contacted, 96.8% of the women reported that all their questions had been answered. Nevertheless, approximately one third of the respondents did not consider themselves to be in research, and almost one quarter of the respondents did not know how to contact the umbilical cord blood bank if they or their infant became seriously ill. Further, a substantial proportion of the respondents did not understand the full range of alternatives to donation and incorrectly endorsed potential benefits. Informed consent could be optimized by (1) having those personnel who obtain consent emphasize that banking involves research and to explain the true benefits of donation, (2) ensuring that parents know how and when to contact the umbilical cord blood bank after donation, and (3) using phone surveys to continue assessments and to monitor changes in the process.

Laparoscopic surgical treatment of umbilical hernia and small eventrations with prosthetic mesh using omentum overlay.

PubMed

Bratu, D; Sabău, A; Dumitra, A; Sabău, D; Miheţiu, A; Beli, L; Hulpuş, R

2014-01-01

Umbilical hernias and abdominal incisional hernias represent current pathologies which require numerous surgical alternative ways of treatment in prosthetic or non prosthetic,open or minimally invasive surgery. The method proposed by us is a less expensive option with no additional risks compared to other similar procedures as surgical technique. We conducted a retrospective study between 01.01.2008 - 01.06.2013 in which we considered a number of 23 patients with umbilical hernia and eventration, patients who received laparoscopic intraperitoneal polyester mesh covered with omentum, procedure applied at the IInd Surgery Clinic, Clinical County Emergency Hospital Sibiu. Out of 23 patients with postoperative umbilical hernia and eventration cases in which we used this surgical technique,16 were umbilical hernias and 7 post incisional hernias. The average time of surgery was 1 hour and 40 minutes, recording 4 postoperative complications remitted under conservative treatment, with a mean hospitalization of 4.1 days. Proepiploic laparoscopic treatment using omentum is a reliable alternative to a more expensive and difficult procedure involving Dual Mesh. Celsius.

Umbilical hernia in patients with liver cirrhosis: A surgical challenge

PubMed Central

Coelho, Julio C U; Claus, Christiano M P; Campos, Antonio C L; Costa, Marco A R; Blum, Caroline

2016-01-01

Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites. Hernia repair is indicated in patients in whom medical treatment is effective in controlling ascites. Patients who have a good perspective to be transplanted within 3-6 mo, herniorrhaphy should be performed during transplantation. Hernia repair with mesh is associated with lower recurrence rate, but with higher surgical site infection when compared to hernia correction with conventional fascial suture. There is no consensus on the best abdominal wall layer in which the mesh should be placed: Onlay, sublay, or underlay. Many studies have demonstrated several advantages of the laparoscopic umbilical herniorrhaphy in cirrhotic patients compared with open surgical treatment. PMID:27462389

Umbilical hernia in patients with liver cirrhosis: A surgical challenge.

PubMed

Coelho, Julio C U; Claus, Christiano M P; Campos, Antonio C L; Costa, Marco A R; Blum, Caroline

2016-07-27

Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites. Hernia repair is indicated in patients in whom medical treatment is effective in controlling ascites. Patients who have a good perspective to be transplanted within 3-6 mo, herniorrhaphy should be performed during transplantation. Hernia repair with mesh is associated with lower recurrence rate, but with higher surgical site infection when compared to hernia correction with conventional fascial suture. There is no consensus on the best abdominal wall layer in which the mesh should be placed: Onlay, sublay, or underlay. Many studies have demonstrated several advantages of the laparoscopic umbilical herniorrhaphy in cirrhotic patients compared with open surgical treatment.

Laparoscopic transabdominal preperitoneal approach for umbilical hernia with rectus diastasis.

PubMed

Capitano, Sante

2017-08-01

Rectus diastasis, when coexistent with umbilical hernia, can benefit from mesh-based repair of the midline. Laparoscopic correction of an umbilical hernia involves the placement of a mesh in the peritoneal cavity, but this comes with the risk of bowel complications. However, newly developed dual-sided composite meshes have helped to reduce this risk. Four men and three women with umbilical hernia and rectus diastasis were treated with laparoscopic transabdominal preperitoneal repair. Composite mesh with a hydrophilic 3-D polyester textile on the parietal side and an absorbable collagen barrier on the peritoneal side were placed in the preperitoneal pocket after hernial sac reduction. Mean hernia size was 2.5 cm, and no recurrences were observed during the mean follow-up period of 9.2 months. The laparoscopic transabdominal preperitoneal approach for umbilical hernia and rectus diastasis may be a safe surgical option when trying to avoid potential complications related to intra-abdominal mesh positioning. © 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

Prognosis elements in surgical treatment of complicated umbilical hernia in patients with liver cirrhosis.

PubMed

Banu, P; Popa, F; Constantin, V D; Bălălău, C; Nistor, M

2013-09-15

The surgical treatment of umbilical hernia in cirrhosis patients raises special management challenges. The attitude upon the repair of these hernias varies from expectancy or elective treatment in early stages of the disease to the surgical treatment only if complications occur. We have assessed 22 consecutive cases of cirrhosis patients treated for complicated umbilical hernia in the Surgical Department of "Sf. Pantelimon" Emergency Hospital in Bucharest between January 2008 and December 2012. The patients' stratification was done in stages of liver disease based upon Child-Pugh classification. Complications that required emergency repair were the following: strangulation, incarceration and hernia rupture. The postoperative complications were ordered in five grades of severity based upon Clavien classification. The severity of the complications was higher in advanced stages of liver cirrhosis, Child B and C. There were 5 deaths representing 22,7%, four of them in patients with Child C disease stage. The incidence of morbidity and mortality after umbilical hernia repair in emergencies increases in advanced stages of liver cirrhosis. It is advisable to prevent complications occurrence and perform surgical repair of umbilical hernia in elective condition.

A matter of health? Legal aspects of private umbilical cord blood banking.

PubMed

Vidalis, Takis

2011-03-01

Private umbilical cord blood banking raises a question of special legal regulation. This practice promises the safe storage of biological material on the assumption that it may be useful, at a certain moment in future, for its own donor (or for a donor's close family member) for curing serious blood diseases. Although currently the therapeutic value of umbilical cord blood is confirmed, there are strong scientific doubts and relevant controversies regarding its use in autologous transplantations. This fact produces conditions of legal uncertainty, since the benefit for those wanting to conclude contracts with private umbilical cord blood banks is not clear. The Greek example illustrates this situation of regulatory deficit well, which eventually creates a major problem, given the increasing number of private banks offering relevant services in the country.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

Crane specialists monitor the progress as the bracket for the Orion Service Module Umbilical (OSMU) is lifted up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Installation

NASA Image and Video Library

2017-03-16

Construction workers assist as a crane and rigging are used to position the Orion Service Module Umbilical (OSMU) for installation high up on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

A view from below the mobile launcher shows a crane positioning the bracket for the Orion Service Module Umbilical (OSMU) high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

Crane specialists monitor the progress as the bracket for the Orion Service Module Umbilical (OSMU) is lifted high up for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

In this view looking down from high up on the mobile launcher, a crane positions the bracket for the Orion Service Module Umbilical (OSMU) for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The mobile launcher tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

ICPSU Install onto Mobile Launcher

NASA Image and Video Library

2018-03-16

The mobile launcher (ML) is reflected in the sunglasses of a construction worker with JP Donovan at NASA's Kennedy Space Center in Florida. A crane is lifting the Interim Cryogenic Propulsion Stage Umbilical (ICPSU) up for installation on the tower of the ML. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical is located at about the 240-foot-level of the mobile launcher and will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

ICPSU Install onto Mobile Launcher - Preps for Lift

NASA Image and Video Library

2018-03-15

A construction worker with JP Donovan helps prepare the Interim Cryogenic Propulsion Stage Umbilical (ICPSU) for installation high up on the tower of the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical will be located at about the 240-foot-level of the mobile launcher and will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

ICPSU Install onto Mobile Launcher - Preps for Lift

NASA Image and Video Library

2018-03-15

Construction workers with JP Donovan attach a heavy-lift crane to the Interim Cryogenic Propulsion Stage Umbilical (ICPSU) to prepare for lifting and installation on the mobile launcher (ML) tower at NASA's Kennedy Space Center in Florida. The last of the large umbilicals to be installed, the ICPSU will provide super-cooled hydrogen and liquid oxygen to the Space Launch System (SLS) rocket's interim cryogenic propulsion stage, or upper stage, at T-0 for Exploration Mission-1. The umbilical will be located at about the 240-foot-level of the ML and will supply fuel, oxidizer, gaseous helium, hazardous gas leak detection, electrical commodities and environment control systems to the upper stage of the SLS rocket during launch. Exploration Ground Systems is overseeing installation of the umbilicals on the ML.

[Effectiveness of Sacral Intervertebral Epidural Block for Umbilical Hernia Repair in Children].

PubMed

Nagamine, Norimitsu; Furuya, Atsushi; Suzuki, Sho; Kondo, Satoko; Kiuchi, Riko; Suzuki, Satomi; Nonaka, Akihiko

2015-02-01

Effectiveness of sacral intervertebral epidural block (S 2-3 block) for umbilical hernia repair has not been clarified. We investigate 24 children, undergoing umbilical hernia repair; mean age of 3 years (age range: 20-65 months). Under general anesthesia, epidural block was performed at S 2-3 interspace with 1 ml x kg(-1) ropivacaine (0.2%) at injecting rate of 1 ml x sec(-1) followed by 0.25 ml x kg(-1) normal saline. In all cases, neither systolic blood pressure nor heart rate increased > 15% from those just before the block. Postoperative analgesics were given in 6 patients (25%) rectally. Mean time between the block and the administration of analgesic was 10.5 hours. S 2-3 block can be effective for postoperative pain in umbilical hernia repair.

Umbilical cord blood banking: implications for perinatal care providers.

PubMed

Armson, B Anthony

2005-03-01

To evaluate the risks and benefits of umbilical cord blood banking for future stem cell transplantation and to provide guidelines for Canadian perinatal care providers regarding the counselling, procedural, and ethical implications of this potential therapeutic option. Selective or routine collection and storage of umbilical cord blood for future autologous (self) or allogenic (related or unrelated) transplantation of hematopoietic stem cells to treat malignant and nonmalignant disorders in children and adults. Maternal and perinatal morbidity, indications for umbilical cord blood transplantation, short- and long-term risks and benefits of umbilical cord blood transplantation, burden of umbilical cord blood collection on perinatal care providers, parental satisfaction, and health care costs. MEDLINE and PubMed searches were conducted from January 1970 to October 2003 for English-language articles related to umbilical cord blood collection, banking, and transplantation; the Cochrane library was searched; and committee opinions of the Royal College of Obstetricians and Gynaecologists, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists were obtained. The evidence collected was reviewed and evaluated by the Maternal/Fetal Medicine Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC), and recommendations were made using the evaluation of evidence guidelines developed by the Canadian Task Force on the Periodic Health Exam. Umbilical cord blood is a readily available source of hematopoietic stem cells used with increasing frequency as an alternative to bone marrow or peripheral stem cells for transplantation in the treatment of malignant and nonmalignant conditions in children and adults. Umbilical cord blood transplantation provides a rich source of hematopoietic stem cells with several advantages, including prompt availability, decreased risk of transmissible viral infections and graft-versus-host disease (GVHD) in both human leukocyte antigen(HLA)-matched and HLA-mismatched stem cell transplants, and ease of collection with little risk to the mother or newborn. Potential limitations of umbilical cord blood transplantation include insufficient stem cell dose to reliably treat larger children and adult recipients, slower rate of engraftment, and the potential for transfer of genetically abnormal hematopoietic stem cells. The optimum method of umbilical cord blood transplantation is not yet clear, though available evidence would favour collection before delivery of the placenta. There are many unresolved ethical issues related to umbilical cord blood banking, particularly related to the rapid growth of private, for-profit, cord blood banks offering long-term storage for potential future autologous or related allogenic transplantation. The financial burden to the health care system for public cord blood banking and to families for private cord blood collection and storage is considerable. 1. Perinatal care providers should be informed about the promising clinical potential of hematopoietic stem cells in umbilical cord blood and about current indications for its collection, storage, and use, based on sound scientific evidence (II-3B). 2. Umbilical cord blood collection should be considered for a sibling or parent in need of stem cell transplantation when an HLA-identical bone marrow cell or peripheral stem cell donation from a sibling or parent is unavailable for transplantation (II-2B). 3. Umbilical cord blood should be considered when allogeneic transplantation is the treatment of choice for a child who does not have an HLA-identical sibling or a well-matched, unrelated adult bone marrow donor (II-2B). 4. Umbilical cord blood should be considered for allogeneic transplantation in adolescents and young adults with hematologic malignancies who have no suitable bone marrow donor and who require urgent transplantation (II-3B). 5. Altruistic donation of cord blood for public banking and subsequent allogeneic transplantation should be encouraged when umbilical cord blood banking is being considered by childbearing women, prenatal care providers, and(or) obstetric facilities (II-2B). 6. Collection and long-term storage of umbilical cord blood for autologous donation is not recommended because of the limited indications and lack of scientific evidence to support the practice (III-D). 7. Birth unit staff should receive training in standardized cord blood unit volume and reduce the rejection rate owing to labelling problems, bacterial contamination, and clotting (II-3B). 8. The safe management of obstetric delivery should never be compromised to facilitate cord blood collection. Manoeuvres to optimize cord blood unit volume, such as early clamping of the umbilical cord, may be employed at the discretion of the perinatal care team, provided the safety of the mother and newborn remains the major priority (III-A). 9. Collection of cord blood should be performed after the delivery of the infant but before delivery of the placenta, using a closed collection system and procedures that minimize risk of bacterial and maternal fluid contamination (see Figures 1a-1c) (I-B). 10. Public and private cord blood banks should strictly adhere to standardized policies and procedures for transportation, safety testing, HLA typing, cryopreservation, and long-term storage of umbilical cord blood units to prevent harm to the recipient, to eliminate the risk of transmitting communicable diseases, and thus to maximize the effectiveness of umbilical cord blood stem cell transplantation (II-1A). 11. Canada should establish registration, regulation, and accreditation of cord blood collection centres and banks (III-B). 12. Recruitment of cord blood donors should be fair and noncoercive. Criteria to ensure an equitable recruitment process include the following: (a) adequate supply to meet population transplantation needs; (b) fair distribution of the burdens and benefits of cord blood collection; (c) optimal timing of recruitment; (d) appropriately trained personnel; and (e) accurate recruitment message (III-A). 13. Informed consent for umbilical cord blood collection and banking should be obtained during prenatal care, before the onset of labour, with confirmation of consent after delivery (III-B). 14. Linkage of cord blood units and donors is recommended for public safety. Policies regarding the disclosure of abnormal test results to donor parents should be developed. Donor privacy and confidentiality of test results must be respected (III-C). 15. Commercial cord blood banks should be carefully regulated to ensure that promotion and pricing practices are fair, financial relationships are transparent, banked cord blood is stored and used according to approved standards, and parents and care providers understand the differences between autologous versus allogenic donations and private versus public banks (III-B). 16. Policies and procedures need to be developed by perinatal facilities and national health authorities to respond to prenatal requests for public and private cord blood banking (III-C).

The conception, birth, and growth of a missile umbilical system

NASA Technical Reports Server (NTRS)

Nordman, G. W.

1977-01-01

The design development was traced for the sprint 2 and improved sprint 2 missile system (ISMS) umbilical system. The unique system requirements, umbilical designs considered to meet the requirements, and the problems encountered and solutions derived during the design, and development testing of the selected systems are described. The sprint 2 development effort consisted of design, analysis, and testing activities. The ISMS effort involved the performance of an extensive trade study to determine the optimum design to meet the ISMS conditions.

Testing of the X-33 umbilical system at KSC

NASA Technical Reports Server (NTRS)

1999-01-01

At the Launch Equipment Test Facility, , Will Reaves and Mike Solomon (kneeling), both with Lockheed Martin Technical Operations, observe parts of the X-33 umbilical system during testing. A team of Kennedy Space Center experts developed the umbilical system, comprising panels, valves and hoses that provide the means to load the X-33 with super-cold propellant. The X-33, under construction at Lockheed Martin Skunk Works in Palmdale, Calif., is a half-scale prototype of the planned operational reusable launch vehicle dubbed VentureStar.

Robots Would Couple And Uncouple Fluid And Electrical Lines

NASA Technical Reports Server (NTRS)

Del Castillo, Eduardo Lopez; Davis, Virgil; Ferguson, Bob; Reichle, Garland

1992-01-01

Robots make and break connections between umbilical plates and mating connectors on rockets about to be launched. Sensing and control systems include vision, force, and torque subsystems. Enhances safety by making it possible to couple and uncouple umbilical plates quickly, without exposing human technicians to hazards of leaking fuels and oxidizers. Significantly reduces time spent to manually connect umbilicals. Robots based on similar principles used in refueling of National AeroSpace Plane (NASP) and satellites and orbital transfer vehicles in space.

Safety and Tolerability of HSC835 in Patients With Hematological Malignancies Undergoing Single Umbilical Cord Blood Transplant

ClinicalTrials.gov

2017-08-31

Single Umbilical Cord Blood Transplantation; Non-myeloablative Conditioning; Acute Lymphocytic Leukemia; Myelodysplastic Syndrome; Non-Hodgkin's Lymphoma; Multiple Myeloma; Chronic Lymphocytic Leukemia

Umbilical Cord Blood: Information for Childbirth Educators

PubMed Central

Waller-Wise, Renece

2011-01-01

Umbilical cord blood was once thought of as a waste product. Now, years after the first successful umbilical cord blood transplant, more families seek information about whether or not to save their newborn’s cord blood. Childbirth educators may be one of the main sources that an expectant family depends on to gain more knowledge about cord blood banking in order to make an informed decision. Preserving umbilical cord blood in public banks is advisable for any family; however, it is recommended that expectant families only consider private cord blood banking when they have a relative with a known disorder that is treatable by stem cell transplants. The childbirth educator is encouraged to be well versed on the topic of cord blood banking, so that as questions from class participants arise, the topic can be explored and addressed appropriately. PMID:22211060

Type II single umbilical artery (persistent vitelline artery) in an otherwise normal fetus.

PubMed

Gamzu, Ronni; Zalel, Yaron; Jacobson, Jeffrey M; Screiber, Leticia; Achiron, Reuven

2002-11-01

A single umbilical artery resulting from absence of the umbilical arteries and persistence of the vitelline artery that arises directly from the abdominal aorta has been described only in malformed fetuses with sirenomelia or caudal regression. Such an aberrant artery was suggested to be the etiology of sirenomelia caused by a 'steal' mechanism of blood flow from the caudal end of the embryo. We present a case in which prenatal ultrasound showed a similar aberrant single artery arising from the abdominal aorta in an otherwise normal fetus with a normal course of pregnancy. This vessel, a continuation of the superior mesenteric artery (SMA), corresponds to a persistent vitelline artery assuming the function of the umbilical arteries. The etiology of such a finding and its possible consequences are discussed. Copyright 2002 John Wiley & Sons, Ltd.

Triple dye plus rubbing alcohol versus triple dye alone for umbilical cord care.

PubMed

Suliman, Alawia K; Watts, Heidi; Beiler, Jessica; King, Tonya S; Khan, Sana; Carnuccio, Marybeth; Paul, Ian M

2010-01-01

Current practices for umbilical cord care vary across centers, but the evidence regarding these practices and their impact on cord separation, complications, and health care use are limited. The objective of this study was to compare the effect of triple dye alone (brilliant green, crystal violet, and proflavine hemisulfate) versus triple dye plus rubbing alcohol (isopropyl alcohol) twice daily on time to umbilical cord separation, complications, and health care use. For the 90 newborns who completed the study, there were no significant differences between treatment groups for time to cord separation, cord-related morbidities, or cord-related urgent care. Based on these study results, there does not appear to be significant benefit to the addition of twice daily applications of rubbing alcohol to neonatal umbilical cords following triple dye treatment after birth.

Orion Service Module Umbilical (OSMU) Lift & Preparation for Ins

NASA Image and Video Library

2017-03-13

Construction workers and crane specialists high up on the mobile launcher tower monitor the progress as a crane positions the bracket for the Orion Service Module Umbilical (OSMU) for installation on the mobile launcher tower at NASA's Kennedy Space Center in Florida. The tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Regulation of malonyl-CoA-acyl carrier protein transacylase network in umbilical cord blood affected by intrauterine hyperglycemia.

PubMed

Zhang, Yong; Ye, Jianping; Fan, Jianxia

2017-09-26

Gestational diabetes mellitus (GDM) has been shown to be associated with high risk of diabetes in offspring. However, the mechanisms involved in the insulin resistance in offspring are still unclear. Mitochondrial dysfunction is related with insulin resistance. In mitochondria, malonyl-CoA-acyl carrier protein transacylase (MCAT) is the key enzyme of mitochondrial fatty acid synthesis and is estimated to contribute to insulin resistance. In this study, we aimed to examine the role of MCAT and its network in the umbilical cord blood in GDM-induced offspring insulin resistance. We isolated lymphocytes from umbilical cord vein blood in 6 GDM patients and 6 controls and examined the differences of RNA by RNA sequencing. qRT-PCR and western blot were used to measure mRNA and protein changes. Bisulfite genomic sequencing PCR was applied to detect DNA methylation. We found more than 400 genes were differentially regulated in the lymphocytes of umbilical cord blood from GDM patients and these genes were mainly enriched in immune system and endocrine system, which relate to mitochondrial dysfunction and insulin resistance. MCAT closely related with PTPN1 (Protein Tyrosine Phosphatase, Non-Receptor Type1) and STAT5A (Signal Transducer And Activator of Transcription 5A), which were all increased in umbilical cord blood from GDM patients. Increase in MCAT may be due to decreased MCAT DNA methylation. MCAT and its network with PTPN1, STAT5A are regulated in umbilical cord blood affected by maternal intrauterine hyperglycemia.

Is human umbilical cord the most suitable substrate for the detection of endomysium antibodies in the screening and follow-up of coeliac disease?

PubMed

Sategna-Guidetti, C; Grosso, S B; Bruno, M; Grosso, S

1997-07-01

Immunoglobulin A (IgA) anti-endomysium antibodies, the most reliable immunological marker for both the screening and follow-up of coeliac disease, need monkey oesophagus as antigenic substrate; this limits their use because of high costs and the exploitation of endangered species. (1) To compare the diagnostic accuracy of anti-endomysium antibodies detected by indirect immunofluorescence on monkey oesophagus and on human umbilical cord; (2) to evaluate their reliability during follow-up in detecting non-compliant patients. One hundred and four untreated adults with biopsy-proven coeliac disease and 94 controls were investigated. Endomysium antibodies were found in 99 patients (95%) on both substrates, with a specificity, respectively, of 100% and 99% on monkey oesophagus and umbilical cord. One year after gluten withdrawal, out of 47 patients who were investigated, only six presented with complete mucosal recovery: none of these subjects was positive on either substrates, while, among patients with persistent histological alterations, endomysium positivity persisted in only 10 on monkey oesophagus, but in 32 on umbilical cord. Histology (recovery or persistent involvement) was in agreement with endomysium (negative or positive) in 34% on monkey oesophagus, but in 81% on umbilical cord (P < 0.0001). Human umbilical cord, with its comparable diagnostic efficiency, could replace monkey tissues, with the advantages of saving both money and monkeys. Moreover, it seems the most suitable substrate in the follow-up, as it enables detection of non-compliant patients with persisting mucosal alterations.

[Without Net and Double Floor: Comparison of Umbilical Hernia Repair by Spitzy in Children and Adults].

PubMed

Kuck, Laura; Seitz, Florian; Wiegering, Armin; Dietz, Ulrich; Meyer, Thomas

2017-11-22

Summary Umbilical hernia occur in both adults and children. For over 100 years, umbilical hernia in children has been treated surgically by the Spitzy method. With adult patients, meshes are being increasingly used. The purpose of our study was to analyse Spitzy herniotomy with respect to the recurrence rate in children and adults. Material and Methods Over a period of 7 years, 383 children (age < 16 years) with umbilical hernia were treated surgically; after applying the exclusion criteria, 370 patients were evaluated. At the same time, 106 adult patients (age > 16 years) were operated for an umbilical hernia: 31 patients were treated with direct suture and thus are included in our study as comparison group. Results The young patients had an average age of 33.81 months and were 44% female and 56% male. After direct Spitzy suture, a low recurrence rate of 1.1% (n = 4) in infancy could be achieved. The average age of the adult patients was 54.55 years; 32% were female, 68% male. In comparison to the group of children, the recurrence rate in adult surgery was 12.9% (n = 4) after direct suture. Conclusion As confirmed in our study, umbilical herniotomy by direct suture in childhood has been the method of choice and gold standard for more than 100 years. Mesh implantation is still not necessary in childhood. Georg Thieme Verlag KG Stuttgart · New York.

N‐Acetylcysteine, a glutathione precursor, reverts vascular dysfunction and endothelial epigenetic programming in intrauterine growth restricted guinea pigs

PubMed Central

Herrera, Emilio A.; Cifuentes‐Zúñiga, Francisca; Figueroa, Esteban; Villanueva, Cristian; Hernández, Cherie; Alegría, René; Arroyo‐Jousse, Viviana; Peñaloza, Estefania; Farías, Marcelo; Uauy, Ricardo; Casanello, Paola

2016-01-01

Key points Intrauterine growth restriction (IUGR) is associated with vascular dysfunction, oxidative stress and signs of endothelial epigenetic programming of the umbilical vessels.There is no evidence that this epigenetic programming is occurring on systemic fetal arteries.In IUGR guinea pigs we studied the functional and epigenetic programming of endothelial nitric oxide synthase (eNOS) (Nos3 gene) in umbilical and systemic fetal arteries, addressing the role of oxidative stress in this process by maternal treatment with N‐acetylcysteine (NAC) during the second half of gestation.The present study suggests that IUGR endothelial cells have common molecular markers of programming in umbilical and systemic arteries. Notably, maternal treatment with NAC restores fetal growth by increasing placental efficiency and reverting the functional and epigenetic programming of eNOS in arterial endothelium in IUGR guinea pigs. Abstract In humans, intrauterine growth restriction (IUGR) is associated with vascular dysfunction, oxidative stress and signs of endothelial programming in umbilical vessels. We aimed to determine the effects of maternal antioxidant treatment with N‐acetylcysteine (NAC) on fetal endothelial function and endothelial nitric oxide synthase (eNOS) programming in IUGR guinea pigs. IUGR was induced by implanting ameroid constrictors on uterine arteries of pregnant guinea pigs at mid gestation, half of the sows receiving NAC in the drinking water (from day 34 until term). Fetal biometry and placental vascular resistance were followed by ultrasound throughout gestation. At term, umbilical arteries and fetal aortae were isolated to assess endothelial function by wire‐myography. Primary cultures of endothelial cells (ECs) from fetal aorta, femoral and umbilical arteries were used to determine eNOS mRNA levels by quantitative PCR and analyse DNA methylation in the Nos3 promoter by pyrosequencing. Doppler ultrasound measurements showed that NAC reduced placental vascular resistance in IUGR (P < 0.05) and recovered fetal weight (P < 0.05), increasing fetal‐to‐placental ratio at term (∼40%) (P < 0.001). In IUGR, NAC treatment restored eNOS‐dependent relaxation in aorta and umbilical arteries (P < 0.05), normalizing eNOS mRNA levels in EC fetal and umbilical arteries (P < 0.05). IUGR‐derived ECs had a decreased DNA methylation (∼30%) at CpG −170 (from the transcription start site) and this epigenetic signature was absent in NAC‐treated fetuses (P < 0.001). These data show that IUGR‐ECs have common molecular markers of eNOS programming in umbilical and systemic arteries and this effect is prevented by maternal treatment with antioxidants. PMID:27739590

Neonatal atrial flutter after insertion of an intracardiac umbilical venous catheter

PubMed Central

de Almeida, Marcos Moura; Tavares, Wládia Gislaynne de Sousa; Furtado, Maria Mônica Alencar Araripe; Fontenele, Maria Marcia Farias Trajano

2016-01-01

Abstract Objective: To describe a case of neonatal atrial flutter after the insertion of an intracardiac umbilical venous catheter, reporting the clinical presentation and reviewing the literature on this subject. Case description: A late-preterm newborn, born at 35 weeks of gestational age to a diabetic mother and large for gestational age, with respiratory distress and rule-out sepsis, required an umbilical venous access. After the insertion of the umbilical venous catheter, the patient presented with tachycardia. Chest radiography showed that the catheter was placed in the position that corresponds to the left atrium, and traction was applied. The patient persisted with tachycardia, and an electrocardiogram showed atrial flutter. As the patient was hemodynamically unstable, electric cardioversion was successfully applied. Comments: The association between atrial arrhythmias and misplaced umbilical catheters has been described in the literature, but in this case, it is noteworthy that the patient was an infant born to a diabetic mother, which consists in another risk factor for heart arrhythmias. Isolated atrial flutter is a rare tachyarrhythmia in the neonatal period and its identification is essential to establish early treatment and prevent systemic complications and even death. PMID:26525686

Concentrations of pentosidine, an advanced glycation end-product, in umbilical cord blood.

PubMed

Tsukahara, Hirokazu; Ohta, Naoko; Sato, Shuko; Hiraoka, Masahiro; Shukunami, Ken-Ichi; Uchiyama, Mayumi; Kawakami, Hisako; Sekine, Kyouichi; Mayumi, Mitsufumi

2004-07-01

Advanced glycation end-products (AGEs) are formed over several weeks to months by non-enzymatic glycation and oxidation ("glycoxidation") reactions between carbohydrate-derived carbonyl groups and protein amino groups, known as the Maillard reaction. Pentosidine is one of the best-characterized AGEs and is accepted as a satisfactory marker for glycoxidation in vivo. The present study was intended to measure pentosidine concentrations in umbilical cord blood from newborns with various gestational ages using our recently established high-performance liquid chromatography method [Tsukahara, H. et al. (2003) Pediatr. Res. 54, 419-424]. Our study demonstrates, for the first time, that pentosidine is detected in most of the umbilical blood samples. This study also shows that the umbilical blood concentrations of pentosidine are considerably lower than normal adult values, but that they increase with gestation progression and fetal growth. Umbilical pentosidine concentrations were significantly elevated in newborns of mothers with preeclampsia compared to those of mothers without preeclampsia. We conclude that accumulation of AGEs and oxidative stress occurs in fetal tissues and organs in utero at the early stage of human life and that their accumulation is augmented in the maternal preeclampsic condition.

A Review of Factors Influencing the Banking of Collected Umbilical Cord Blood Units

PubMed Central

Allan, David; Petraszko, Tanya; Elmoazzen, Heidi; Smith, Susan

2013-01-01

Umbilical cord blood banking efforts have increased dramatically in the past two decades in response to increasing demand for alternative sources of blood stem cells to support patients requiring hematopoietic stem cell transplantation. Transplant centres have accumulated increasing expertise in their understanding of umbilical cord blood characteristics that are associated with improved outcome following transplantation. These characteristics and factors can assist transplant centres in selecting cord blood units from the worldwide inventory of banked units. Umbilical cord blood banks, therefore, need to remain agile in adjusting the inventory of the banks to address shifts or changes in the needs of transplant centres. Public umbilical cord blood banks face the challenge of building inventory while managing limited resources and are faced with decisions regarding which units can be stored and which units that have been collected should be discarded or used for other endeavours such as research. To this end, we sought to review parameters influencing the decision to bank a collected cord blood unit. In this paper, we will address parameters associated with graft potency and address other factors that guide the decision to bank collected units. PMID:23533442

Experimental studies on the tensile properties of human umbilical cords.

PubMed

Tantius, Britta; Rothschild, Markus A; Valter, Markus; Michael, Joern; Banaschak, Sibylle

2014-03-01

When tried in court, mothers accused of neonaticide may claim that the umbilical cord just broke during birth and the newborn child bled to death accordingly. To evaluate the possibility of a breakage of the umbilical cord is the goal of this work. Therefore 25 umbilical cords from neonates of both sexes born at term were stretched using an electrically operated material testing machine and the energy necessary to break them was measured. This experimental set-up equals a static strain, not a dynamic one. The maximum force endured (F max) ranged from 37.24 N to 150.04 N. The average force endured was 79.87 N with a standard deviation of 27.39. The elongation at break varied from 13.24% to a maximum of 119.93%. We found no relationship between the force endured and any of the following parameters: birth weight, pH of the venous umbilical blood, diameter of cord, free length under testing, duration of pregnancy or the mother's age. We performed a literature research and tried to define the circumstances in which a break is more likely to occur, these being malformations, entanglement or disease, e.g. inflammation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

How does tobacco smoke influence the morphometry of the fetus and the umbilical cord?-Research on pregnant women with intrauterine growth restriction exposed to tobacco smoke.

PubMed

Milnerowicz-Nabzdyk, Ewa; Bizoń, Anna

2015-12-01

Proper structure of the umbilical cord is important for the fetal development. We evaluated effects of toxic factors from tobacco smoke on fetal and umbilical cord morphometry. 109 women in weeks 29-40 of pregnancy (31 smokers with intrauterine growth restriction (IUGR); 28 non-smoking women with IUGR; 50 healthy pregnancies) were included. In smokers with IUGR, cotinine, cadmium and lead concentrations were significantly higher than in controls (mean 55.23ng/l; 1.52ng/ml; 14.85ng/ml vs 1.07; 0.34; 9.42) and inverse correlation between lead concentration and uncoiled umbilical cord was significant (r=-0.80). In smokers with IUGR, area of Wharton's jelly was increased compared to nonsmokers and controls. Inverse correlations occurred between cotinine and cadmium concentration and fetal percentile in smokers (r=-0.87; r=-0.87) and non-smokers (r=-0.47; r=-0.78) with IUGR. Exposure to tobacco smoke measured by cotinine, cadmium and lead concentration has an impact on fetal growth and umbilical cord morphometry and correlates with intensity of IUGR. Copyright © 2015 Elsevier Inc. All rights reserved.

Testing of the X-33 umbilical system at KSC

NASA Technical Reports Server (NTRS)

1999-01-01

At the Launch Equipment Test Facility, Mike Solomon, with Lockheed Martin Technical Operations, studies a part of the X-33 umbilical system during testing. Pointing to the part is Will Reaves, also with Lockheed Martin Technical Operations. A team of Kennedy Space Center experts developed the umbilical system, comprising panels, valves and hoses that provide the means to load the X-33 with super-cold propellant. The X-33, under construction at Lockheed Martin Skunk Works in Palmdale, Calif., is a half-scale prototype of the planned operational reusable launch vehicle dubbed VentureStar.

Umbilical cord blood banking and the next generation of human tissue regulation: an agenda for research.

PubMed

Stewart, Cameron; Kerridge, Ian

2012-03-01

The transformation of umbilical cord blood from being a waste product to being a valuable source of stem cells has led to the emergence of significant legal, ethical and social issues. This editorial proposes an agenda for research into the regulation of umbilical cord blood banking which focuses on issues of characterisation, consent, the interplay of public and private services, and the importance of applying property concepts. It concludes by stressing the need for reform to be based on well-informed public debate.

Introduction to the Portable Life Support Schematic and Technology Development Components

NASA Technical Reports Server (NTRS)

Conger, Bruce

2008-01-01

Conger presented the operations and functions of the baseline Constellation Program (CxP) Portable Life Support System (PLSS) schematic and key development technologies. He explained the functional descriptions of the schematic components in the fluid systems of the PLSS for multiple operational scenarios. PLSS subsystems include the oxygen subsystem, the ventilation subsystem, and the thermal subsystem. He also presented the operational PLSS modes: Nominal EVA mode, Umbilical - no recharge mode, Umbilical - with recharge mode, BENDS mode, BUDDY mode, Secondary oxygen mode, and the PLSS-removed umbilical mode.

Testing of the X-33 umbilical system at KSC

NASA Technical Reports Server (NTRS)

1999-01-01

At the Launch Equipment Test Facility, Mike Solomon (left) and Will Reaves (right), both with Lockheed Martin Technical Operations, move in for a close look at part of the X-33 umbilical system. A team of Kennedy Space Center experts developed the umbilical system, comprising panels, valves and hoses that provide the means to load the X-33 with super-cold propellant. The X-33, under construction at Lockheed Martin Skunk Works in Palmdale, Calif., is a half-scale prototype of the planned operational reusable launch vehicle dubbed VentureStar.

Incarceration of umbilical hernia: a rare complication of large volume paracentesis.

PubMed

Khodarahmi, Iman; Shahid, Muhammad Usman; Contractor, Sohail

2015-09-01

We present two cases of umbilical hernia incarceration following large volume paracentesis (LVP) in patients with cirrhotic ascites. Both patients became symptomatic within 48 hours after the LVP. Although being rare, given the significantly higher mortality rate of cirrhotic patients undergoing emergent herniorrhaphy, this complication of LVP is potentially serious. Therefore, it is recommended that patients be examined closely for the presence of umbilical hernias before removal of ascitic fluid and an attempt should be made for external reduction of easily reducible hernias, if a hernia is present.

Incarceration of umbilical hernia: a rare complication of large volume paracentesis

PubMed Central

Khodarahmi, Iman; Shahid, Muhammad Usman; Contractor, Sohail

2015-01-01

We present two cases of umbilical hernia incarceration following large volume paracentesis (LVP) in patients with cirrhotic ascites. Both patients became symptomatic within 48 hours after the LVP. Although being rare, given the significantly higher mortality rate of cirrhotic patients undergoing emergent herniorrhaphy, this complication of LVP is potentially serious. Therefore, it is recommended that patients be examined closely for the presence of umbilical hernias before removal of ascitic fluid and an attempt should be made for external reduction of easily reducible hernias, if a hernia is present. PMID:26629305

Newborn umbilical cord and skin care in Sylhet District, Bangladesh: Implications for promotion of umbilical cord cleansing with topical chlorhexidine

PubMed Central

Alam, Ashraful; Ali, Nabeel Ashraf; Sultana, Nighat; Mullany, Luke C.; Teela, Katherine C.; Khan, Nazib Uz Zaman; Baqui, Abdullah H.; Arifeen, Shams El; Mannan, Ishtiaq; Darmstadt, Gary L.; Winch, Peter J.

2010-01-01

Background Newborn cord care practices may directly contribute to infections, which account for a large proportion of the 4 million annual global neonatal deaths. This formative research study assessed current umbilical and skin care knowledge and practices for neonates in Sylhet, Bangladesh in preparation for a cluster-randomised trial of the impact of topical chlorhexidine cord cleansing on neonatal mortality and omphalitis. Methodology Unstructured interviews (n=60), structured observations (n=20), rating and ranking exercises (n=40), and household surveys (n=400) were conducted to elicit specific behaviours regarding newborn cord and skin care practices. These included hand-washing, skin and cord care at the time of birth, persons engaged in cord care, cord cutting practices, topical applications to the cord at the time of birth, wrapping/dressing of the cord stump, and use of skin-to-skin care. Results Ninety percent of deliveries occurred at home. The umbilical cord was almost always (98%) cut after delivery of the placenta, and cut by mothers in more than half the cases (57%). Substances were commonly (52%) applied to the stump after cord cutting; turmeric was the most common application (83%). Umbilical stump care revolved around bathing, skin massage with mustard oil, and heat massage on the umbilical stump. Forty-two percent of newborns were bathed on the day of birth. Mothers were the principal provider for skin and cord care during the neonatal period and 9% reported umbilical infections in their infants. Discussion Unhygienic cord care practices are prevalent in the study area. Efforts to promote hand washing, cord cutting with clean instruments, and avoiding unclean home applications to the cord may reduce exposure and improve neonatal outcomes. Such efforts should broadly target a range of caregivers, including mothers and other female household members. PMID:19057570

Local Perceptions, Cultural Beliefs and Practices That Shape Umbilical Cord Care: A Qualitative Study in Southern Province, Zambia

PubMed Central

Herlihy, Julie M.; Shaikh, Affan; Mazimba, Arthur; Gagne, Natalie; Grogan, Caroline; Mpamba, Chipo; Sooli, Bernadine; Simamvwa, Grace; Mabeta, Catherine; Shankoti, Peggy; Messersmith, Lisa; Semrau, Katherine; Hamer, Davidson H.

2013-01-01

Background Global policy regarding optimal umbilical cord care to prevent neonatal illness is an active discussion among researchers and policy makers. In preparation for a large cluster-randomized control trial to measure the impact of 4% chlorhexidine as an umbilical wash versus dry cord care on neonatal mortality in Southern Province, Zambia, we performed a qualitative study to determine local perceptions of cord health and illness and the cultural belief system that shapes umbilical cord care knowledge, attitudes, and practices. Methods and Findings This study consisted of 36 focus group discussions with breastfeeding mothers, grandmothers, and traditional birth attendants, and 42 in-depth interviews with key community informants. Semi-structured field guides were used to lead discussions and interviews at urban and rural sites. A wide variation in knowledge, beliefs, and practices surrounding cord care was discovered. For home deliveries, cords were cut with non-sterile razor blades or local grass. Cord applications included drying agents (e.g., charcoal, baby powder, dust), lubricating agents (e.g., Vaseline, cooking oil, used motor oil) and agents intended for medicinal/protective purposes (e.g., breast milk, cow dung, chicken feces). Concerns regarding the length of time until cord detachment were universally expressed. Blood clots in the umbilical cord, bulongo-longo, were perceived to foreshadow neonatal illness. Management of bulongo-longo or infected umbilical cords included multiple traditional remedies and treatment at government health centers. Conclusion Umbilical cord care practices and beliefs were diverse. Dry cord care, as recommended by the World Health Organization at the time of the study, is not widely practiced in Southern Province, Zambia. A cultural health systems model that depicts all stakeholders is proposed as an approach for policy makers and program implementers to work synergistically with existing cultural beliefs and practices in order to maximize effectiveness of evidence-based interventions. PMID:24244447

The risk of umbilical hernia and other complications with laparoendoscopic single-site surgery.

PubMed

Gunderson, Camille C; Knight, Jason; Ybanez-Morano, Jessica; Ritter, Carol; Escobar, Pedro F; Ibeanu, Okechukwu; Grumbine, Francis C; Bedaiwy, Mohamed A; Hurd, William W; Fader, Amanda Nickles

2012-01-01

To estimate the risk of umbilical hernia and other latent complications in women who underwent laparoendoscopic single-site surgery (LESS) for a gynecologic indication. Retrospective, nonrandomized clinical study (Canadian Task Force classification II-2). Four tertiary care academic medical centers. Women undergoing LESS for a benign or malignant gynecologic indication from 2009 to 2011. A total of 211 women underwent LESS via a single 1.5- to 2.0-cm umbilical incision. All surgeries were performed by advanced gynecologic laparoscopists. Incisions were repaired with a running, delayed absorbable suture. Subject demographics and clinical variables were collected and surgical outcomes analyzed. Median age and body mass index were 45 years and 30 kg/m(2), respectively. Approximately half of study subjects underwent a hysterectomy with or without salpingo-oophorectomy, and 15% had a diagnosis of cancer. Overall, 0.9% of women were diagnosed with a preoperative umbilical hernia, and 2.4% of women experienced a major perioperative complication. After a median postoperative follow-up time of 16 months, 2.4% had development of an umbilical hernia. However, 4/5 of these women had significant risk factors for fascial weakening independent of LESS, including requirement for a second abdominal surgery in 1 subject and a cancer diagnosis with postoperative chemotherapy administration in 2 subjects. When these subjects deemed "high risk" for incisional disruption were excluded from the analysis, the umbilical hernia rate was 0.5% (1/207). On univariable analysis, obesity was the only factor associated with complications (p = .04). When performed by advanced laparoscopic surgeons, laparoendoscopic single-site gynecologic surgery is associated with a low risk of major adverse events. Additionally, the overall umbilical hernia rate was 2.4% and was lower (0.5%) in subjects without significant comorbidities. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

Umbilical Cord Care in the Newborn Infant.

PubMed

Stewart, Dan; Benitz, William

2016-09-01

Postpartum infections remain a leading cause of neonatal morbidity and mortality worldwide. A high percentage of these infections may stem from bacterial colonization of the umbilicus, because cord care practices vary in reflection of cultural traditions within communities and disparities in health care practices globally. After birth, the devitalized umbilical cord often proves to be an ideal substrate for bacterial growth and also provides direct access to the bloodstream of the neonate. Bacterial colonization of the cord not infrequently leads to omphalitis and associated thrombophlebitis, cellulitis, or necrotizing fasciitis. Various topical substances continue to be used for cord care around the world to mitigate the risk of serious infection. More recently, particularly in high-resource countries, the treatment paradigm has shifted toward dry umbilical cord care. This clinical report reviews the evidence underlying recommendations for care of the umbilical cord in different clinical settings. Copyright © 2016 by the American Academy of Pediatrics.

Endometriosis of umbilical cicatrix: case report and review of the literature.

PubMed

Rosina, Paolo; Pugliarello, Silvia; Colato, Chiara; Girolomoni, Giampiero

2008-01-01

Umbilical endometriosis has an estimated incidence of 0.5%-1% of all patients with endometrial ectopia. It is a very rare disease, but should be considered on the differential diagnosis of umbilical lesions. We report on a case of spontaneous umbilical endometriosis in a 38-year-old woman, with a dark brown nodule periodically bleeding, associated with severe abdominal pain. There was no history of endometriosis and she had not been pregnant before. Laparoscopic visualization of pelvic cavity showed bilateral ovarian endometrioma (it was removed while sparing the ovaries). Surgical treatment proved effective. Cutaneous endometriosis could be a sign of internal endometriosis. Presentations may be atypical and pose diagnostic difficulty, mimicking other acute diseases, e.g., skin neoplasm, folliculitis, etc., but it should be suspected in any female presenting with a painful or bleeding mass close to the umbilicus or abdominal surgical scar.

Design, Development, And Testing of Umbilical System Mechanisms for the X-33 Advanced Technology Demonstrator

NASA Technical Reports Server (NTRS)

Littlefield, Alan C.; Melton, Gregory S.

2000-01-01

The X-33 Advanced Technology Demonstrator is an un-piloted, vertical take-off, horizontal landing spacecraft. The purpose of the X-33 program is to demonstrate technologies that will dramatically lower the cost of access to space. The rocket-powered X-33 will reach an altitude of up to 100 km and speeds between Mach 13 and 15. Fifteen flight tests are planned, beginning in 2000. Some of the key technologies demonstrated will be the linear aerospike engine, improved thermal protection systems, composite fuel tanks and reduced operational timelines. The X-33 vehicle umbilical connections provide monitoring, power, cooling, purge, and fueling capability during horizontal processing and vertical launch operations. Two "rise-off" umbilicals for the X-33 have been developed, tested, and installed. The X-33 umbilical systems mechanisms incorporate several unique design features to simplify horizontal operations and provide reliable disconnect during launch.

Design, Development,and Testing of Umbillical System Mechanisms for the X-33 Advanced Technology Demonstrator

NASA Technical Reports Server (NTRS)

Littlefield, Alan C.; Melton, Gregory S.

1999-01-01

The X-33 Advanced Technology Demonstrator is an un-piloted, vertical take-off, horizontal landing spacecraft. The purpose of the X-33 program is to demonstrate technologies that will dramatically lower the cost of access to space. The rocket-powered X-33 will reach an altitude of up to 100 km and speeds between Mach 13 and 15. Fifteen flight tests are planned, beginning in 2000. Some of the key technologies demonstrated will be the linear aerospike engine, improved thermal protection systems, composite fuel tanks and reduced operational timelines. The X-33 vehicle umbilical connections provide monitoring, power, cooling, purge, and fueling capability during horizontal processing and vertical launch operations. Two "rise-ofF' umbilicals for the X-33 have been developed, tested, and installed. The X-33 umbilical systems mechanisms incorporate several unique design features to simplify horizontal operations and provide reliable disconnect during launch.

Regulation of malonyl-CoA-acyl carrier protein transacylase network in umbilical cord blood affected by intrauterine hyperglycemia

PubMed Central

Zhang, Yong; Ye, Jianping; Fan, Jianxia

2017-01-01

Background Gestational diabetes mellitus (GDM) has been shown to be associated with high risk of diabetes in offspring. However, the mechanisms involved in the insulin resistance in offspring are still unclear. Mitochondrial dysfunction is related with insulin resistance. In mitochondria, malonyl-CoA-acyl carrier protein transacylase (MCAT) is the key enzyme of mitochondrial fatty acid synthesis and is estimated to contribute to insulin resistance. In this study, we aimed to examine the role of MCAT and its network in the umbilical cord blood in GDM-induced offspring insulin resistance. Methods We isolated lymphocytes from umbilical cord vein blood in 6 GDM patients and 6 controls and examined the differences of RNA by RNA sequencing. qRT-PCR and western blot were used to measure mRNA and protein changes. Bisulfite genomic sequencing PCR was applied to detect DNA methylation. Results We found more than 400 genes were differentially regulated in the lymphocytes of umbilical cord blood from GDM patients and these genes were mainly enriched in immune system and endocrine system, which relate to mitochondrial dysfunction and insulin resistance. MCAT closely related with PTPN1 (Protein Tyrosine Phosphatase, Non-Receptor Type1) and STAT5A (Signal Transducer And Activator of Transcription 5A), which were all increased in umbilical cord blood from GDM patients. Increase in MCAT may be due to decreased MCAT DNA methylation. Conclusion MCAT and its network with PTPN1, STAT5A are regulated in umbilical cord blood affected by maternal intrauterine hyperglycemia. PMID:29088862

Proteomic evaluation of human umbilical cord tissue exposed to polybrominated diphenyl ethers in an e-waste recycling area.

PubMed

Li, Minghui; Huo, Xia; Pan, Yukui; Cai, Haoxing; Dai, Yifeng; Xu, Xijin

2018-02-01

Parental exposure to polybrominated diphenyl ethers (PBDEs) is associated with adverse birth outcomes. This study aims to examine differentially-expressed protein profiles in umbilical cord tissue, derived from mothers exposed to PBDEs, and investigate candidate biomarkers to reveal the underlying molecular mechanisms. Umbilical cord samples were obtained from women residing in an electronic waste (e-waste) recycling area (Guiyu) and reference area (Haojiang) in China. The concentration of PBDEs in umbilical cord tissue was determined by gas chromatography and mass spectrometry (GC/MS). Isobaric tagging for relative and absolute quantification (iTRAQ)-based proteomic technology was conducted to analyze differentially-expressed protein profiles. The total PBDE concentration was approximately five-fold higher in umbilical cords from Guiyu than from Haojiang (median 71.92ng/g vs. 15.52ng/g lipid, P<0.01). Neonatal head circumference, body-mass index (BMI) and Apgar1 score were lower in Guiyu and negatively correlated with PBDE concentration (P<0.01). Proteomic analysis showed 697 proteins were differentially expressed in the e-waste-exposed group compared with the reference group. The differentially-expressed proteins were principally involved in antioxidant defense, apoptosis, cell structure and metabolism. Among them, catalase and glutathione S-transferase omega-1, were down-regulated, and cytochrome c was found to be up-regulated, changes which were further verified by enzyme-linked immunosorbent assays. These results suggest that an antioxidant imbalance and cell apoptosis in the umbilical cord following PBDE exposure is associated with neonatal birth outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Systematic umbilical cord blood analysis at birth: feasibility and reliability in a French labour ward].

PubMed

Ernst, D; Clerc, J; Decullier, E; Gavanier, G; Dupuis, O

2012-10-01

At birth, evaluation of neonatal well-being is crucial. It is though important to perform umbilical cord blood gas analysis, and then to analyze the samples. We wanted to establish the feasibility and reliability of systematic umbilical cord blood sampling in a French labour ward. Study of systematic umbilical cord blood gas analysis was realized retrospectively from 1000 consecutive deliveries. We first established the feasibility of the samples. Feasibility was defined by the ratio of complete cord acid-base data on the number of deliveries from alive newborns. Afterwards, we established the reliability on the remaining cord samples. Reliability was the ratio of samples that fulfilled quality criteria defined by Westgate et al. and revised by Kro et al., on the number of complete samples from alive newborns. At last, we looked for factors that would influence these results. The systematic umbilical cord blood sample feasibility reached 91.6%, and the reliability reached 80.7%. About the delivery mode, 38.6% of emergency caesarians (IC 95% [30.8-46.3]; P<0.0001) led to non-valid samples, when only 11.3% of programmed caesarians (IC 95% [4.3-18.2]; P<0.0001) led to non-valid samples. Umbilical cord blood analysis were significantly less validated during emergency caesarians. Realization of systematic cord blood gas analysis was followed by 8.4% of incomplete samples, and by 19.3% that were uninterpretable. Training sessions should be organized to improve the feasibility and reliability, especially during emergency caesarians. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Probabilistic Design Methodology and its Application to the Design of an Umbilical Retract Mechanism

NASA Technical Reports Server (NTRS)

Onyebueke, Landon; Ameye, Olusesan

2002-01-01

A lot has been learned from past experience with structural and machine element failures. The understanding of failure modes and the application of an appropriate design analysis method can lead to improved structural and machine element safety as well as serviceability. To apply Probabilistic Design Methodology (PDM), all uncertainties are modeled as random variables with selected distribution types, means, and standard deviations. It is quite difficult to achieve a robust design without considering the randomness of the design parameters which is the case in the use of the Deterministic Design Approach. The US Navy has a fleet of submarine-launched ballistic missiles. An umbilical plug joins the missile to the submarine in order to provide electrical and cooling water connections. As the missile leaves the submarine, an umbilical retract mechanism retracts the umbilical plug clear of the advancing missile after disengagement during launch and retrains the plug in the retracted position. The design of the current retract mechanism in use was based on the deterministic approach which puts emphasis on factor of safety. A new umbilical retract mechanism that is simpler in design, lighter in weight, more reliable, easier to adjust, and more cost effective has become desirable since this will increase the performance and efficiency of the system. This paper reports on a recent project performed at Tennessee State University for the US Navy that involved the application of PDM to the design of an umbilical retract mechanism. This paper demonstrates how the use of PDM lead to the minimization of weight and cost, and the maximization of reliability and performance.

Comparison between open and closed methods of herniorrhaphy in calves affected with umbilical hernia

PubMed Central

Hossain, Mohammad Farhad; Das, Bhajan Chandra; Kim, Gonhyung; Hossain, Mohammad Alamgir

2009-01-01

Umbilical hernias in calves commonly present to veterinary clinics, which are normally secondary to failure of the normal closure of the umbilical ring, and which result in the protrusion of abdominal contents into the overlying subcutis. The aim of this study was to compare the suitability of commonly-used herniorrhaphies for the treatment of reducible umbilical hernia in calves. Thirty-four clinical cases presenting to the Veterinary Teaching Hospital, Chittagong Veterinary and Animal Sciences University, Chittagong, Bangladesh from July 2004 to July 2007 were subjected to comprehensive study including history, classification of hernias, size of the hernial rings, presence of adhesion with the hernial sacs, postoperative care and follow-up. They were reducible, non-painful and had no evidence of infection present on palpation. The results revealed a gender influence, with the incidence of umbilical hernia being higher in female calves than in males. Out of the 34 clinical cases, 14 were treated by open method of herniorrhaphy and 20 were treated by closed method. Complications of hernia were higher (21%) in open method-treated cases than in closed method-treated cases (5%). Hernia recurred in three calves treated with open herniorrhaphy within 2 weeks of the procedure, with swelling in situ and muscular weakness at the site of operation. Shorter operation time and excellent healing rate (80%) were found in calves treated with closed herniorrhaphy. These findings suggest that the closed herniorrhaphy is better than the commonly-used open method for the correction of reducible umbilical hernia in calves. PMID:19934601

47. BASE OF UMBILICAL MAST, WITH ELECTRICAL POWER CABLES ON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

47. BASE OF UMBILICAL MAST, WITH ELECTRICAL POWER CABLES ON LEFT; AIR-CONDITIONER DUCTS ON RIGHT - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Maternal nutritional status during pregnancy and surma use determine cord lead levels in Karachi, Pakistan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Janjua, Naveed Zafar; Department of Community Health Sciences, Aga Khan University, Karachi; Delzell, Elizabeth

Objectives: To estimate the umbilical cord blood lead levels (BLLs) of Pakistani neonates and to identify determinants for umbilical BLLs. Methods: We conducted a cross-sectional study of mothers and infants at one of the two obstetric units of two tertiary care hospitals in Karachi during January-August 2005. Information from 540 mothers selected randomly from those registered for delivery was obtained about their pregnancy, diet, and current and past lead exposures. We collected umbilical cord blood for lead levels analyzed using graphite furnace atomic absorption spectrophotometry. We computed geometric and arithmetic means. We performed multiple linear regression analysis to identify factorsmore » associated with log-transformed umbilical cord BLLs. We also performed logistic regression analysis to identify determinants of high lead cord BLLs ({>=}10 {mu}g/dl). Results: The geometric mean cord BLL of the neonates was 9.6 {mu}g/dl; arithmetic mean (S.D.) was 10.8 {mu}g/dl (5.7) with a median of 9.7 {mu}g/dl and a range of 1.8-48.9 {mu}g/dl. Women who reported intake of less than 58.5 mg of elemental iron supplement per day during pregnancy had cord BLL of 10.0 {mu}g/dl; in comparison those women who had higher iron intake had lower cord BLL (8.4 {mu}g/dl). Those who used surma (an eye cosmetic) daily had higher cord BLL (11.5 {mu}g/dl) as compared to those who used it less frequently (9.4 {mu}g/dl). In multivariable linear regression model, higher iron intake, owning a car, and being in 2nd quartile of mid-arm circumference were associated with low lead levels while father's occupation in lead-based industry was associated with significantly higher umbilical cord BLLs. There was interaction of daily surma use and ethnicity. Geometric mean BLLs were varied among surma users by ethnicity. Conclusions: Umbilical cord BLLs are high in Karachi, Pakistan, in comparison to those in developed countries such as United States. Measures are needed to reduce fetal lead exposure to prevent adverse affect on neurocognitive development. Association of low iron (below RDA of 60 mg per day) with high umbilical cord has implications for strengthening iron supplement intake during pregnancy. Umbilical cord BLLs differed among surma users by ethnicity.« less

A prospective study on elective umbilical hernia repair in patients with liver cirrhosis and ascites.

PubMed

Eker, Hasan H; van Ramshorst, G H; de Goede, B; Tilanus, H W; Metselaar, H J; de Man, R A; Lange, J F; Kazemier, G

2011-09-01

Patients with both cirrhosis and ascites have a 20% risk of developing umbilical hernia. A retrospective study from our center comparing conservative management of umbilical hernia with elective repair in these patients showed a significant risk of mortality as a result of hernia incarceration in conservatively treated patients. The goal of this study was to assess the safety and efficacy of elective umbilical hernia repair in these patients prospectively. Patients with liver cirrhosis and ascites presenting with an umbilical hernia were included in this study. For all patients, the expected time to liver transplantation was more than 3 months, and they did not have a patent umbilical vein in the hernia sac. The following data were collected prospectively for all patients: Child-Pugh-Turcotte (CPT) classification, model for end-stage liver disease (MELD) score, kidney failure, cardiovascular comorbidity, operation-related complications, and duration of hospital stay. Mortality rates were registered in hospital records and verified in government records during follow-up. Mortality rates were registered in hospital records and verified in government records during follow-up. On completion of the study, a retrospective survey was performed to search for any patients who met the study inclusion criteria but were left out of the study cohort. In total, 30 patients (25 males) underwent operation at a mean age of 58 years (standard deviation [SD] ± 9 years). Of these 30 patients, 6 were classified as CPT grade A (20%), 19 (63%) as grade B, and 5 (17%) as grade C. The patients' median MELD score was 12 (interquartile range [IQR], 8-16). In 10 (33%) of the 30 patients hernia repair was performed with mesh. The median duration of hospital stay was 3 days (IQR, 2-4). None of the patients were admitted to the intensive care unit. Postoperative complications included pneumonia and decompensation of cirrhosis (1 case each,) resulting in prolonged hospital stay for those 2 patients. After a median follow-up period of 25 months (IQR, 14-34), 2 (7%) of the 30 patients died; neither of the deaths were attributable to the umbilical hernia repair. A total of 2 patients suffered recurrence. Elective umbilical hernia repair is safe and the preferred approach in cirrhotic patients with ascites. Copyright © 2011 Mosby, Inc. All rights reserved.

9. DETAIL OF UMBILICAL MAST BASE WITH STEEL STOPS AT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. DETAIL OF UMBILICAL MAST BASE WITH STEEL STOPS AT EAST END OF MOBILE SERVICE STRUCTURE RAIL; VIEW TO NORTHWEST. - Cape Canaveral Air Station, Launch Complex 17, Facility 28501, East end of Lighthouse Road, Cape Canaveral, Brevard County, FL

Sonographic diagnosis of hepatic erosion caused by umbilical catheterization.

PubMed

Schiavone, R; Narese, D; Ognibene, N; Rossi, E; Antonello, M; Basile, M; Di Maurizio, M; Defilippi, C

2016-01-01

The use of umbilical venous catheter (UVC) is common practice in neonatal units. The traumatic injury of the hepatic parenchyma is a rare complication. We present a case of a preterm newborn underwent ultrasound examination revealing a hyperechogenic focal lesion at the confluence of the hepatic veins This finding, according to patient's history, was suspected to be a traumatic injury of the liver parenchyma caused by umbilical catheterization. During sonographic follow-up this lesion gradually reduced until complete resolution. Finally, when focal hyperechogenic hepatic lesion is incidentally detected in newborn with history of UVC placement, the radiologists must consider the traumatic etiology.

Placental transfer of flunitrazepam following intramuscular administration during labour.

PubMed Central

Kanto, J; Erkkola, R; Kangas, L; Pitkänen, Y

1987-01-01

After a single intramuscular dose of flunitrazepam 0.015 mg kg-1 (n = 14) in women 37 to 41 weeks pregnant, the concentrations in the umbilical artery and amniotic fluid were significantly lower than in maternal venous plasma. Although the difference between the maternal venous and umbilical venous plasma concentrations was not significant, the mean fetomaternal ratio was 0.7. The plasma protein binding of flunitrazepam was 80 +/- 4% in the mother and 79 +/- 5% in the umbilical circulation. Both mothers and midwives subjectively estimated intramuscular flunitrazepam as a valuable sedative-anxiolytic agent during the first stage of labour. PMID:3580256

Agenesis of the venous duct: two cases of extrahepatic drainage of the umbilical vein and extrahepatic portosystemic shunt with a review of the literature.

PubMed

Loomba, Rohit S; Frommelt, Michele; Moe, David; Shillingford, Amanda J

2015-02-01

Agenesis of the venous duct is a rare congenital anomaly resulting in abnormal drainage of the umbilical vein into the foetal venous circulation. The clinical presentation and prognosis is variable, and may depend on the specific drainage pathways of the umbilical vein. We present two foetuses with agenesis of the venous duct, both associated with a postnatal portosystemic shunt, but with markedly different postnatal clinical courses. We also review all previously reported cases to better characterise this foetal disorder and the prognosis.

Cure of beta-thalassaemia major by umbilical cord blood transplantation--a case report of Malaysia's first cord blood transplantation.

PubMed

Chan, L L; Lin, H P

1999-08-01

A 25-month-old boy with beta-thalassaemia major was presented with an opportunity for umbilical cord blood transplantation when his unborn sibling was diagnosed in utero to be a beta-thalassaemia carrier and also human leucocyte antigen compatible. A barely adequate amount of cord blood was collected at the birth of his sibling and infused into the patient after appropriate chemo-conditioning. Engraftment occurred without major complications. The subject is now alive and well 9 months post-transplant, thus marking our first success in umbilical cord blood transplantation.

Differences in twins: the importance of birth order.

PubMed

Young, B K; Suidan, J; Antoine, C; Silverman, F; Lustig, I; Wasserman, J

1985-04-01

Despite the clinical impression that firstborn twins do better than second-born twins, recent reports have shown no difference in perinatal mortality between them. In order to evaluate differences in twins, more sensitive means than perinatal deaths are necessary. This study examines differences between 80 firstborn and second-born twin pairs with respect to Apgar score, umbilical venous and arterial blood gas, and acid-base data. The umbilical venous and arterial blood PO2, PCO2, base deficit, pH, and lactic acid concentration were measured in paired samples and compared with the paired t test and chi 2 when applicable. Statistically significant differences favoring twin A, the firstborn, were found in 1-minute Apgar score, umbilical venous pH, PO2, and PCO2, and umbilical arterial PO2. The other factors in umbilical venous and arterial blood did not show statistically significant differences. When these parameters were examined with respect to route of delivery, monochorionic and dichorionic twins, interval between twins, and vertex twins only, with the possible effects of malpresentation eliminated, the results persistently favored the firstborn twin. Thus it is unequivocally demonstrated that there are substantial differences at birth favoring the first twin, despite similar perinatal mortality for both. The data suggest that the second-born twin has potentially greater susceptibility to hypoxia and trauma.

Evolution of congenital malformations of the umbilical-portal-hepatic venous system.

PubMed

Scalabre, Aurelien; Gorincour, Guillaume; Hery, Geraldine; Gamerre, Marc; Guys, Jean-Michel; de Lagausie, Pascal

2012-08-01

The objective of this study is to describe the evolution of 8 cases of congenital malformations of the umbilical-portal-hepatic venous system diagnosed before the first month of life. All cases of congenital malformation of the portal and hepatic venous system diagnosed prenatally or during the first month of life in our institution were systematically reviewed since November 2000. Clinical features, imaging, and anatomical findings were reviewed, focusing primarily on clinical and radiologic evolution. Eight cases of congenital malformation of the umbilical-portal-hepatic venous system were studied. Fifty percent of these malformations were diagnosed prenatally. We report 4 portosystemic shunts. Three involuted spontaneously, and the fourth one required surgical treatment. We report a variation of the usual anatomy of portal and hepatic veins that remained asymptomatic, an aneurysmal dilatation of a vitelline vein causing portal vein thrombosis that needed prompt surgical treatment with good result, a complex portal and hepatic venous malformation treated operatively, and a persistent right umbilical vein that remained asymptomatic. Prenatal diagnosis of malformations of the umbilical-portal-hepatic venous network is uncommon. Little is known about the postnatal prognosis. Clinical, biologic, and radiologic follow-up by ultrasonography is essential to distinguish pathologic situations from normal anatomical variants. Copyright © 2012 Elsevier Inc. All rights reserved.

Delivery route determines the presence of immune complexes on umbilical cord erythrocytes.

PubMed

de Lima, Andrés; Franco, Luis C; Sarmiento, Andrés; González, John M

2017-11-01

Umbilical cord blood offers a unique opportunity to study the basal level of immunoglobulin complexes. This study aims to determine the presence of immune complexes and complement deposition on erythrocytes from umbilical cord blood from normal, full-term pregnancies. In vitro pre-formed IgA, IgG, and IgM complexes were used as positive control for flow cytometry detection, and for C3d deposition. Blood samples (34) of umbilical cord blood taken from vaginal and cesarean deliveries were tested for the presence of immunoglobulin complexes. Fourteen samples from vaginal deliveries and 20 samples from cesarean deliveries were assessed. IgG and IgM complexes were detected on erythrocytes, whereas no IgA complexes or complement deposition was observed. Interestingly, the percentage of IgG complexes was higher on erythrocytes from vaginal delivery samples compared to those from cesarean deliveries. No other associations between immune complexes and other maternal or newborn variables were found. IgG and IgM complexes seem to be normally present on umbilical cord erythrocytes. Erythrocytes from vaginal deliveries have a higher percentage of IgG complexes present compared to that from cesarean deliveries. Since no C3d activity was detected, these complexes are non-pathological and should be part of the newborn's initial innate immune response.

Clinicopathologic features and surgical management of primary umbilical melanoma: a case series.

PubMed

Di Monta, Gianluca; Caracò, Corrado; Marone, Ugo; Grimaldi, Antonio Maria; Anniciello, Anna Maria; Di Marzo, Massimiliano; Simeone, Ester; Mori, Stefano

2015-04-15

Primary umbilical melanoma is an uncommon tumor that is poorly described in the medical literature. The umbilical region is a particular anatomic site owing to the presence of embryonal remnants, which can be a potential metastatic pathway, as well as the braided lymphatic network drainage. Hence, primary malignant neoplasms affecting the umbilicus require a different and more radical surgical approach compared with other melanomas. In this report, we describe a series of three patients of Caucasian ethnicity who presented with primary umbilical melanoma at the National Cancer Institute of Naples, Italy. All patients underwent wide excision of the tumor including the underlying peritoneum. No surgical complications, either immediate or delayed, were observed in any of the patients. Sentinel lymph node biopsy was negative in two cases. Two of the patients developed metastatic disease and died after systemic medical therapy. The other patient is currently in follow-up, and remains disease-free after 21 months. The umbilicus has vascular and embryological connections with the underlying peritoneum, so that early visceral involvement is more likely to occur with primary umbilical melanomas. As such, tumor resection including the underlying peritoneum is required to avoid local relapse, whilst sentinel lymph node biopsy appears to be of poor diagnostic value.

Exploring the umbilical and vaginal port during minimally invasive surgery.

PubMed

Tinelli, Andrea; Tsin, Daniel A; Forgione, Antonello; Zorron, Ricardo; Dapri, Giovanni; Malvasi, Antonio; Benhidjeb, Tahar; Sparic, Radmila; Nezhat, Farr

2017-09-01

This article focuses on the anatomy, literature, and our own experiences in an effort to assist in the decision-making process of choosing between an umbilical or vaginal port. Umbilical access is more familiar to general surgeons; it is thicker than the transvaginal entry, and has more nerve endings and sensory innervations. This combination increases tissue damage and pain in the umbilical port site. The vaginal route requires prophylactic antibiotics, a Foley catheter, and a period of postoperative sexual abstinence. Removal of large specimens is a challenge in traditional laparoscopy. Recently, there has been increased interest in going beyond traditional laparoscopy by using the navel in single-incision and port-reduction techniques. The benefits for removal of surgical specimens by colpotomy are not new. There is increasing interest in techniques that use vaginotomy in multifunctional ways, as described under the names of culdolaparoscopy, minilaparoscopy-assisted natural orifice surgery, and natural orifice transluminal endoscopic surgery. Both the navel and the transvaginal accesses are safe and convenient to use in the hands of experienced laparoscopic surgeons. The umbilical site has been successfully used in laparoscopy as an entry and extraction port. Vaginal entry and extraction is associated with a lower risk of incisional hernias, less postoperative pain, and excellent cosmetic results.

Umbilical hernia following gastroschisis closure: a common event?

PubMed

Tullie, L G C; Bough, G M; Shalaby, A; Kiely, E M; Curry, J I; Pierro, A; De Coppi, P; Cross, K M K

2016-08-01

To assess incidence and natural history of umbilical hernia following sutured and sutureless gastroschisis closure. With audit approval, we undertook a retrospective clinical record review of all gastroschisis closures in our institution (2007-2013). Patient demographics, gastroschisis closure method and umbilical hernia occurrence were recorded. Data, presented as median (range), underwent appropriate statistical analysis. Fifty-three patients were identified, gestation 36 weeks (31-38), birth weight 2.39 kg (1-3.52) and 23 (43 %) were male. Fourteen patients (26 %) underwent sutureless closure: 12 primary, 2 staged; and 39 (74 %) sutured closure: 19 primary, 20 staged. Sutured closure was interrupted sutures in 24 patients, 11 pursestring and 4 not specified. Fifty patients were followed-up over 53 months (10-101) and 22 (44 %) developed umbilical hernias. There was a significantly greater hernia incidence following sutureless closure (p = 0.0002). In sutured closure, pursestring technique had the highest hernia rate (64 %). Seven patients underwent operative hernia closure; three secondary to another procedure. Seven patients had their hernias resolve. One patient was lost to follow-up and seven remain under observation with no reported complications. There is a significant umbilical hernia incidence following sutureless and pursestring sutured gastroschisis closure. This has not led to complications and the majority have not undergone repair.

Suture versus tack fixation of mesh in laparoscopic umbilical hernia repair.

PubMed

Kitamura, Riley K; Choi, Jacqueline; Lynn, Elizabeth; Divino, Celia M

2013-01-01

Mesh fixation in laparoscopic umbilical hernia repair is poorly studied. We compared postoperative outcomes of laparoscopic umbilical hernia repair in suture versus tack mesh fixation. Patients who underwent laparoscopic umbilical hernia repair were separated by method of mesh fixation: sutures versus primarily tacks. Medical history and follow-up data were collected through medical records. The primary outcome of this study was the recurrence rates of hernias. Postoperative major and minor complications, such as surgical site infection, small-bowel obstruction, and seroma formation, were regarded as secondary outcomes. Additionally, a telephone interview was conducted to assess postoperative pain, recovery time, and overall patient satisfaction. Eighty-six patients were identified: 33 in the suture group and 53 in the tacks group. The number of emergent cases was increased in the tacks group (6 vs 0; P = .022). Mean follow-up time was 2.7 years for both groups. Documented postoperative follow-up was obtained in 29 (90%) suture group and 31 (58%) tacks group patients. Hernia recurrence occurred in 3 and 2 patients in the sutures and tacks groups, respectively (P was not significant). No differences were found in secondary outcomes, including subjective outcomes from telephone interviews, between groups. There are no differences in postoperative complication rates in suture versus tack mesh fixation in laparoscopic umbilical hernia repair.

Fetal demise by umbilical cord around abdomen and stricture.

PubMed

Tan, Shun-Jen; Chen, Chi-Huang; Wu, Gwo-Jang; Chen, Wei-Hwa; Chang, Cheng-Chang

2010-01-01

Umbilical cord abnormalities are accepted as conditions associated with intrauterine fetal demise (IUFD), and umbilical cord stricture is most frequently encountered. In addition, although cord entanglement with multiple loops rarely increases the perinatal mortality, it is associated with a significant increase in variable kind of morbidity such as growth restriction. We describe a 27-year-old woman, with a missed abortion history at about 10 weeks' gestation in her first pregnancy, who presented to our outpatient department at 34 4/7 weeks of gestation due to decreased fetal activity during the preceding week. No fetal heart activity and blood flow had been detected by ultrasonography and pulsed-wave Doppler. A demised fetus with umbilical cord stricture and three loops around abdomen was delivered and was weighted 1,830 g that was below the tenth percentile for the gestational age. Either umbilical cord stricture or entanglement around the body can affect the development of the fetus and even be lethal. The former might play a more important role in this case. Their etiology and the sequence of the events are still undetermined, and additional evaluation such as autopsy and further research may be needed. In addition, counsel and frequent fetal surveillance should be done in patients with previous IUFD attributed to cord stricture during next pregnancy because of undetermined risk of recurrence.

N-Acetylcysteine, a glutathione precursor, reverts vascular dysfunction and endothelial epigenetic programming in intrauterine growth restricted guinea pigs.

PubMed

Herrera, Emilio A; Cifuentes-Zúñiga, Francisca; Figueroa, Esteban; Villanueva, Cristian; Hernández, Cherie; Alegría, René; Arroyo-Jousse, Viviana; Peñaloza, Estefania; Farías, Marcelo; Uauy, Ricardo; Casanello, Paola; Krause, Bernardo J

2017-02-15

Intrauterine growth restriction (IUGR) is associated with vascular dysfunction, oxidative stress and signs of endothelial epigenetic programming of the umbilical vessels. There is no evidence that this epigenetic programming is occurring on systemic fetal arteries. In IUGR guinea pigs we studied the functional and epigenetic programming of endothelial nitric oxide synthase (eNOS) (Nos3 gene) in umbilical and systemic fetal arteries, addressing the role of oxidative stress in this process by maternal treatment with N-acetylcysteine (NAC) during the second half of gestation. The present study suggests that IUGR endothelial cells have common molecular markers of programming in umbilical and systemic arteries. Notably, maternal treatment with NAC restores fetal growth by increasing placental efficiency and reverting the functional and epigenetic programming of eNOS in arterial endothelium in IUGR guinea pigs. In humans, intrauterine growth restriction (IUGR) is associated with vascular dysfunction, oxidative stress and signs of endothelial programming in umbilical vessels. We aimed to determine the effects of maternal antioxidant treatment with N-acetylcysteine (NAC) on fetal endothelial function and endothelial nitric oxide synthase (eNOS) programming in IUGR guinea pigs. IUGR was induced by implanting ameroid constrictors on uterine arteries of pregnant guinea pigs at mid gestation, half of the sows receiving NAC in the drinking water (from day 34 until term). Fetal biometry and placental vascular resistance were followed by ultrasound throughout gestation. At term, umbilical arteries and fetal aortae were isolated to assess endothelial function by wire-myography. Primary cultures of endothelial cells (ECs) from fetal aorta, femoral and umbilical arteries were used to determine eNOS mRNA levels by quantitative PCR and analyse DNA methylation in the Nos3 promoter by pyrosequencing. Doppler ultrasound measurements showed that NAC reduced placental vascular resistance in IUGR (P < 0.05) and recovered fetal weight (P < 0.05), increasing fetal-to-placental ratio at term (∼40%) (P < 0.001). In IUGR, NAC treatment restored eNOS-dependent relaxation in aorta and umbilical arteries (P < 0.05), normalizing eNOS mRNA levels in EC fetal and umbilical arteries (P < 0.05). IUGR-derived ECs had a decreased DNA methylation (∼30%) at CpG -170 (from the transcription start site) and this epigenetic signature was absent in NAC-treated fetuses (P < 0.001). These data show that IUGR-ECs have common molecular markers of eNOS programming in umbilical and systemic arteries and this effect is prevented by maternal treatment with antioxidants. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

Insulin restores gestational diabetes mellitus-reduced adenosine transport involving differential expression of insulin receptor isoforms in human umbilical vein endothelium.

PubMed

Westermeier, Francisco; Salomón, Carlos; González, Marcelo; Puebla, Carlos; Guzmán-Gutiérrez, Enrique; Cifuentes, Fredi; Leiva, Andrea; Casanello, Paola; Sobrevia, Luis

2011-06-01

To determine whether insulin reverses gestational diabetes mellitus (GDM)-reduced expression and activity of human equilibrative nucleoside transporters 1 (hENT1) in human umbilical vein endothelium cells (HUVECs). Primary cultured HUVECs from full-term normal (n = 44) and diet-treated GDM (n = 44) pregnancies were used. Insulin effect was assayed on hENT1 expression (protein, mRNA, SLC29A1 promoter activity) and activity (initial rates of adenosine transport) as well as endothelial nitric oxide (NO) synthase activity (serine(1177) phosphorylation, l-citrulline formation). Adenosine concentration in culture medium and umbilical vein blood (high-performance liquid chromatography) as well as insulin receptor A and B expression (quantitative PCR) were determined. Reactivity of umbilical vein rings to adenosine and insulin was assayed by wire myography. Experiments were in the absence or presence of l-N(G)-nitro-l-arginine methyl ester (l-NAME; NO synthase inhibitor) or ZM-241385 (an A(2A)-adenosine receptor antagonist). Umbilical vein blood adenosine concentration was higher, and the adenosine- and insulin-induced NO/endothelium-dependent umbilical vein relaxation was lower in GDM. Cells from GDM exhibited increased insulin receptor A isoform expression in addition to the reported NO-dependent inhibition of hENT1-adenosine transport and SLC29A1 reporter repression, and increased extracellular concentration of adenosine and NO synthase activity. Insulin reversed all these parameters to values in normal pregnancies, an effect blocked by ZM-241385 and l-NAME. GDM and normal pregnancy HUVEC phenotypes are differentially responsive to insulin, a phenomenon where insulin acts as protecting factor for endothelial dysfunction characteristic of this syndrome. Abnormal adenosine plasma levels, and potentially A(2A)-adenosine receptors and insulin receptor A, will play crucial roles in this phenomenon in GDM.

A risk factor analysis of outcomes after unrelated cord blood transplantation for children with Wiskott-Aldrich syndrome

PubMed Central

Shekhovtsova, Zhanna; Bonfim, Carmem; Ruggeri, Annalisa; Nichele, Samantha; Page, Kristin; AlSeraihy, Amal; Barriga, Francisco; de Toledo Codina, José Sánchez; Veys, Paul; Boelens, Jaap Jan; Mellgren, Karin; Bittencourt, Henrique; O’Brien, Tracey; Shaw, Peter J.; Chybicka, Alicja; Volt, Fernanda; Giannotti, Federica; Gluckman, Eliane; Kurtzberg, Joanne; Gennery, Andrew R.; Rocha, Vanderson

2017-01-01

Wiskott-Aldrich syndrome is a severe X-linked recessive immune deficiency disorder. A scoring system of Wiskott-Aldrich syndrome severity (0.5–5) distinguishes two phenotypes: X-linked thrombocytopenia and classic Wiskott-Aldrich syndrome. Hematopoietic cell transplantation is curative for Wiskott-Aldrich syndrome; however, the use of unrelated umbilical cord blood transplantation has seldom been described. We analyzed umbilical cord blood transplantation outcomes for 90 patients. The median age at umbilical cord blood transplantation was 1.5 years. Patients were classified according to clinical scores [2 (23%), 3 (30%), 4 (23%) and 5 (19%)]. Most patients underwent HLA-mismatched umbilical cord blood transplantation and myeloablative conditioning with anti-thymocyte globulin. The cumulative incidence of neutrophil recovery at day 60 was 89% and that of grade II–IV acute graft-versus-host disease at day 100 was 38%. The use of methotrexate for graft-versus-host disease prophylaxis delayed engraftment (P=0.02), but decreased acute graft-versus-host disease (P=0.03). At 5 years, overall survival and event-free survival rates were 75% and 70%, respectively. The estimated 5-year event-free survival rates were 83%, 73% and 55% for patients with a clinical score of 2, 4–5 and 3, respectively. In multivariate analysis, age <2 years at the time of the umbilical cord blood transplant and a clinical phenotype of X-linked thrombocytopenia were associated with improved event-free survival. Overall survival tended to be better in patients transplanted after 2007 (P=0.09). In conclusion, umbilical cord blood transplantation is a good alternative option for young children with Wiskott-Aldrich syndrome lacking an HLA identical stem cell donor. PMID:28255019

Improvement of renal function after human umbilical cord mesenchymal stem cell treatment on chronic renal failure and thoracic spinal cord entrapment: a case report.

PubMed

Rahyussalim, Ahmad Jabir; Saleh, Ifran; Kurniawati, Tri; Lutfi, Andi Praja Wira Yudha

2017-11-30

Chronic renal failure is an important clinical problem with significant socioeconomic impact worldwide. Thoracic spinal cord entrapment induced by a metabolic yield deposit in patients with renal failure results in intrusion of nervous tissue and consequently loss of motor and sensory function. Human umbilical cord mesenchymal stem cells are immune naïve and they are able to differentiate into other phenotypes, including the neural lineage. Over the past decade, advances in the field of regenerative medicine allowed development of cell therapies suitable for kidney repair. Mesenchymal stem cell studies in animal models of chronic renal failure have uncovered a unique potential of these cells for improving function and regenerating the damaged kidney. We report a case of a 62-year-old ethnic Indonesian woman previously diagnosed as having thoracic spinal cord entrapment with paraplegic condition and chronic renal failure on hemodialysis. She had diabetes mellitus that affected her kidneys and had chronic renal failure for 2 years, with creatinine level of 11 mg/dl, and no urinating since then. She was treated with human umbilical cord mesenchymal stem cell implantation protocol. This protocol consists of implantation of 16 million human umbilical cord mesenchymal stem cells intrathecally and 16 million human umbilical cord mesenchymal stem cells intravenously. Three weeks after first intrathecal and intravenous implantation she could move her toes and her kidney improved. Her creatinine level decreased to 9 mg/dl. Now after 8 months she can raise her legs and her creatinine level is 2 mg/dl with normal urinating. Human umbilical cord mesenchymal stem cell implantations led to significant improvement for spinal cord entrapment and kidney failure. The major histocompatibility in allogeneic implantation is an important issue to be addressed in the future.

A risk factor analysis of outcomes after unrelated cord blood transplantation for children with Wiskott-Aldrich syndrome.

PubMed

Shekhovtsova, Zhanna; Bonfim, Carmem; Ruggeri, Annalisa; Nichele, Samantha; Page, Kristin; AlSeraihy, Amal; Barriga, Francisco; de Toledo Codina, José Sánchez; Veys, Paul; Boelens, Jaap Jan; Mellgren, Karin; Bittencourt, Henrique; O'Brien, Tracey; Shaw, Peter J; Chybicka, Alicja; Volt, Fernanda; Giannotti, Federica; Gluckman, Eliane; Kurtzberg, Joanne; Gennery, Andrew R; Rocha, Vanderson

2017-06-01

Wiskott-Aldrich syndrome is a severe X-linked recessive immune deficiency disorder. A scoring system of Wiskott-Aldrich syndrome severity (0.5-5) distinguishes two phenotypes: X-linked thrombocytopenia and classic Wiskott-Aldrich syndrome. Hematopoietic cell transplantation is curative for Wiskott-Aldrich syndrome; however, the use of unrelated umbilical cord blood transplantation has seldom been described. We analyzed umbilical cord blood transplantation outcomes for 90 patients. The median age at umbilical cord blood transplantation was 1.5 years. Patients were classified according to clinical scores [2 (23%), 3 (30%), 4 (23%) and 5 (19%)]. Most patients underwent HLA-mismatched umbilical cord blood transplantation and myeloablative conditioning with anti-thymocyte globulin. The cumulative incidence of neutrophil recovery at day 60 was 89% and that of grade II-IV acute graft- versus -host disease at day 100 was 38%. The use of methotrexate for graft- versus -host disease prophylaxis delayed engraftment ( P =0.02), but decreased acute graft- versus -host disease ( P =0.03). At 5 years, overall survival and event-free survival rates were 75% and 70%, respectively. The estimated 5-year event-free survival rates were 83%, 73% and 55% for patients with a clinical score of 2, 4-5 and 3, respectively. In multivariate analysis, age <2 years at the time of the umbilical cord blood transplant and a clinical phenotype of X-linked thrombocytopenia were associated with improved event-free survival. Overall survival tended to be better in patients transplanted after 2007 ( P =0.09). In conclusion, umbilical cord blood transplantation is a good alternative option for young children with Wiskott-Aldrich syndrome lacking an HLA identical stem cell donor. Copyright© Ferrata Storti Foundation.

The timing of umbilical cord clamping at birth: physiological considerations.

PubMed

Hooper, Stuart B; Binder-Heschl, Corinna; Polglase, Graeme R; Gill, Andrew W; Kluckow, Martin; Wallace, Euan M; Blank, Douglas; Te Pas, Arjan B

2016-01-01

While it is now recognized that umbilical cord clamping (UCC) at birth is not necessarily an innocuous act, there is still much confusion concerning the potential benefits and harms of this common procedure. It is most commonly assumed that delaying UCC will automatically result in a time-dependent net placental-to-infant blood transfusion, irrespective of the infant's physiological state. Whether or not this occurs, will likely depend on the infant's physiological state and not on the amount of time that has elapsed between birth and umbilical cord clamping (UCC). However, we believe that this is an overly simplistic view of what can occur during delayed UCC and ignores the benefits associated with maintaining the infant's venous return and cardiac output during transition. Recent experimental evidence and observations in humans have provided compelling evidence to demonstrate that time is not a major factor influencing placental-to-infant blood transfusion after birth. Indeed, there are many factors that influence blood flow in the umbilical vessels after birth, which depending on the dominating factors could potentially result in infant-to-placental blood transfusion. The most dominant factors that influence umbilical artery and venous blood flows after birth are lung aeration, spontaneous inspirations, crying and uterine contractions. It is still not entirely clear whether gravity differentially alters umbilical artery and venous flows, although the available data suggests that its influence, if present, is minimal. While there is much support for delaying UCC at birth, much of the debate has focused on a time-based approach, which we believe is misguided. While a time-based approach is much easier and convenient for the caregiver, ignoring the infant's physiology during delayed UCC can potentially be counter-productive for the infant.

Effect of maternal activity during gestation on maternal behavior, fetal growth, umbilical blood flow, and farrowing characteristics in pigs.

PubMed

Harris, E K; Berg, E P; Berg, E L; Vonnahme, K A

2013-02-01

Yorkshire gilts either remained in their individual stall from d 40 to term (CON; n = 7) or were subjected to exercise for 30 min 3 times per week from mid to late gestation (EX; n = 7) to determine the impact of increased maternal activity during gestation on maternal behavior, fetal growth, umbilical blood flow, and parturition. In parity 1, maternal body composition (10th rib back fat and LM area), maternal behavior, and farrowing characteristics were recorded. In parities 1 and 2, fetal growth, fetal heart rate, pulsatility index and resistance index, and umbilical blood flow were monitored beginning at d 39 of gestation continuing to d 81 of gestation. Exercise continued until d 104. Gilts allowed to exercise sat less (P < 0.01), stood more (P < 0.01), tended (P = 0.06) to lie down less, and had fewer postural changes (P < 0.01) compared with CON gilts. Umbilical blood flow increased (P < 0.01) in EX compared with CON gilts. Moreover, gilts had greater (P < 0.01) umbilical blood flow in their first parity compared with their second. Indices of vascular resistance were not affected (P ≥ 0.15) by maternal treatment; however, EX gilts reached peak pulsatility index earlier than CON gilts (56.2 vs. 64.3 ± 3.6 d). Fetal weights, piglet birth weights, placental weight, interval between piglet births, and blood lactate of newborn piglets were unaffected (P ≥ 0.15) by maternal treatment. Although maternal exercise during gestation in the pig increased umbilical blood flow and appeared to reduce maternal restlessness, impacts on offspring development in postnatal life are not known.

The umbilical and paraumbilical veins of man.

PubMed

Martin, B F; Tudor, R G

1980-03-01

During its transit through the umbilicus structural changes occur in the thick wall of the extra-abdominal segment of the umbilical vein whereby the components of the intra-abdominal segment acquire an essentially longitudinal direction and become arranged in fibro-elastic and fibro-muscular zones. The vein lumen becomes largely obliterated by asymmetrical proliferation of loose subendothelial conective tissue. The latter forms a new inner zone within which a small segment of the lumen persists in an eccentric position. This residual lumen transmits blood to the portal system from paraumbilical and systemic sources, and is retained in the upper part of the vein, even in old age. A similar process of lumen closure is observed in the ductus venosus. In early childhood the lower third of the vein undergoes breakdown, with fatty infiltration, resulting in its complete division into vascular fibro-elastic strands, and in old age some breakdown occurs in the outermost part of the wall of the upper two thirds. The paraumbilical veins are thick-walled and of similar structure to the umbilical vein. Together they constitute an accessory portal system which is confined between the layers of the falciform ligament and is in communication with the veins of the ventral abdominal wall. The constituents form an ascending series, namely, Burow's veins, the umbilical vein, and Sappey's inferior and superior veins. The main channel of Sappey's inferior veins may be the remnant of the right umbilical vein since it communicates with the right rectus sheath and often communicates directly with the portal system within the right lobe of the liver. The results are of significance in relation to clinical usage of the umbilical vein.

Reappraisal of adhesive strapping as treatment for infantile umbilical hernia.

PubMed

Yanagisawa, Satohiko; Kato, Mototoshi; Oshio, Takehito; Morikawa, Yasuhide

2016-05-01

Most umbilical hernias spontaneously close by 3-5 years of age; therefore, surgical repair is considered only in children whose hernias have not closed by this point. At present, adhesive strapping is not the preferred treatment for umbilical hernias because of the lack of supporting evidence regarding its efficacy, and its association with skin complications. This aim of this study was to examine umbilical hernia closure on ultrasonography, and reassess the merits of adhesive strapping. Between January 2013 and December 2014, 89 infants underwent adhesive strapping for umbilical hernia. The strapping was changed once a week. The diameter of the hernia orifice was measured on ultrasonography every 2 weeks until closure. The closure speed (CS) of the hernia orifice was compared between the infants treated with adhesive strapping and those undergoing observation alone. The association between CS and birthweight, gestational age, diameter of the hernia orifice, and timing of treatment (before 12 weeks of age vs between 12 and 26 weeks of age) was also analyzed. Closure was achieved after 2-13 weeks of strapping in 81 infants (91%), and the likelihood of closure was not affected by the diameter of the hernia orifice, gestational age, or the timing of treatment. The mean CS of the infants treated with adhesive strapping was significantly faster than that of the infants undergoing observation alone (2.59 vs 0.37 mm/week, P < 0.05). Adhesive strapping was discontinued in five of the 89 infants (5.6%) due to severe skin complications. Adhesive strapping promoted early spontaneous umbilical hernia closure compared with observation alone, regardless of the diameter of the hernia orifice. Adhesive strapping is an effective alternative to surgery and observation. © 2015 Japan Pediatric Society.

The Hernia-Neck-Ratio (HNR), a Novel Predictive Factor for Complications of Umbilical Hernia.

PubMed

Fueter, T; Schäfer, M; Fournier, P; Bize, P; Demartines, N; Allemann, P

2016-09-01

Umbilical hernia is a common pathology and surgical repair is advised to prevent complications in symptomatic patients. However, risk factors that predict such advert events are unknown. The aim of the study was to determine whether morphological characteristics are associated with the occurrence of complications. Retrospective review of adult patients with elective and emergent umbilical hernia repair operated from January 2004 to December 2013. The size of the hernia and the size of the neck were measured based on operative reports, ultrasound, CT or MRI images. The Hernia-Neck-Ratio (HNR) was then calculated as novel risk indicator. 106 patients underwent umbilical hernia repair (70 for uncomplicated and 36 for complicated hernia) as single procedure. The median size of the hernia sac was statistically significantly smaller in the uncomplicated group (30 mm, interquartile range (IQR) 20-49 vs. 50 mm, IQR 40-71, p = 0.037). The median size of the neck was not different between both groups (15 mm, IQR 11-29 vs. 16 mm, IQR 12-21, p = 0.44). The median HNR was smaller in the uncomplicated group (1.76, IQR 1.45-2.18 vs. 3.33, IQR 2.97-3.91, p = 0.00026). Based on ROC curve analysis (area under the curve: 0.9038), a cut-off value of 2.5 was associated with 91 % sensitivity and 84 % specificity. A novel predictive factor for complications related to umbilical hernia is proposed. The Hernia-Neck Ratio can easily be calculated. These results suggest that umbilical hernia with HNR >2.5 should be operated, irrespective of the presence of symptoms.

Evaluation of hyaluronan from different sources: Streptococcus zooepidemicus, rooster comb, bovine vitreous, and human umbilical cord.

PubMed

Shiedlin, Aviva; Bigelow, Russell; Christopher, William; Arbabi, Saman; Yang, Laura; Maier, Ronald V; Wainwright, Norman; Childs, Alice; Miller, Robert J

2004-01-01

Sodium hyaluronate (HA) is widely distributed in extracellular matrixes and can play a role in orchestrating cell function. Consequently, many investigators have looked at the effect of exogenous HA on cell behavior in vitro. HA can be isolated from several sources (e.g., bacterial, rooster comb, umbilical cord) and therefore can possess diverse impurities. This current study compares the measured impurities and the differences in biological activity between HA preparations from these sources. It was demonstrated that nucleic acid and protein content was highest in human umbilical cord and bovine vitreous HA and was low in bacterial and rooster comb HA. Macrophages exposed to human umbilical cord HA produced significantly higher amounts of TNF-alpha relative to control or bacterial-derived HA. These results indicate that the source of HA should be considered due to differences in the amounts and types of contaminants that could lead to widely different behaviors in vitro and in vivo.

Armored umbilical apparatus for towing a marine seismic air gun sub array

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burrage, E.C.

1985-06-25

An armored umbilical and termination housing is disclosed for towing a sub-array of seismic air guns used in marine seismic surveying comprising a single air hose for supplying all the high pressure air to the individual air guns surrounded by all the electrical control cables needed to operate the air guns in the sub-array. Protective coatings are applied around the electrical control cables and stress members for carrying the load of towing the sub-array are incorporated within the umbilical. A termination housing is provided on the end of the umbilical for terminating the single air hose and all the electricalmore » control lines to common connectors so that individual electrical control lines and air hoses can run from the termination housing to each individual air gun in the sub-array. Air shut off valves are provided so that the high pressure air can be shut off to the individual air guns within the sub-array remotely from the survey vessel.« less

KSC-2014-3662

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. All three swing arms on the tower are undergoing tests to confirm that they are operating correctly. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

KSC-2014-3660

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. All three swing arms on the tower will undergo tests to confirm that they are operating correctly. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

KSC-2014-3661

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. All three swing arms on the tower will undergo tests to confirm that they are operating correctly. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

The Usefulness of Patch Repair Using the Repermeabilized Umbilical Vein of the Round Ligament for Hepatobiliary Malignancies.

PubMed

Takahashi, Michiro; Saiura, Akio; Takahashi, Yu

2017-11-01

Patients with tumors invading major veins may require combined resection and reconstruction. However, venous reconstruction often demands complex hepatobiliary and vascular surgical procedures. In this study, we report a simple patch repair technique for venous reconstruction using the repermeabilized umbilical vein of the round ligament. We reviewed the outcomes of eleven patients who underwent venous wedge resection and patch repair using the repermeabilized umbilical vein of the round ligament at our institution. Procurement of the round ligament and method of making a patch is simple. The duration of anastomosis was approximately 15 min. Eight patients (73%) underwent hepatic resection followed by hepatic vein reconstruction; two (18%) pancreaticoduodenectomy followed by inferior vena cava (IVC) reconstruction; one (9%) hepatic resection followed by IVC reconstruction. Although one reconstructed vein became narrowed, the other ten veins were patent after surgery. Patch repair using the repermeabilized umbilical vein of the round ligament is a simple and useful technique.

Laparoscopic umbilical hernia repair in a cirrhotic patient with a peritoneovenous shunt.

PubMed

Umemura, Akira; Suto, Takayuki; Sasaki, Akira; Fujita, Tomohiro; Endo, Fumitaka; Wakabayashi, Go

2015-05-01

A 62-year-old Japanese woman who had developed massive cirrhotic ascites was referred to our hospital for a peritoneovenous shunt implant. However, CT examination revealed an umbilical hernia that had not been observed before the peritoneovenous shunt was implanted. We decided to perform laparoscopic umbilical hernia repair to keep carbon dioxide from flowing backward into the central circulatory system. We first clamped the catheter and set the upper limit of the pneumoperitoneum pressure to 6 mmHg. The central venous pressure was also measured simultaneously. Mesh was then applied over the hernia and fixed by the double-crown technique. Finally, 1000-mL physiological saline was infused into the abdominal cavity while the pneumoperitoneum was slowly released. In this case, we safely performed laparoscopic umbilical hernia repair while making some alterations, specifically catheter clamping, reducing pneumoperitoneum pressure, monitoring central venous pressure, and infusing physiological saline. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

Laparoscopic management of urachal cyst associated with umbilical hernia.

PubMed

Gregory, G C; Vijay, R; Ligaj, M; Shiwani, M H

2011-02-01

The urachal cyst is a rare clinical entity of a urachal remnant. It is usually asymptomatic but can present with haematuria, tumour, urachal stone and infection. We present a case of a 63-year-old lady with a body mass index (BMI) of 49 who presented with a painful swelling in the umbilical region associated with an umbilical hernia. An ultrasound and computed tomography (CT) scan showed a suspected herniation of an umbilical remnant cyst through a paraumbilical defect. Laparoscopy confirmed the urachal cyst of 3 cm in size with a band connected with the cyst down to the urinary bladder associated with a 3-cm paraumbilical hernia. We removed the cyst and repaired the hernia laparoscopically uneventfully, after which her recovery was perfect. Radiological and laparoscopic pictures have not been reported in the English literature before. Although this condition is very rare, we suggest that it should be considered in the differential diagnosis of painful paraumbilical swelling. CT scanning and laparoscopy seems to be valuable, especially in obese patients.

Safety and effectiveness of umbilical hernia repair in patients with cirrhosis.

PubMed

Hew, S; Yu, W; Robson, S; Starkey, G; Testro, A; Fink, M; Angus, P; Gow, P

2018-03-27

Umbilical hernia is a common complication in patients with cirrhosis. Early studies have reported a high morbidity and mortality associated with hernia repair. The traditional approach has been to non-operatively manage umbilical hernias in patients with cirrhosis. There are emerging data suggesting that an elective repair is a preferable approach. This study examined the outcomes of umbilical hernia repair in patients with advanced liver disease and compared this with a control group of non-cirrhotic patients. Prospective data were collected regarding the outcome of umbilical hernia repairs performed between 2004 and 2013 at the Austin Hospital, Melbourne, Australia. Outcomes at 90 days were compared between patients with and without cirrhosis. 79 patients with cirrhosis and 249 controls were analysed. Of the patients with cirrhosis, 9% were classified as Child-Pugh A, 61% were Child-Pugh B and 30% were Child-Pugh C. Emergency repairs for complicated hernias was undertaken in 18% of the cirrhosis population and 10% in controls (P = 0.10). Post-operative complications occurred more commonly in patients with cirrhosis (26%) compared with controls (11%) (P < 0.01). Emergency hernia repairs were associated with a higher complication rate in both patients with cirrhosis (62%) and controls (20%) (P = 0.01). There was no significant difference in the rate of hernia recurrence as assessed by clinical examination between patients with cirrhosis (2.7%) and controls (6.8%) (P = 0.17) nor in 90-day mortality between patients with cirrhosis (n = 1, 1.3%) and the controls (n = 0) (P = 0.43). Within the limitations of a small study cohort and therefore an underpowered study, elective surgical repair of umbilical hernias in patients with cirrhosis, including decompensated cirrhosis, may not be associated with a significant increase in mortality when compared to a control cohort. Whilst complications are higher in cirrhotic patients, there is no difference in the rate of hernia recurrence. Emergency repairs of umbilical hernias are associated with a high complication rate in cirrhotic patients.

Hepatic laceration because of malpositioning of the umbilical vein catheter: case report and literature review.

PubMed

Yiğiter, Murat; Arda, Irfan Serdar; Hiçsönmez, Akgün

2008-05-01

Umbilical vein catheterization that is a common bedside procedure in the neonatal intensive care units is not without complication. The most common complications are thrombus formation, embolism, vessel perforation, hemorrhage, and infection. Complications related to the liver carry a high risk for mortality. Laceration is an ominous complication of umbilical vein catheter that is generally a result of direct injury through the liver parenchyma. Abdominal distension that develops gradually should alert the physician for a likely development of intrahepatic bleeding. Surgery is mandatory in patients with ongoing bleeding after the withdrawal of the catheter. Early diagnosis and treatment are lifesaving in these patients.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

A crane lowers the first Tail Service Mast Umbilical (TSMU) onto a test stand at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Patent vitellointestinal duct as paraumblical abcess: A rare presentation

PubMed Central

Rekhi, Harnam Singh; Mittal, Sushil; Singh, Gurtej; Rekhi, Balwinder Kaur; Dugg, Pankaj

2015-01-01

Introduction Umbilical and paraumblical abscess can occur in children with presenting complaint of discharge from umbilical region. However, patent vitello intestinal duct presenting as paraumblical abscess is rare phenomenon. Presentation of case One year old male child presented with complain of discharge from umbilical region since birth. Incision & drainage done twice thinking it to be paraumblical abscess. Discussion Vitellointestinal duct as abscess is rare presentation but it should be considered as a differential diagnosis of discharging umbilicus as management of abscess and patent duct are different. Conclusion Patent vitellointestinal duct can present as paraumbilical abscess, and it should be kept in differential diagnosis specifically in children. PMID:26301682

Prenatal diagnosis of abnormal course of umbilical vein and ductus venosus agenesis: report of three cases.

PubMed

Corbacioglu, Aytul; Aslan, Halil; Dagdeviren, Hediye; Ceylan, Yavuz

2012-01-01

Ductus venosus connecting the portal and embryonic venous circulation into the inferior vena cava has a crucial role in fetal circulation. The absence of ductus venosus is a rare anomaly, in which the umbilical vein connection to the venous system may be extrahepatic, bypassing the liver or intrahepatic via the portal venous system. We report three cases of ductus venosus agenesis with associated anomalies. In two of them the connection was directly to the right atrium, whereas the umbilical vein drained to the left internal iliac artery in the third case. Copyright © 2012 Wiley Periodicals, Inc.

Design guidelines for an umbilical cord blood stem cell therapy quality assessment model

NASA Astrophysics Data System (ADS)

Januszewski, Witold S.; Michałek, Krzysztof; Yagensky, Oleksandr; Wardzińska, Marta

The paper enlists the pivotal guidelines for producing an empirical umbilical cord blood stem cell therapy quality assessment model. The methodology adapted was single equation linear model with domain knowledge derived from MEDAFAR classification. The resulting model is ready for therapeutical application.

41. VIEW OF UMBILICAL MAST AND LAUNCH PAD FROM LAUNCHER; ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

41. VIEW OF UMBILICAL MAST AND LAUNCH PAD FROM LAUNCHER; SOUTH FACE OF MST IN BACKGROUND. RAIL SYSTEM FROM BASE OF MST PARALLEL TO MAST. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Umbilical cannulation optimizes circuit flows in premature lambs supported by the EXTra-uterine Environment for Neonatal Development (EXTEND).

PubMed

Hornick, Matthew A; Davey, Marcus G; Partridge, Emily A; Mejaddam, Ali Y; McGovern, Patrick E; Olive, Aliza M; Hwang, Grace; Kim, Jenny; Castillo, Orlando; Young, Kathleen; Han, Jiancheng; Zhao, Sheng; Connelly, James T; Dysart, Kevin C; Rychik, Jack; Peranteau, William H; Flake, Alan W

2018-05-01

Bronchopulmonary dysplasia is a disease of extreme prematurity that occurs when the immature lung is exposed to gas ventilation. We designed a novel 'artificial womb' system for supporting extreme premature lambs (called EXTEND) that obviates gas ventilation by providing oxygen via a pumpless arteriovenous circuit with the lamb submerged in sterile artificial amniotic fluid. In the present study, we compare different arteriovenous cannulation strategies on EXTEND, including carotid artery/jugular vein (CA/JV), carotid artery/umbilical vein (CA/UV) and umbilical artery/umbilical vein (UA/UV). Compared to CA/JV and CA/UV cannulation, UA/UV cannulation provided significantly higher, physiological blood flows to the oxygenator, minimized flow interruptions and supported significantly longer circuit runs (up to 4 weeks). Physiological circuit blood flow in UA/UV lambs made possible normal levels of oxygen delivery, which is a critical step toward the clinical application of artificial womb technology. EXTEND (EXTra-uterine Environment for Neonatal Development) is a novel system that promotes physiological development by maintaining the premature lamb in a sterile fluid environment and providing gas exchange via a pumpless arteriovenous oxygenator circuit. During the development of EXTEND, different cannulation strategies evolved with the aim of improving circuit flow. The present study examines how different cannulation strategies affect EXTEND circuit haemodynamics in extreme premature lambs. Seventeen premature lambs were cannulated at gestational ages 105-117 days (term 145-150 days) and supported on EXTEND for up to 4 weeks. Experimental groups were distinguished by cannulation strategy: carotid artery outflow and jugular vein inflow (CA/JV; n = 4), carotid artery outflow and umbilical vein inflow (CA/UV; n = 5) and double umbilical artery outflow and umbilical vein inflow (UA/UV; n = 8). Circuit flows and pressures were measured continuously. As we transitioned from CA/JV to CA/UV to UA/UV cannulation, mean duration of circuit run and weight-adjusted circuit flows increased (P < 0.001) and the frequency of flow interruptions declined (P < 0.05). Umbilical vessels generally accommodated larger-bore cannulas, and cannula calibre was directly correlated with circuit pressures and indirectly correlated with flow:pressure ratio (a measure of post-membrane resistance). We conclude that UA/UV cannulation in fetal lambs on EXTEND optimizes circuit flow dynamics and flow stability and also supports circuit flows that closely approximate normal placental flow. © 2018 The Authors. The Journal of Physiology © 2018 The Physiological Society.

UV-activated 7-dehydrocholesterol-coated titanium implants promote differentiation of human umbilical cord mesenchymal stem cells into osteoblasts.

PubMed

Satué, María; Ramis, Joana M; Monjo, Marta

2016-01-01

Vitamin D metabolites are essential for bone regeneration and mineral homeostasis. The vitamin D precursor 7-dehydrocholesterol can be used after UV irradiation to locally produce active vitamin D by osteoblastic cells. Furthermore, UV-irradiated 7-dehydrocholesterol is a biocompatible coating for titanium implants with positive effects on osteoblast differentiation. In this study, we examined the impact of titanium implants surfaces coated with UV-irradiated 7-dehydrocholesterol on the osteogenic differentiation of human umbilical cord mesenchymal stem cells. First, the synthesis of cholecalciferol (D3) was achieved through the incubation of the UV-activated 7-dehydrocholesterol coating for 48 h at 23℃. Further, we investigated in vitro the biocompatibility of this coating in human umbilical cord mesenchymal stem cells and its potential to enhance their differentiation towards the osteogenic lineage. Human umbilical cord mesenchymal stem cells cultured onto UV-irradiated 7-dehydrocholesterol-coated titanium implants surfaces, combined with osteogenic supplements, upregulated the gene expression of several osteogenic markers and showed higher alkaline phosphatase activity and calcein blue staining, suggesting increased mineralization. Thus, our results show that the use of UV irradiation on 7-dehydrocholesterol -treated titanium implants surfaces generates a bioactive coating that promotes the osteogenic differentiation of human umbilical cord mesenchymal stem cells, with regenerative potential for improving osseointegration in titanium-based bone anchored implants. © The Author(s) 2015.

Quantitative determination of famotidine in human maternal plasma, umbilical cord plasma and urine using high-performance liquid chromatography - mass spectrometry

PubMed Central

Wang, Xiaoming; Rytting, Erik; Abdelrahman, Doaa R.; Nanovskaya, Tatiana N.; Hankins, Gary D.V.; Ahmed, Mahmoud S.

2013-01-01

The liquid chromatography with electrospray ionization mass spectrometry for the quantitative determination of famotidine in human urine, maternal and umbilical cord plasma was developed and validated. The plasma samples were alkalized with ammonium hydroxide and extracted twice with ethyl acetate. The extraction recovery of famotidine in maternal and umbilical cord plasma ranged from 53% to 64% and 72% to 79%, respectively. Urine samples were directly diluted with the initial mobile phase then injected into the HPLC system. Chromatographic separation of famotidine was achieved by using a Phenomenex Synergi™ Hydro-RP™ column with a gradient elution of acetonitrile and 10 mM ammonium acetate aqueous solution (pH 8.3, adjusted with ammonium hydroxide). Mass Spectrometric detection of famotidine was set in the positive mode and used a selected ion monitoring method. Carbon-13-labeled famotidine was used as internal standard. The calibration curves were linear (r2> 0.99) in the concentration ranges of 0.631-252 ng/mL for umbilical and maternal plasma samples, and of 0.075-30.0 μg/mL for urine samples. The relative deviation of method was less than 14% for intra- and inter-day assays, and the accuracy ranged between 93% and 110%. The matrix effect of famotidine in human urine, maternal and umbilical cord plasma is less than 17%. PMID:23401067

Umbilical hernia in cirrhotic patients: outcome of elective repair.

PubMed

Lasheen, Adel; Naser, Hatem M; Abohassan, Ahmed

2013-12-01

Cirrhotic patients with umbilical hernia have an increased likelihood of complications following repair. The aim of this study was to assess the outcomes of elective umbilical hernia repair in cirrhotic patients. Fifty patients having uncomplicated umbilical hernia with a cirrhotic liver were studied prospectively. These patients divided into three groups' according to Child-Turcotte-Pugh (CTP) classification. After management of coagulopathy, correction of hypoalbuminaemia and electrolytes imbalance, and control of ascites, all patients underwent elective hernia repair under regional anesthesia. A comparison was made between the three groups as regard the size of the defect in the linea Alba, operative time, postoperative morbidity and mortality, length of hospital stay, time of return to daily life and postoperative changes in liver function tests (LFTs) in relation to the regional anesthesia applied. hernioplasty was done under spinal anesthesia in 13 patients (26%), under epidural anesthesia in 10 patients (20%), under intercostal nerve block in 7 patients (14%), and under local anesthesia in 20 patients (40%). There was an increased safety (less changes in LFTs) in cases done under local anesthesia and intercostal nerve block. The overall complications rate was 30%. There was an increased complications rate towards the decompensated cases. The differences in the mean length of hospital stay and mean time of return to daily life are statistically significant between the three groups. Umbilical hernia recurrence rate was 2% and no mortality was reported in the study groups.

43. TOP PART OF UMBILICAL MAST, NORTH AND WEST SIDES. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

43. TOP PART OF UMBILICAL MAST, NORTH AND WEST SIDES. AIR CONDITIONING DUCTING IS VISIBLE ON INTERIOR OF MAST. RAIL IS VISIBLE LEFT OF THE MAST. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Distinct adipogenic differentiation phenotypes of human umbilical cord mesenchymal cells dependent on adipogenic conditions

USDA-ARS?s Scientific Manuscript database

The umbilical cord (UC) matrix is a source of multipotent mesenchymal stem cells (MSCs) that have adipogenic potential and thus can be a model to study adipogenesis. However, existing variability in adipocytic differentiation outcomes may be due to discrepancies in methods utilized for adipogenic d...

Umbilical Cord Blood: Counselling, Collection, and Banking.

PubMed

Armson, B Anthony; Allan, David S; Casper, Robert F

2015-09-01

To review current evidence regarding umbilical cord blood counselling, collection, and banking and to provide guidelines for Canadian health care professionals regarding patient education, informed consent, procedural aspects, and options for cord blood banking in Canada. Selective or routine collection and banking of umbilical cord blood for future stem cell transplantation for autologous (self) or allogeneic (related or unrelated) treatment of malignant and non-malignant disorders in children and adults. Cord blood can be collected using in utero or ex utero techniques. Umbilical cord blood counselling, collection, and banking, education of health care professionals, indications for cord blood collection, short- and long-term risk and benefits, maternal and perinatal morbidity, parental satisfaction, and health care costs. Published literature was retrieved through searches of Medline and PubMed beginning in September 2013 using appropriate controlled MeSH vocabulary (fetal blood, pregnancy, transplantation, ethics) and key words (umbilical cord blood, banking, collection, pregnancy, transplantation, ethics, public, private). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date limits, but results were limited to English or French language materials. Searches were updated on a regular basis and incorporated in the guideline to September 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Umbilical cord blood is a readily available source of hematopoetic stem cells used with increasing frequency as an alternative to bone marrow or peripheral stem cell transplantation to treat malignant and non-malignant conditions in children and adults. There is minimal harm to the mother or newborn provided that priority is given to maternal/newborn safety during childbirth management. Recipients of umbilical cord stem cells may experience graft-versus-host disease, transfer of infection or genetic abnormalities, or therapeutic failure. The financial burden on the health system for public cord blood banking and on families for private cord blood banking is considerable. Recommendations 1. Health care professionals should be well-informed about cord blood collection and storage and about factors that influence the volume, quality, and ability to collect a cord blood unit. (III-A) 2. Health care professionals caring for women and families who choose private umbilical cord blood banking must disclose any financial interests or potential conflicts of interest. (III-A) 3. Pregnant women should be provided with unbiased information about umbilical cord blood banking options, including the benefits and limitations of public and private banks. (III-A) 4. Health care professionals should obtain consent from mothers for the collection of umbilical cord blood prior to the onset of active labour, ideally during the third trimester, with ample time to address any questions. (III-A) 5. Health care professionals must be trained in standardized procedures (ex utero and in utero techniques) for cord blood collection to ensure the sterility and quality of the collected unit. (II-2A) 6. Umbilical cord blood should be collected with the goal of maximizing the content of hematopoietic progenitors through the volume collected. The decision to bank the unit will depend upon specific measures of graft potency. (II-2A) 7. Umbilical cord blood collection must not adversely affect the health of the mother or newborn. Cord blood collection should not interfere with delayed cord clamping. (III-E) 8. Health care professionals should inform pregnant women and their partners of the benefits of delayed cord clamping and of its impact on cord blood collection and banking. (II-2A) 9. Cord blood units collected for public or private banking can be used for biomedical research, provided consent is obtained, when units cannot be banked or when consent for banking is withdrawn. (II-3B) 10. Mothers may be approached to donate cells for biomedical research. Informed consent for research using cord blood should ideally be obtained prior to the onset of active labour or elective Caesarean section following established research ethics guidelines. (II-2A).

Neonatal testicular infarction--possibly due to compression of the umbilical cord?

PubMed

Eifinger, Frank; Ahrens, Ulrike; Wille, Sebastian; Roth, Bernhard; Engelmann, Udo

2010-06-01

Neonatal testicular infarction is a rare occurrence. We report on a newborn infant with bilateral testicular infarction. At birth, the uncut umbilical cord ran taut between the thighs making a complete loop around the genitals, compressing the testes. At the age of 6 hours, because of increasing agitation and the beginnings of scrotal discoloration, the infant was operated on, showing a bilateral testicular infarction potentially induced by strangulation of the twisted umbilical cord. Here, we discuss the clinical findings of neonatal testicular infarction and give advice as to the management of this serious complication with regard to the available published data. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

A heavy-lift transport truck arrives at the Launch Equipment Test Facility (LETF) at NASA’s Kennedy Space Center in Florida, with the first of two Tail Service Mast Umbilicals (TSMU) for NASA’s Space Launch System (SLS). Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

Technicians assist as a crane is used to lift the first Tail Service Mast Umbilical (TSMU) into the vertical position at the Launch Equipment Test Facility (LETF) at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

A crane is prepared to help lift the first Tail Service Mast Umbilical (TSMU) for NASA’s Space Launch System (SLS) at the Launch Equipment Test Facility (LETF) at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

A crane is attached to the first Tail Service Mast Umbilical (TSMU) for NASA’s Space Launch System (SLS) at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

A crane lifts the first Tail Service Mast Umbilical (TSMU) up for placement on a test stand at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

Technician monitors the progress as a crane lowers the first Tail Service Mast Umbilical (TSMU) onto a test stand at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

A technician monitors the progress as a crane lifts the first Tail Service Mast Umbilical (TSMU) for transfer to a test stand at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Fetal MRI as a complementary technique after prenatal diagnosis of persistent vitelline artery in an otherwise normal fetus.

PubMed

Bravo, Coral; De León-Luis, Juan; Gámez, Francisco; Ruiz, Yolanda; Pintado, Pilar; Pérez, Ricardo; Ortiz-Quintana, Luis

2013-10-01

Prenatal ultrasound is the standard for the diagnosis of fetal anomalies. However, fetal MRI has emerged as a valuable diagnosis tool to complete the study of fetal malformations. Type II single umbilical artery results from the absence of both umbilical arteries and persistence of the vitelline artery. It has been described only in fetuses with sirenomelia or caudal regression syndrome. We report a favorable outcome in a normal fetus in which prenatal ultrasound and MRI showed a single umbilical artery arising from the aorta. The etiology of such a finding and its possible consequences are discussed. Copyright © 2013 Wiley Periodicals, Inc.

Determination of amphetamine and methamphetamine in umbilical cord using liquid chromatography-tandem mass spectrometry

PubMed Central

Jones, Joseph; Rios, Rosemarie; Jones, Mary; Lewis, Douglas; Plate, Charles

2009-01-01

The use of meconium as a drug-screening matrix for newborns has been the gold standard of care for the past two decades. A recent study using matched pairs of meconium and umbilical cord demonstrated a high degree of agreement. The use of liquid chromatography-tandem mass spectrometry as a means to confirm amphetamines presumptive positive umbilical cord specimens for amphetamine and methamphetamine is described here for the first time. The limit of detection for both compounds was 0.2 ng/g. The limit of quantitation for both compounds was 0.6 ng/g. The assay was linear for both compounds up to 100 ng/g. PMID:19783234

Atlantis TPS Processing

NASA Image and Video Library

2003-10-01

In the Orbiter Processing Facility, Harrell Watts (left), with United Space Alliance, removes a tile from the thermal barrier around the umbilical areas, the external tank attach points, on the underside of Atlantis. The umbilical areas are closed off after ET separation by a door, seen here. The exposed area of each closed door is covered with reusable surface insulation.

Core Stage Forward Skirt Umbilical Installation onto Mobile Launcher

NASA Image and Video Library

2017-06-29

Just north of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, the core stage forward skirt umbilical is installed on the mobile launcher. The mobile launcher is designed to support the assembly, testing and check-out of the agency's Space Launch System (SLS) rocket and the Orion spacecraft.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-06-30

Just north of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, the core stage forward skirt umbilical is installed on the mobile launcher. The mobile launcher is designed to support the assembly, testing and check-out of the agency's Space Launch System (SLS) rocket and the Orion spacecraft.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-06-30

Just north of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, a crane lifts the core stage forward skirt umbilical for installation onto the mobile launcher. The mobile launcher is designed to support the assembly, testing and check-out of the agency's Space Launch System (SLS) rocket and the Orion spacecraft.

Core Stage Forward Skirt Umbilical Installation onto Mobile Laun

NASA Image and Video Library

2017-06-30

Just north of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, technicians install the core stage forward skirt umbilical on the mobile launcher. The mobile launcher is designed to support the assembly, testing and check-out of the agency's Space Launch System (SLS) rocket and the Orion spacecraft.

Sex-Specific Associations between Umbilical Cord Blood Testosterone Levels and Language Delay in Early Childhood

ERIC Educational Resources Information Center

Whitehouse, Andrew J. O.; Mattes, Eugen; Maybery, Murray T.; Sawyer, Michael G.; Jacoby, Peter; Keelan, Jeffrey A.; Hickey, Martha

2012-01-01

Background: Preliminary evidence suggests that prenatal testosterone exposure may be associated with language delay. However, no study has examined a large sample of children at multiple time-points. Methods: Umbilical cord blood samples were obtained at 861 births and analysed for bioavailable testosterone (BioT) concentrations. When…

Umbilical metastases: current viewpoint

PubMed Central

Gabriele, Raimondo; Conte, Marco; Egidi, Federico; Borghese, Mario

2005-01-01

Background Umbilical metastases from a malignant neoplasm, also termed Sister Mary Joseph's nodule, are not commonly reported in the English literature, and they have usually been considered as a sign of a poor prognosis for the patient. The present article reports on the current view point on umbilical metastasis besides discussing the epidemiology, clinical presentation, pathophysiology and treatment. Method A search of Pubmed was carried out using the term 'umblic*' and 'metastases' or metastasis' revealed no references. Another search was made using the term "Sister Joseph's nodule" or sister Joseph nodule" that revealed 99 references. Of these there were 14 review articles, however when the search was limited to English language it yielded only 20 articles. Articles selected from these form the basis of this report along with cross references. Results The primary lesions usually arise from gastrointestinal or genitourinary tract malignancies and may be the presenting symptom or sign of a primary tumour in an unknown site. Conclusion A careful evaluation of all umbilical lesions, including an early biopsy if appropriate, is recommended. Recent studies suggest an aggressive surgical approach combined with chemotherapy for such patients may improve survival. PMID:15723695

A case report of umbilical ring constriction with application of amnioinfusion.

PubMed

Tokunaka, Mayumi; Hasegawa, Junichi; Nakamura, Masamitsu; Hamada, Shoko; Matsuoka, Ryu; Ichizuka, Kiyotake; Sekizawa, Akihiko; Okai, Takashi

2013-07-01

This is a case report of a pregnant 38-year-old primigravida woman. Due to severe fetal growth restriction and oligohydramnios, she was referred to our tertiary perinatal center at 24 weeks' gestation. To rule out chromosomal abnormalities and facilitate ultrasound evaluation of fetal morphology, we performed amniocentesis and subsequent amnioinfusion. Thereafter, a precise ultrasound examination revealed no obvious fetal morphological abnormalities except for a hyper-coiled cord and marginal placenta previa. During expectant management, the amount of amniotic fluid was maintained at 20-26 mm for a few days; however, the pregnancy resulted in intrauterine fetal death after 26 weeks + 5 days of gestation. The stillborn infant weighed 530 g (-3.3 SD) and had no obvious external abnormalities apart from umbilical ring constriction. Although a postmortem autopsy was not performed, it is suspected that the fetal growth restriction and the intrauterine fetal death were associated with the hyper-coiled cord and the umbilical ring constriction. It is thought that umbilical ring constriction might therefore be an irreversible fatal condition in cases with a hyper-coiled cord.

Applications of human umbilical cord blood cells in central nervous system regeneration.

PubMed

Herranz, Antonio S; Gonzalo-Gobernado, Rafael; Reimers, Diana; Asensio, Maria J; Rodríguez-Serrano, Macarena; Bazán, Eulalia

2010-03-01

In recent decades, there has been considerable amount of information about embryonic stem cells (ES). The dilemma facing scientists interested in the development and use of human stem cells in replacement therapies is the source of these cells, i.e. the human embryo. There are many ethical and moral problems related to the use of these cells. Hematopoietic stem cells from umbilical cord blood have been proposed as an alternative source of embryonic stem cells. After exposure to different agents, these cells are able to express antigens of diverse cellular lineages, including the neural type. The In vitro manipulation of human umbilical cord blood (hUCB) cells has shown their stem capacity and plasticity. These cells are easily accessible, In vitro amplifiable, well tolerated by the host, and with more primitive molecular characteristics that give them great flexibility. Overall, these properties open a promising future for the use of hUCB in regenerative therapies for the Central Nervous System (CNS). This review will focus on the available literature concerning umbilical cord blood cells as a therapeutic tool for the treatment of neurodegenerative diseases.

KSC-2014-3665

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. All three swing arms on the tower are undergoing tests to confirm that they are operating correctly. They are being swung out and closer to the Vertical Integration Facility at the pad. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

KSC-2014-3664

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. All three swing arms on the tower are undergoing tests to confirm that they are operating correctly. They are being swung out and closer to the Vertical Integration Facility at the pad. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

KSC-2014-3667

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. All three swing arms on the tower are undergoing tests to confirm that they are operating correctly. They are being swung out and closer to the Vertical Integration Facility at the pad. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

KSC-2014-3668

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. The swing arm is undergoing a test to confirm that it is operating correcting. During the test, the arm was swung out and closer to the Vertical Integration Facility at the pad. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

KSC-2014-3663

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. All three swing arms on the tower are undergoing tests to confirm that they are operating correctly. They are being swung out and closer to the Vertical Integration Facility at the pad. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

KSC-2014-3666

NASA Image and Video Library

2014-08-25

CAPE CANAVERAL, Fla. – The umbilical swing arm for Orion's Exploration Flight Test 1, or EFT-1, has been attached to the uppermost location on the fixed umbilical tower at Space Launch Complex 37 at Cape Canaveral Air Force Station in Florida. All three swing arms on the tower are undergoing tests to confirm that they are operating correctly. They are being swung out and closer to the Vertical Integration Facility at the pad. The uppermost swing arm will carry umbilicals that will be mated to Orion's launch abort system and environmental control system. During launch, all three umbilicals will pull away from Orion and the United Launch Alliance Delta IV Heavy rocket at T-0. During the EFT-1 mission, Orion will travel farther into space than any human spacecraft has gone in more than 40 years. The data gathered during the flight will influence design decisions, validate existing computer models and innovative new approaches to space systems development, as well as reduce overall mission risks and costs for later Orion flights. Liftoff of Orion on its first flight test is planned for fall 2014. Photo credit: NASA/Daniel Casper

A new approach to oxidative stress and inflammatory signaling during labour in healthy mothers and neonates.

PubMed

Díaz-Castro, Javier; Florido, Jesus; Kajarabille, Naroa; Prados, Sonia; de Paco, Catalina; Ocon, Olga; Pulido-Moran, Mario; Ochoa, Julio J

2015-01-01

The objective of the current study was to investigate for the first time and simultaneously the oxidative stress and inflammatory signaling induced during the delivery in healthy mothers and their neonates. 56 mothers with normal gestational course and spontaneous delivery were selected. Blood samples were taken from mother (before and after delivery) both from vein and artery of umbilical cord. Lower antioxidant enzymes activities were observed in neonates compared with their mothers and lower oxidative stress in umbilical cord artery with respect to vein. There was an overexpression of inflammatory cytokines in the mother, such as IL-6 and TNF-α, and, in addition, PGE2 was also increased. Neonates showed lower levels of IL-6 and TNF-α and higher values of sTNF-RII and PGE2 in comparison with their mothers. Parturition increases oxidative damage in the mother, although the indicators of oxidative damage were lower in umbilical cord artery with respect to umbilical vein. The overexpression of inflammatory cytokines reveals that fetus suffers its own inflammatory process during parturition.

A New Approach to Oxidative Stress and Inflammatory Signaling during Labour in Healthy Mothers and Neonates

PubMed Central

Díaz-Castro, Javier; Florido, Jesus; Prados, Sonia; de Paco, Catalina; Ocon, Olga; Pulido-Moran, Mario; Ochoa, Julio J.

2015-01-01

The objective of the current study was to investigate for the first time and simultaneously the oxidative stress and inflammatory signaling induced during the delivery in healthy mothers and their neonates. 56 mothers with normal gestational course and spontaneous delivery were selected. Blood samples were taken from mother (before and after delivery) both from vein and artery of umbilical cord. Lower antioxidant enzymes activities were observed in neonates compared with their mothers and lower oxidative stress in umbilical cord artery with respect to vein. There was an overexpression of inflammatory cytokines in the mother, such as IL-6 and TNF-α, and, in addition, PGE2 was also increased. Neonates showed lower levels of IL-6 and TNF-α and higher values of sTNF-RII and PGE2 in comparison with their mothers. Parturition increases oxidative damage in the mother, although the indicators of oxidative damage were lower in umbilical cord artery with respect to umbilical vein. The overexpression of inflammatory cytokines reveals that fetus suffers its own inflammatory process during parturition. PMID:25722791

Musculoskeletal tissue engineering with human umbilical cord mesenchymal stromal cells

PubMed Central

Wang, Limin; Ott, Lindsey; Seshareddy, Kiran; Weiss, Mark L; Detamore, Michael S

2011-01-01

Multipotent mesenchymal stromal cells (MSCs) hold tremendous promise for tissue engineering and regenerative medicine, yet with so many sources of MSCs, what are the primary criteria for selecting leading candidates? Ideally, the cells will be multipotent, inexpensive, lack donor site morbidity, donor materials should be readily available in large numbers, immunocompatible, politically benign and expandable in vitro for several passages. Bone marrow MSCs do not meet all of these criteria and neither do embryonic stem cells. However, a promising new cell source is emerging in tissue engineering that appears to meet these criteria: MSCs derived from Wharton’s jelly of umbilical cord MSCs. Exposed to appropriate conditions, umbilical cord MSCs can differentiate in vitro along several cell lineages such as the chondrocyte, osteoblast, adipocyte, myocyte, neuronal, pancreatic or hepatocyte lineages. In animal models, umbilical cord MSCs have demonstrated in vivo differentiation ability and promising immunocompatibility with host organs/tissues, even in xenotransplantation. In this article, we address their cellular characteristics, multipotent differentiation ability and potential for tissue engineering with an emphasis on musculoskeletal tissue engineering. PMID:21175290

Primary peritoneal adenocarcinoma as content of an incarcerated umbilical hernia: A case-report and review of the literature.

PubMed

Varga-Szabó, D; Papadakis, M; Pröpper, S; Zirngibl, H

2016-01-01

Umbilical hernia is a common finding in many cases, posing potentially life-threatening complications, such as incarceration or strangulation. The presence of malignancy in hernia sacs is, however, rather rare. Here we report on a case of primary peritoneal adenocarcinoma found through histological examination of omental tissue, resected due to an incarcerated umbilical hernia of an 84-years-old woman. There was no macroscopic sign of malignancy during operation; only after routine examination of histological sections the diagnosis was found. To our knowledge this is the first report of primary peritoneal cancer as content of an umbilical hernia. This is a rare neoplasm and histologically identical to epithelial ovarian carcinoma. For this reason, the diagnosis is usually based on the histological finding and exclusion of a primary ovarian tumor. Primary peritoneal cancer has a poor outcome in general. Early diagnosis is, therefore, essential for effective treatment. Histological analysis of resected hernia sac or content should be performed routinely to discover malignant diseases in the background of a hernia. Copyright © 2015. Published by Elsevier Ltd.

Characteristics of the umbilical artery velocity waveform as function of measurement site.

PubMed

Ruissen, C J; von Drongelen, M M; Hoogland, H J; Jager, W; Hoeks, A P

1990-01-01

In 30 uncomplicated singleton pregnancies, varying in duration between 24 and 40 weeks, the variability of the flow velocity waveform (FVW) along the course of the umbilical artery was investigated. Blood flow velocities were recorded at 4 locations in the vessel: within the fetal abdomen, 0-5 cm from the origin of the umbilical cord, in the free-floating part, and 0-5 cm from its insertion in the placenta. From the Doppler signals recorded, the pulsatility index (PI) and a parameter for the frequency distribution index (FDI) were calculated. PI values differed among the locations, but no unequivocal tendency could be demonstrated. Statistical analysis, including multiple regression analysis for maternal and menstrual age and fetal heart rate, showed no significant difference in PI and FDI values for any of the 4 locations. It can be concluded that in uncomplicated pregnancies, possible changes in FVW (quantified by PI) along the course of the umbilical artery have no clinical relevance. Therefore, standardization for the sampling site when measuring PI in this vessel seems to be unnecessary.

A geometrically exact formulation for three-dimensional numerical simulation of the umbilical cable in a deep-sea ROV system

NASA Astrophysics Data System (ADS)

Quan, Wei-cai; Zhang, Zhu-ying; Zhang, Ai-qun; Zhang, Qi-feng; Tian, Yu

2015-04-01

This paper proposes a geometrically exact formulation for three-dimensional static and dynamic analyses of the umbilical cable in a deep-sea remotely operated vehicle (ROV) system. The presented formulation takes account of the geometric nonlinearities of large displacement, effects of axial load and bending stiffness for modeling of slack cables. The resulting nonlinear second-order governing equations are discretized spatially by the finite element method and solved temporally by the generalized- α implicit time integration algorithm, which is adapted to the case of varying coefficient matrices. The ability to consider three-dimensional union action of ocean current and ship heave motion upon the umbilical cable is the key feature of this analysis. The presented formulation is firstly validated, and then three numerical examples for the umbilical cable in a deep-sea ROV system are demonstrated and discussed, including the steady configurations only under the action of depth-dependent ocean current, the dynamic responses in the case of the only ship heave motion, and in the case of the combined action of the ship heave motion and ocean current.

Specific factors for prenatal lead exposure in the border area of China.

PubMed

Kawata, Kimiko; Li, Yan; Liu, Hao; Zhang, Xiao Qin; Ushijima, Hiroshi

2006-07-01

The objectives of this study are to examine the prevalence of increased blood lead concentrations in mothers and their umbilical cords, and to identify risk factors for prenatal lead exposure in Kunming city, Yunnan province, China. The study was conducted at two obstetrics departments, and 100 peripartum women were enrolled. The mean blood lead concentrations of the mothers and the umbilical cords were 67.3microg/l and 53.1microg/l, respectively. In multiple linear regression analysis, maternal occupational exposure, maternal consumption of homemade dehydrated vegetables and maternal habitation period in Kunming city were significantly associated with an increase of umbilical cord blood lead concentration. In addition, logistic regression analysis was used to assess the association of umbilical cord blood lead concentrations that possibly have adverse effects on brain development of newborns with each potential risk factor. Maternal frequent use of tableware with color patterns inside was significantly associated with higher cord blood lead concentration in addition to the three items in the multiple linear regression analysis. These points should be considered as specific recommendations for maternal and fetal lead exposure in this city.

Breaking the Blood-Brain Barrier With Mannitol to Aid Stem Cell Therapeutics in the Chronic Stroke Brain.

PubMed

Tajiri, Naoki; Lee, Jea Young; Acosta, Sandra; Sanberg, Paul R; Borlongan, Cesar V

2016-01-01

Blood-brain barrier (BBB) permeabilizers, such as mannitol, can facilitate peripherally delivered stem cells to exert therapeutic benefits on the stroke brain. Although this BBB permeation-aided stem cell therapy has been demonstrated in the acute stage of stroke, such BBB permeation in the chronic stage of the disease remains to be examined. Adult Sprague-Dawley rats initially received sham surgery or experimental stroke via the 1-h middle cerebral artery occlusion (MCAo) model. At 1 month after the MCAo surgery, stroke animals were randomly assigned to receive human umbilical cord stem cells only (2 million viable cells), mannitol only (1.1 mol/L mannitol at 4°C), combined human umbilical cord stem cells (200,000 viable cells) and mannitol (1.1 mol/L mannitol at 4°C), and vehicle (phosphate-buffered saline) only. Stroke animals that received human umbilical cord blood cells alone or combined human umbilical cord stem cells and mannitol exhibited significantly improved motor performance and significantly better brain cell survival in the peri-infarct area compared to stroke animals that received vehicle or mannitol alone, with mannitol treatment reducing the stem cell dose necessary to afford functional outcomes. Enhanced neurogenesis in the subventricular zone accompanied the combined treatment of human umbilical cord stem cells and mannitol. We showed that BBB permeation facilitates the therapeutic effects of a low dose of peripherally transplanted stem cells to effectively cause functional improvement and increase neurogenesis in chronic stroke.

Generation of functional islets from human umbilical cord and placenta derived mesenchymal stem cells.

PubMed

Kadam, Sachin; Govindasamy, Vijayendran; Bhonde, Ramesh

2012-01-01

Bone marrow-derived mesenchymal stem cells (BM-MSCs) have been used for allogeneic application in tissue engineering but have certain drawbacks. Therefore, mesenchymal stem cells (MSCs) derived from other adult tissue sources have been considered as an alternative. The human umbilical cord and placenta are easily available noncontroversial sources of human tissue, which are often discarded as biological waste, and their collection is noninvasive. These sources of MSCs are not subjected to ethical constraints, as in the case of embryonic stem cells. MSCs derived from umbilical cord and placenta are multipotent and have the ability to differentiate into various cell types crossing the lineage boundary towards endodermal lineage. The aim of this chapter is to provide a detailed reproducible cookbook protocol for the isolation, propagation, characterization, and differentiation of MSCs derived from human umbilical cord and placenta with special reference to harnessing their potential towards pancreatic/islet lineage for utilization as a cell therapy product. We show here that mesenchymal stromal cells can be extensively expanded from umbilical cord and placenta of human origin retaining their multilineage differentiation potential in vitro. Our report indicates that postnatal tissues obtained as delivery waste represent a rich source of mesenchymal stromal cells, which can be differentiated into functional islets employing three-stage protocol developed by our group. These islets could be used as novel in vitro model for screening hypoglycemics/insulin secretagogues, thus reducing animal experimentation for this purpose and for the future human islet transplantation programs to treat diabetes.

Umbilical hernia repair in the presence of cirrhosis and ascites: results of a survey and review of the literature.

PubMed

McKay, A; Dixon, E; Bathe, O; Sutherland, F

2009-10-01

Umbilical hernias are common in cirrhotics, yet, their management poses several challenges. The objective of this paper was to evaluate the indications, selection criteria, and technical aspects of umbilical hernia repair in patients with cirrhosis and ascites. An extensive review of the literature since 1980 was performed. A survey was also conducted to obtain expert consensus to supplement any available conclusions from the literature. Nineteen surgeons (45%) responded to the survey. For asymptomatic hernias, all would consider hernia repair in Child's A cirrhosis, but not in more advanced disease, whereas the vast majority would consider the repair of complicated hernias. This seems to reflect the respondents' higher estimates of morbidity and mortality with more advanced liver disease. However, because the recent literature demonstrates much lower morbidity and mortality than in the past, many authors now advocate early elective repair. In addition, uncontrolled ascites appear to be strongly predictive of hernia recurrence (relative risk [RR] 8.5; 95% confidence interval [CI] 2.7-26.9). While acknowledging the limitations of this study, it appears that the early repair of umbilical hernias in patients with cirrhosis and ascites is safer than it was in the past and can be considered for selected patients. This may avoid increased morbidity and mortality associated with urgent repair later on. The control of ascites is critical to a successful outcome. Urgent repair of umbilical hernia in cirrhotic patients is indicated when complications develop.

The repair of umbilical hernia in cirrhotic patients: 18 consecutive case series in a single institute

PubMed Central

Yu, Byung Chul; Lee, Giljae

2015-01-01

Purpose Traditionally, the surgical repair of umbilical hernia in cirrhotic patients with ascites is avoided because of a significant recurrence rate and perioperative morbidity/mortality. However, recent reports recommend early elective surgery in these patients because surgery-related complications can be reduced with minimally invasive surgery and development of perioperative patient care. The current study was conducted to analyze safety and feasibility of umbilical hernia repairs performed in a single institute. Methods A single center retrospective analysis of patients' data was conducted. Eighteen patients with umbilical hernia accompanied by liver cirrhosis underwent hernia repair in the period between 2005 and 2012. The charts of these patients were reviewed and demographic data, postoperative complications, and recurrence were recorded. Results Eleven males and seven females with a mean age of 62.9 years were analyzed. Two of the patients were classified as Child's class A, 11 as Child's class B, and five as Child's class C. Four patients underwent emergency surgery because of perforations in the hernia sac in two cases and incarcerated hernias in the other two cases. Of the 18 patients who underwent surgery, four (22%) experienced a recurrence, three (17%) developed edema at the surgical sites, one (5%) experienced hepatic coma, and one (5%) showed postoperative variceal hemorrhage. All of these events occurred after emergency surgery. Conclusion In contrast to traditional concepts, early and elective repair of umbilical hernia can be performed easily and safely in cirrhotic patients. PMID:26236698

[EFFECTIVENESS OF PREPERITONEAL HERNIORRHAPHY WITH Ultrapro Plug MESH FOR UMBILICAL HERNIA REPAIR IN ADULTS].

PubMed

Xie, Yanyan; Ma, Dongyang; Song, Yinghan; Lu, Anqing; Wang, Menghong; Lei, Wenzhang

2016-06-08

To explore the effectiveness of preperitoneal herniorrhaphy with Ultrapro Plug (UPP) mesh for umbilical hernia repair in adults. Between September 2011 and June 2015, 71 patients with umbilical hernia underwent preperitoneal herniorrhaphy with UPP mesh. There were 26 males and 45 females, aged 19-92 years (mean, 54.3 years). The disease duration was 45 days to 30 years (median, 18 months). Umbilical hernia was diagnosed through physical examination, ultrasound, and other relevant auxiliary examination. According to American Society of Anesthesiologists (ASA) classification, 12 cases were rated as grade Ⅰ, 34 cases as grade Ⅱ, 21 cases as grade Ⅲ, and 4?cases as grade Ⅳ. The operation time, postoperative hospitalization time, complication, and recurrence were recorded. The diameter of hernia ring ranged 0.5-3.0 cm (mean, 1.8 cm). There was no vessel or intestine injury. The operation time was 12-35 minutes (mean, 22.4 minutes); postoperative hospitalization time was 12-48 hours (mean, 16.3 hours). Fat liquefaction of incision occurred in 2 cases, and primary healing of incision was obtained in the other cases. Sixty-nine patients were followed up 8-51 months (median, 28 months). Hernia recurrence and patch infection occurred in 1 case respectively during follow-up. No postoperative foreign body sensation and chronic pain occurred. Repairing umbilical hernia in adults with UPP mesh should be safe and reliable, because it has the advantages of short operation time, short hospital stay, less complication, and lower incidence of recurrence.

The repair of umbilical hernia in cirrhotic patients: 18 consecutive case series in a single institute.

PubMed

Yu, Byung Chul; Chung, Min; Lee, Giljae

2015-08-01

Traditionally, the surgical repair of umbilical hernia in cirrhotic patients with ascites is avoided because of a significant recurrence rate and perioperative morbidity/mortality. However, recent reports recommend early elective surgery in these patients because surgery-related complications can be reduced with minimally invasive surgery and development of perioperative patient care. The current study was conducted to analyze safety and feasibility of umbilical hernia repairs performed in a single institute. A single center retrospective analysis of patients' data was conducted. Eighteen patients with umbilical hernia accompanied by liver cirrhosis underwent hernia repair in the period between 2005 and 2012. The charts of these patients were reviewed and demographic data, postoperative complications, and recurrence were recorded. Eleven males and seven females with a mean age of 62.9 years were analyzed. Two of the patients were classified as Child's class A, 11 as Child's class B, and five as Child's class C. Four patients underwent emergency surgery because of perforations in the hernia sac in two cases and incarcerated hernias in the other two cases. Of the 18 patients who underwent surgery, four (22%) experienced a recurrence, three (17%) developed edema at the surgical sites, one (5%) experienced hepatic coma, and one (5%) showed postoperative variceal hemorrhage. All of these events occurred after emergency surgery. In contrast to traditional concepts, early and elective repair of umbilical hernia can be performed easily and safely in cirrhotic patients.

Insulin Restores Gestational Diabetes Mellitus–Reduced Adenosine Transport Involving Differential Expression of Insulin Receptor Isoforms in Human Umbilical Vein Endothelium

PubMed Central

Westermeier, Francisco; Salomón, Carlos; González, Marcelo; Puebla, Carlos; Guzmán-Gutiérrez, Enrique; Cifuentes, Fredi; Leiva, Andrea; Casanello, Paola; Sobrevia, Luis

2011-01-01

OBJECTIVE To determine whether insulin reverses gestational diabetes mellitus (GDM)–reduced expression and activity of human equilibrative nucleoside transporters 1 (hENT1) in human umbilical vein endothelium cells (HUVECs). RESEARCH DESIGN AND METHODS Primary cultured HUVECs from full-term normal (n = 44) and diet-treated GDM (n = 44) pregnancies were used. Insulin effect was assayed on hENT1 expression (protein, mRNA, SLC29A1 promoter activity) and activity (initial rates of adenosine transport) as well as endothelial nitric oxide (NO) synthase activity (serine1177 phosphorylation, l-citrulline formation). Adenosine concentration in culture medium and umbilical vein blood (high-performance liquid chromatography) as well as insulin receptor A and B expression (quantitative PCR) were determined. Reactivity of umbilical vein rings to adenosine and insulin was assayed by wire myography. Experiments were in the absence or presence of l-NG-nitro-l-arginine methyl ester (l-NAME; NO synthase inhibitor) or ZM-241385 (an A2A-adenosine receptor antagonist). RESULTS Umbilical vein blood adenosine concentration was higher, and the adenosine- and insulin-induced NO/endothelium-dependent umbilical vein relaxation was lower in GDM. Cells from GDM exhibited increased insulin receptor A isoform expression in addition to the reported NO–dependent inhibition of hENT1-adenosine transport and SLC29A1 reporter repression, and increased extracellular concentration of adenosine and NO synthase activity. Insulin reversed all these parameters to values in normal pregnancies, an effect blocked by ZM-241385 and l-NAME. CONCLUSIONS GDM and normal pregnancy HUVEC phenotypes are differentially responsive to insulin, a phenomenon where insulin acts as protecting factor for endothelial dysfunction characteristic of this syndrome. Abnormal adenosine plasma levels, and potentially A2A-adenosine receptors and insulin receptor A, will play crucial roles in this phenomenon in GDM. PMID:21515851

Duration to Establish an Emergency Vascular Access and How to Accelerate It: A Simulation-Based Study Performed in Real-Life Neonatal Resuscitation Rooms.

PubMed

Schwindt, Eva M; Hoffmann, Florian; Deindl, Philipp; Waldhoer, Thomas J; Schwindt, Jens C

2018-05-01

To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. Retrospective analysis of audio-video recorded neonatal simulation training. Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Equipment was prepared the same way as for real clinical events. Medical teams of four to five persons with birth-related background (midwives, nurses, neonatologists, and anesthesiologists) in a realistic team composition. Audio-video recorded mannequin-based simulated resuscitation of an asphyxiated newborn including the establishment of either umbilical venous catheter or intraosseous access. The duration of access establishment (time from decision to first flush/aspiration), preparation (decision to start of procedure), and the procedure itself (start to first flush/aspiration) was significantly longer for umbilical venous catheter than for intraosseous access (overall duration 199 vs 86 s). Delaying factors for umbilical venous catheter establishment were mainly due to the complex approach itself, the multitude of equipment required, and uncertainties about necessary hygiene standards. Challenges in intraosseous access establishment were handling of the unfamiliar material and absence of an intraosseous access kit in the resuscitation room. There was no significant difference between the required duration for access establishment between large centers and small hospitals, but a trend was observed that duration for umbilical venous catheter was longer in small hospitals than in centers. Duration for intraosseous access was similar in both hospital types. Vascular access establishment in neonatal resuscitation could be accelerated by infrastructural improvements and specific training of medical teams. In simulated in situ neonatal resuscitation, intraosseous access is faster to establish than umbilical venous catheter. Future studies are required to assess efficacy and safety of both approaches in real resuscitation settings.

Detection of in utero cannabis exposure by umbilical cord analysis.

PubMed

Kim, Jiyoung; de Castro, Ana; Lendoiro, Elena; Cruz-Landeira, Angelines; López-Rivadulla, Manuel; Concheiro, Marta

2018-04-01

According to the 2014 National Survey on Drug Use and Health, 5.3% of pregnant women smoked marijuana in the past month. This prevalence is expected to increase as a growing number of states and countries are now considering legalization. Although the umbilical cord is becoming a useful objective tool to detect in utero drug exposure, currently data about analytical methods and its utility to detect cannabis exposure are scarce. The objective of this work was to develop a method for the determination of Δ 9 -tetrahydrocannabinol (THC), 11-hydroxyTHC (THC-OH), 11-nor-9-carboxy-THC (THCCOOH), 8-β-11-dihydroxyTHC (THC-diOH), THC and THCCOOH glucuronides, and cannabidiol (CBD) in the umbilical cord by liquid chromatography-tandem mass spectrometry (LC-MS/MS) with dual ionization source. Umbilical cord samples (0.5 g) were homogenized in methanol and extracted by solid-phase extraction. Reversed-phase chromatographic separation was performed in 14 minutes, and 2 transitions per analyte were monitored in multiple reaction monitoring mode. Method validation included linearity (1-10 to 20-200 ng/g), precision (4.1%-23.4%), accuracy (87.5%-111.4%), matrix effect (-54.8% to -5.8%), extraction efficiency (25%-45.6%), limits of detection and quantification (1-10 ng/g), and endogenous (n = 5) or exogenous interferences (not detected). The method was applied to 13 authentic samples from cannabis-exposed newborns, which meconium samples had tested positive for cannabis. Twelve cord specimens tested positive for THCCOOH-glucuronide (1.6-19.1 ng/g). We developed and validated a specific and sensitive method for the simultaneous determination of THC, its metabolites, including THC and THCCOOH glucuronides, and CBD in umbilical cord samples by LC-MS/MS. The analysis of authentic samples showed the usefulness of umbilical cord to detect cannabis in utero exposure. Copyright © 2017 John Wiley & Sons, Ltd.

Transplacental transfer of polycyclic aromatic hydrocarbons in paired samples of maternal serum, umbilical cord serum, and placenta in Shanghai, China.

PubMed

Zhang, Xiaolan; Li, Xiaojing; Jing, Ye; Fang, Xiangming; Zhang, Xinyu; Lei, Bingli; Yu, Yingxin

2017-03-01

Prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) is a high-priority public health concern. However, maternal to fetal transplacental transfer of PAHs has not been systematically studied. To investigate the transplacental transfer of PAHs from mother to fetus and determine the influence of lipophilicity (octanol-water partition coefficient, K OW ) on transfer process, in the present study, we measured the concentrations of 15 PAHs in 95 paired maternal and umbilical cord serum, and placenta samples (in total 285 samples) collected in Shanghai, China. The average concentration of total PAHs was the highest in maternal serums (1290 ng g -1 lipid), followed by umbilical cord serums (1150 ng g -1 lipid). The value was the lowest in placenta samples (673 ng g -1 lipid). Low molecular weight PAHs were the predominant compounds in the three matrices. Increases in fish and meat consumption did not lead to increases in maternal PAH levels, and no obvious gender differences in umbilical cord serums were observed. The widespread presence of PAHs in umbilical cord serums indicated the occurrence of transplacental transfer. The ratios of PAH concentrations in umbilical cord serum to those in maternal serum (F/M) and the concentrations in placenta to those in maternal serum (P/M) of paired samples were analyzed to characterize the transfer process of individual PAHs. Most F/M ratios on lipid basis were close to one (range: 0.79 to 1.36), which suggested that passive diffusion may control the transplacental transfer of PAHs from maternal serum to the fetal circulation. The P/M and F/M values calculated on lipid basis showed that PAHs with lower K OW were more likely to transfer from mother to fetus via the placenta. Copyright © 2016 Elsevier Ltd. All rights reserved.

The best option: Umbilical LESS radical nephrectomy with vaginal extraction.

PubMed

Andrés, G; García-Mediero, J M; García-Tello, A; Arance, I; Cabrera, P M; Angulo, J C

2015-04-01

Umbilical laparoendoscopic single-site (LESS) surgery represents an excellent alternative to laparoscopic or robotic multiport surgery. LESS surgery offers faster recovery, less postoperative pain and optimal cosmetic results. The reusable nature of its instruments also has significant economic advantages. We present a 34-year-old patient with a solid mesorenal lesion measuring 8 cm in the left kidney treated with pure LESS radical nephrectomy assisted by vaginal extraction of the specimen. The umbilical approach using a single-site multichannel KeyPort (Richard Wolf GmbH, Knittlingen, Germany) with DuoRotate curved instruments allows for minimum crushing and fewer spatial conflicts. Its perfect umbilical adaptation provides a hermetic system. The instrument's double rotation provides considerable movement precision. Vaginal extraction avoids damage to the abdominal wall and the need for widening the umbilical incision. After the placement of the device and triangulation of the clips, we proceeded to operate on posterior parietal peritoneum. The descending colon was mobilized to access the retroperitoneum and dissect the renal hilum. Hem-o-lok clips were placed on the artery and vein, which were subsequently sectioned. The specimen was inserted into a laparoscopic bag. Under direct vision, we placed a 15-mm trocar through the bottom of the vaginal posterior fornix to facilitate the extraction of the bag's thread. The incision was widened with the fingers, and the specimen was extracted, closing the vagina from the perineum with visualization from the navel. Abdominal drainage was not employed. The surgical time was 180 min. The patient was discharged the following day without needing analgesia. A year later, the patient was disease-free and had no complications. Umbilical LESS radical nephrectomy with vaginal extraction is feasible in selected cases. The procedure is oncologically safe, avoids scars and facilitates early recovery. From a practical point of view, this approach greatly simplifies natural orifice transluminal endoscopic surgery (NOTES) and enables a minimally invasive equivalent result. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

The comparison of umbilical cord arterial blood lactate and pH values for predicting short-term neonatal outcomes.

PubMed

Einikyte, Ruta; Snieckuviene, Vilija; Ramasauskaite, Diana; Panaviene, Jurate; Paliulyte, Virginija; Opolskiene, Gina; Kazenaite, Edita

2017-12-01

Current clinical practice of assessing neonatal condition is based on evaluation of umbilical cord arterial blood pH value rather than lactate. However, evidence shows that lactate is direct and more predictive measurement than pH or at least of equal importance. This study is to assess and compare umbilical cord arterial lactate and pH values for predicting short-term neonatal outcomes. A retrospective cohort study was conducted at the tertiary level hospital, were arterial umbilical cord blood sampling was collected according to the standard procedures. Neonatal morbidity was registered if at least one of the following conditions was noted: Apgar score at 1 min after delivery was 6 or lower, resuscitation performed, including assisted ventilation and requirement of admission to neonatal intensive care unit. Mothers-newborns pairs were allocated into two groups: newborns exposed to perinatal hypoxia (group 1) and observed as healthy newborns (group 2). Receiver operating characteristics curves (ROC) were generated to assess the predictive ability of pH and lactate for the short-term neonatal outcomes. 901 neonates born at ≥37 weeks of gestation were included. Newborns exposed to perinatal hypoxia (group 1) encompassed 39 (4.3%) patients, and observed as healthy (group 2) - 862 (95.7%). Arterial umbilical cord blood pH in group 1 was 7.160 ± 0.126 as compared to 7.314 ± 0.083 in group 2; p < 0.001. Mean arterial lactate was significantly higher in group 1 than group 2 (6.423 ± 2.335 as compared to 3.600 ± 1.833; p < 0.001). The difference between areas under ROC curves representing pH and lactate was not significant (0.848 and 0.831 respectively; p = 0.6132). Umbilical cord arterial lactate and pH predicted short-term neonatal outcomes with similar efficacies. Copyright © 2017. Published by Elsevier B.V.

[Long-term follow-up results after open small umbilical hernia repairs].

PubMed

Malý, O; Sotona, O

2014-04-01

Adult umbilical hernia is a common surgical condition in the fifth and sixth decade of life. Despite the high frequency of umbilical hernia repairs, disappointingly high recurrence rates after simple suture repairs are reported, amounting to 54%. In addition, it is reported that with the rising frequency of recurrences, the size of the hernial sac and gate gradually increases. Therefore we decided to find out the incidence of recurrences after operative repair of an umbilical hernia at our department. Patient data for this retrospective study focusing on the period between 2006 and 2010 were obtained from the electronic hospital database. Patients with umbilical hernia and the abdominal wall defect up to 3 cm who underwent primary elective procedure were included in the study. Patients with incisional hernias were excluded. All patients were contacted at least 3 years after operation to confirm the accuracy of data. A total of 127 patients were included in this study. In the abovementioned period, no mesh was used during primary surgery in any of the patients. Recurrence occurred in a total of 13.4% of patients. Approximately 40% of patients with the first recurrence were re-operated at our department, 30% of patients were re-operated in other hospitals and the rest have not sought medical attention in respect of the recurrence. Patients with recurrence did not differ from the others as regards age, body mass index or surgical site infection development. Due to the high recurrence rates after operative sutures of the umbilical hernias there is a need to thoroughly consider the potential risk factors such as the body mass index and the abdominal wall defect size. Therefore, it is recommended to use the mesh more widely during primary surgery, especially in obese patients with BMI over 30 and the wall defect size exceeding 3 cm. The question remains whether to use the mesh in all overweight patients and with wall defect smaller than 3 cm.

Adherent umbilical hernia containing Meckel's diverticulum resected due to intraoperative injury.

PubMed

Kibil, Wojciech; Pach, Radosław; Szura, Mirosław; Matyja, Andrzej

2012-01-01

The aim of this report was to describe a rare case of a male patient with dry umbilical hernia with Meckel's diverticulum adherent to the neck of hernia sac. The patient's history, results of physical examination, laboratory testing, intraoperative findings, treatment method and postoperative course are summarized in details in this report. Follow-up visits were performed 14 days, one month and one year after the operation. A 35-year-old overweight Caucasian male patient (initials: D-B, body weight 90 kg, height 172 cm) was admitted to the hospital on 2nd April 2009 with reducible umbilical hernia for elective surgical treatment. The patient was operated on in the Specialist Diagnostic and Therapeutic Centre Medicina in Cracow and discharged from the hospital on fourth postoperative day. This case is compared with a few similar cases which have been described in the literature till now--all of these reports dealt with strangulated umbilical hernias but not reducible one. The patient underwent elective operation performed on the day of admission. Antibiotic prophylaxis included single dose of pefloxacine (400 mg intravenously) administered just before start of the operation. Subarachnoid anaesthesia was applied 15 minutes before start of the operation. The procedure lasted 75 minutes. Hernia sac was dissected and opened. In the hernia neck adherent Meckel's diverticulum was found. It was localised 80 cm from ileocecal valve and its length was 45 millimetres. During dissection process the diverticulum was injured in the apical region so cuneiform resection of the ileum with Meckel's diverticulum was performed. Ileum was sutured with two layers of absorbable sutures. The tissue defect in umbilical region was repaired primarily with onlay synthetic mesh prosthesis (polypropylene mesh, size 7 x 12 cm). 1) Adherent incidental Meckel's diverticulum in a sac of reducible umbilical hernia is a very rare finding. 2) During umbilical herniorrhaphy (elective or urgent) the presence of Meckel diverticulum in hernia sac should be taken into consideration. 3) If Meckel diverticulum is adherent to the hernia sac it requires careful dissection and resection of the diverticulum in selected patients. 4) When there is a tumour palpable in the wall or basis of Meckel diverticulum segmental resection of the small intestine with appropriate margins should be performed.

Concentrations of Sex Hormones in Umbilical-Cord Blood: Their Relations to Sex and Birth Order of Infants.

ERIC Educational Resources Information Center

Maccoby, Eleanor E.; And Others

1979-01-01

Results showed that concentrations of testosterone were significantly greater in the umbilical blood of newborn males than females. In both sexes, firstborns had significantly more progesterone and estrogens than later borns, and among males, firstborns had higher concentrations of testosterone. Temporal spacing of childbirths had greater effects…

Apollo/Saturn V facilities Test Vehicle and Launch Umbilical Tower

NASA Image and Video Library

1966-05-25

An Apollo/Saturn V facilities Test Vehicle and Launch Umbilical Tower (LUT) atop a crawler-transporter move from the Vehicle Assembly Building (VAB) on the way to Pad A. This test vehicle, designated the Apollo/Saturn 500-F, is being used to verify launch facilities, train launch crews, and develop test and checkout procedures.

Maternal pre-gravid body mass index and adiposity influence umbilical cord gene expression at term in AGA infants

USDA-ARS?s Scientific Manuscript database

While maternal obesity is associated with unfavorable maternal and fetal outcomes, the influence of maternal obesity on fetal gene expression is less clear. Umbilical cords (UC) from 12 lean (pre-gravid BMI < 25) and 10 overweight/obese (OB, pre-gravid BMI =25) women without gestational diabetes wer...

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

Technicians assist as a crane is used to lift the first Tail Service Mast Umbilical (TSMU) up from the flatbed of the transport truck at the Launch Equipment Test Facility (LETF) at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Tail Service Mast Umbilical Arrival

NASA Image and Video Library

2016-08-02

Technicians assist as a crane is used to lift the first Tail Service Mast Umbilical (TSMU) away from the flatbed of the transport truck at the Launch Equipment Test Facility (LETF) at NASA’s Kennedy Space Center in Florida. Two TSMUs will provide liquid propellants and power to the Space Launch System (SLS) rocket’s core stage engine. Both TSMUs will connect to the zero-level deck on the mobile launcher, providing fuel and electricity to the SLS rocket before it launches on Exploration Mission 1. The TSMU will undergo testing and validation at the LETF to verify it is functioning properly. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Omentum in the Pediatric Umbilical Hernia: Is It a Potential Alarm for the Appearance of Complications?

PubMed Central

Sinopidis, Xenophon; Panagidis, Antonios; Alexopoulos, Vasileios; Karatza, Ageliki; Mitropoulou, Konstantina; Varvarigou, Anastasia; Georgiou, George

2012-01-01

Umbilical hernia is a common benign condition which resolves spontaneously during the first five years of life. However, in certain cases there are some characteristics which may be indicative of a different prognostic approach, as they increase the possibility of complications. The two cases of umbilical hernia that we describe here were treated operatively and revealed the presence of strangulated and adhered omentum, respectively. Reflecting on the adhesive properties of the omentum, we hypothesized that this may occur more often than it is believed, especially in those cases that are described as recurrent symptomatic herniations. In such cases, there should be increased alert for the possibility of complications during the period of the conservative expectance for resolution. PMID:23213589

Variations from morning to afternoon of middle cerebral and umbilical artery blood flow, and fetal heart rate variability, and fetal characteristics in the normally developing fetus.

PubMed

Avitan, Tehila; Sanders, Ari; Brain, Ursula; Rurak, Dan; Oberlander, Tim F; Lim, Ken

2018-05-01

To determine if there are changes in maternal uterine blood flow, fetal brain blood flow, fetal heart rate variability, and umbilical blood flow between morning (AM) and afternoon (PM) in healthy, uncomplicated pregnancies. In this prospective study, 68 uncomplicated singleton pregnancies (mean 35 + 0.7 weeks gestation) underwent a standard observational protocol at both 08:00 (AM) and 13:30 (PM) of the same day. This protocol included Doppler measurements of uterine, umbilical, and fetal middle cerebral artery (MCA) volume flow parameters (flow, HR, peak systolic velocity [PSV], PI, and RI) followed by computerized cardiotocography. Standard descriptive statistics, χ 2 and t tests were used where appropriate. P < .05 was considered significant. A significant increase in MCA flow and MCA PSV was observed in the PM compared to the AM. This was accompanied by a fall in MCA resistance. Higher umbilical artery resistance indices were also observed in the PM compared to AM. In contrast, fetal heart rate characteristics, maternal uterine artery Doppler flow and resistance indices did not vary significantly between the AM and PM. In normal pregnancies, variations in fetal cerebral and umbilical blood flow parameters were observed between AM and PM independent of other fetal movements or baseline fetal heart rate. In contrast, uterine flow parameters remained stable across the day. These findings may have implications for the use of serial Doppler parameters used to guide clinical management in high-risk pregnancies. © 2017 Wiley Periodicals, Inc.

Placental pathology in early intrauterine growth restriction associated with maternal hypertension.

PubMed

Veerbeek, J H W; Nikkels, P G J; Torrance, H L; Gravesteijn, J; Post Uiterweer, E D; Derks, J B; Koenen, S V; Visser, G H A; Van Rijn, B B; Franx, A

2014-09-01

To identify key pathological characteristics of placentas from pregnancies complicated by early intrauterine growth restriction, and to examine their relations with maternal hypertensive disease and umbilical artery Doppler waveform abnormalities. Single-center retrospective cohort study of singleton pregnancies with abnormal umbilical artery Doppler flow patterns resulting in a live birth <34 weeks of a baby with a weight <10th percentile for gestational age. Umbilical artery end diastolic flow was classified as being either present or absent/reversed (AREDF). Data were stratified into intrauterine growth restriction with or without hypertensive disease and pathological characteristics were compared between these various conditions according to predefined scoring criteria. Among 164 placentas studied, we found high rates of characteristic histopathological features that were associated with intrauterine growth restriction, including infarction (>5% in 42%), chronic villitis (21%), chronic chorioamnionitis (36%), membrane necrosis (20%), elevated nucleated red blood cells (89%), increased syncytial knotting (93%), increased villous maturation (98%), fetal thrombosis (32%) and distal villous hypoplasia (35%). Chronic inflammation of fetal membranes and syncytial knotting were more common in women with concomitant hypertensive disease as compared to women with normotensive IUGR (p < 0.05). Placentas from women with umbilical artery AREDF were more likely to show increased numbers of nucleated red blood cells and distal villous hypoplasia (p < 0.05). Placentas of women with early IUGR show high rates of several histological aberrations. Further, concomitant maternal hypertension is associated with characteristic inflammatory changes and umbilical artery AREDF with signs of chronic hypoxia. Copyright © 2014 Elsevier Ltd. All rights reserved.

Exploring opinions and beliefs about cord blood donation among Hispanic and non-Hispanic black women.

PubMed

Rucinski, Dianne; Jones, Risé; Reyes, Brenda; Tidwell, Lawon; Phillips, RoiAnn; Delves, Denise

2010-05-01

Despite higher birth rates among non-Hispanic blacks and Hispanics, the availability of umbilical cord blood from these groups is lower due to lower donation rates than that of non-Hispanic whites. Similar racial and ethnic disparities in donation rates have been found for blood and organ donation. This study is among the first to explore beliefs and attitudes toward umbilical cord blood donation among Hispanic and non-Hispanic black women. Five focus groups composed of Hispanic and non-Hispanic black women were conducted to explore how women conceptualize information needs about umbilical cord blood donation and from whom women want to receive information about donation. Participants were adult women who had given birth within the past year or were pregnant. Lack of basic information regarding umbilical cord blood, its harvesting and use, and the steps and conditions necessary to donate were primary barriers to donation. Women expressed confusion over the differences between "donation" and "banking." The social value of donation was explicitly weighed in terms of the cost of the donation effort. Doctors were viewed as critical sources for information about donation, although women expressed skepticism about doctors' ability to convey sufficient information during short office visits. Efforts to increase donation rates among Hispanic and non-Hispanic black women should include information about both the technical aspects and the social value of donation. The specific terms "umbilical" and "donation" should be used consistently to prevent misunderstanding. Information should be provided by physicians with follow-up by other health providers.

Ethical issues in umbilical cord blood banking. Working Group on Ethical Issues in Umbilical Cord Blood Banking.

PubMed

Sugarman, J; Kaalund, V; Kodish, E; Marshall, M F; Reisner, E G; Wilfond, B S; Wolpe, P R

1997-09-17

Banking umbilical cord blood (UCB) to be used as a source of stem cells for transplantation is associated with a set of ethical issues. An examination of these issues is needed to inform public policy and to raise the awareness of prospective parents, clinicians, and investigators. Individuals with expertise in anthropology, blood banking, bone marrow transplantation, ethics, law, obstetrics, pediatrics, and the social sciences were invited to join the Working Group on Ethical Issues in Umbilical Cord Blood Banking. Members were assigned topics to present to the Working Group. Following independent reviews, background materials were sent to the Working Group. Individual presentations of topics at a 2-day meeting were followed by extensive group discussions in which consensus emerged. A writing committee then drafted a document that was circulated to the entire Working Group. After 3 rounds of comments over several months, all but 1 member of the Working Group agreed with the presentation of our conclusions. (1) Umbilical cord blood technology is promising although it has several investigational aspects; (2) during this investigational phase, secure linkage should be maintained of stored UCB to the identity of the donor; (3) UCB banking for autologous use is associated with even greater uncertainty than banking for allogeneic use; (4) marketing practices for UCB banking in the private sector need close attention; (5) more data are needed to ensure that recruitment for banking and use of UCB are equitable; and (6) the process of obtaining informed consent for collection of UCB should begin before labor and delivery.

Placental disease and abnormal umbilical artery Doppler waveforms in trisomy 21 pregnancy: A case-control study.

PubMed

Corry, Edward; Mone, Fionnuala; Segurado, Ricardo; Downey, Paul; McParland, Peter; McAuliffe, Fionnuala M; Mooney, Eoghan E

2016-11-01

The objectives of this study were firstly to determine the proportion of placental pathology in fetuses affected by trisomy 21 (T21) using current pathological descriptive terminology and secondly to examine if a correlation existed between the finding of an abnormal umbilical artery Doppler (UAD) waveform, the presence of T21 and defined placental pathological categories. This case-control study assessed singleton fetuses with karyotypically confirmed trisomy 21 where placental histopathology had been conducted from 2003 to 2015 inclusive, within a university tertiary obstetric centre. This was compared with unselected normal singleton control pregnancies matched within a week of gestation at delivery. Data included birthweight centiles and placental histopathology. Comparisons of Doppler findings across placental pathological categories were performed using statistical analysis. 104 cases were analysed; 52 cases of trisomy 21 and 52 controls. Fetal vascular malperfusion (48.1% vs. 5.8%, p = 0.001) and maturation defects (39.2% vs. 15.7%, p = 0.023) were more common in trisomy 21 placentas. Compared with controls, trisomy 21 fetuses were more likely to have shorter umbilical cords (p = 0.001) and had more UAD abnormalities. Amongst T21 pregnancies, umbilical artery Doppler abnormalities are associated with the presence of maternal vascular malperfusion. Fetal vascular malperfusion and maturation defects are more common in trisomy 21 placentas. Abnormal umbilical artery Doppler waveforms are more common in T21 and are associated with maternal vascular malperfusion. Placental disease may explain the increased rate of intrauterine death in T21. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationship between umbilical cord essential fatty acid content and the quality of general movements of healthy term infants at 3 months.

PubMed

Bouwstra, Hylco; Dijck-Brouwer, Da Janneke; Decsi, Tamás; Boehm, Günther; Boersma, E Rudy; Muskiet, Frits A J; Hadders-Algra, Mijna

2006-05-01

Prenatal essential fatty acid (EFA) status might be an important factor in the development of the central nervous system (CNS). The aim of the present study was to evaluate the relationship between the fatty acid compositions of the umbilical blood vessels at birth, used as a proxy of prenatal EFA status, and quality of general movements (GMs) at 3 mo. Umbilical artery and vein fatty acid compositions were investigated in a mixed group of breastfed infants and infants fed with formula with or without long-chain polyunsaturated fatty acid (LCPUFA) supplementation. At the age of 3 mo, video assessment of the quality of GMs was performed to evaluate neurologic condition. The quality of GMs was scored by assessing the degree of variation, complexity, and fluency. Outcomes were classified as normal-optimal, normal suboptimal, mildly abnormal, and definitely abnormal movements. Information on potential confounders, including the type of postnatal feeding, was collected prospectively. Associations between fatty acid status at birth and quality of GMs were investigated, and multinomial logistic regression analyses were carried out. None of the infants showed definitely abnormal movements. Infants with mildly abnormal GMs had a lower EFA index, lower arachidonic acid (AA) content, higher total n-9 fatty acid, and higher total monounsaturated fatty acid (MUFA) content in the umbilical artery compared with infants with normal GMs. Multivariate analyses confirmed these findings. We conclude that mildly abnormal GMs are associated with a less favorable EFA status in the umbilical artery.

Large Scale Expansion of Human Umbilical Cord Cells in a Rotating Bed System Bioreactor for Cardiovascular Tissue Engineering Applications

PubMed Central

Reichardt, Anne; Polchow, Bianca; Shakibaei, Mehdi; Henrich, Wolfgang; Hetzer, Roland; Lueders, Cora

2013-01-01

Widespread use of human umbilical cord cells for cardiovascular tissue engineering requires production of large numbers of well-characterized cells under controlled conditions. In current research projects, the expansion of cells to be used to create a tissue construct is usually performed in static cell culture systems which are, however, often not satisfactory due to limitations in nutrient and oxygen supply. To overcome these limitations dynamic cell expansion in bioreactor systems under controllable conditions could be an important tool providing continuous perfusion for the generation of large numbers of viable pre-conditioned cells in a short time period. For this purpose cells derived from human umbilical cord arteries were expanded in a rotating bed system bioreactor for up to 9 days. For a comparative study, cells were cultivated under static conditions in standard culture devices. Our results demonstrated that the microenvironment in the perfusion bioreactor was more favorable than that of the standard cell culture flasks. Data suggested that cells in the bioreactor expanded 39 fold (38.7 ± 6.1 fold) in comparison to statically cultured cells (31.8 ± 3.0 fold). Large-scale production of cells in the bioreactor resulted in more than 3 x 108 cells from a single umbilical cord fragment within 9 days. Furthermore cell doubling time was lower in the bioreactor system and production of extracellular matrix components was higher. With this study, we present an appropriate method to expand human umbilical cord artery derived cells with high cellular proliferation rates in a well-defined bioreactor system under GMP conditions. PMID:23847691

Impact of maternal HIV on umbilical cord lactate measurement at delivery in a South African labor ward.

PubMed

Allanson, Emma R; Pattinson, Robert C; Nathan, Elizabeth A; Dickinson, Jan E

2018-06-01

To assess umbilical artery lactate levels and perinatal outcomes among women with and without HIV infection. The present prospective cohort study recruited women planning to undergo vaginal delivery at Kalafong Hospital, South Africa, between March 3 and November 12, 2014. Umbilical artery lactate levels were measured and perinatal outcome data were recorded. Outcome analyses were stratified by maternal HIV status, and a subgroup analysis was performed where women with a CD4 count below 350 × 10 6 cells/L were compared with women without HIV. In total, 936 women with singleton fetuses were enrolled. Maternal HIV status was available for 897 (95.8%) participants, of whom 202 (21.6%) had HIV infections. Overall, 186 (92.1%) women with HIV infections received prophylaxis or treatment. There was no difference between participants with and without HIV infections in the preterm delivery rate (P=0.770), mode of delivery (P=0.354), neonatal resuscitation rate (P=0.717), 1- or 5-minute Apgar scores below 7 (P=0.353), or the rate of having an umbilical artery lactate level above 5.45 mmol/L (P=0.301). Similarly, there were no differences in outcomes in the subgroup analysis of women with a CD4 count below 350 × 10 6 cells/L. Umbilical artery lactate levels and perinatal outcomes were found to be comparable between patients with and without HIV infections in a South African setting. © 2018 International Federation of Gynecology and Obstetrics.

[Ultrasound-guided Rectus Sheath Block vs Transversus Abdominis Plane Block in Children Undergoing Umbilical Hernia Repair].

PubMed

Torii, Naoko; Tachibana, Kazuya; Iwasaki, Mitsuo; Takeuchi, Muneyuki; Kinouchi, Keiko

2016-06-01

Although many reports describe the usefulness of the rectus sheath block (RSB) in the umbilical hernia repair, the efficacy of the transversus abdominis plane block (TAPB) is rarely reported. The purpose of this study was to compare the efficacy and technique of ultrasound-guided RSB and TAPB in children undergoing umbilical hernia repair. Thirty-four children younger than 12 years of age scheduled for umbilical hernia repair were enrolled in this prospective observer-blinded randomized clinical trial. They were randomly assigned either to RSB group (median age, 3.7 years) or TAPB group (median age, 3.8 years). After the induction of general anesthesia with sevoflurane, nitrous oxide, and oxygen children in both groups received regional anesthesia with 0.3 ml x kg(-1) of 0.25% ropivacaine on each side under ultrasound guidance. Hemodynamic changes at the skin incision, postoperative pain scores and parental satisfaction were recorded. Anesthesiologists rated the quality of ultrasound images and easiness of the block performance. The patients' demographics of the two groups were similar. There were no significant differences in the time needed for the block procedure, quality of ultrasound images and the change of the heart rate and blood pressure at the skin incision between the two groups. Postoperative pain score (immediately, 2 and 4 hours after the operation), need for rescue analgesia and satisfaction of the parents also did not differ. There were no major complications in the patients. TAPB provided comparable perioperative analgesia and easiness of block performance to RSB in the pediatric umbilical hernia repair.

Long-term follow-up results of umbilical hernia repair.

PubMed

Venclauskas, Linas; Jokubauskas, Mantas; Zilinskas, Justas; Zviniene, Kristina; Kiudelis, Mindaugas

2017-12-01

Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery. To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence. A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed. One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias (< 2 cm) had a recurrence in the suture repair group. Logistic regression analysis showed that body mass index (BMI) > 30 kg/m 2 , diabetes and wound infection were independent risk factors for umbilical hernia recurrence. The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m 2 , diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

KSC-03pd2762

NASA Image and Video Library

2003-10-01

KENNEDY SPACE CENTER, FLA. - In the Orbiter Processing Facility, Ryan Levann, with United Space Alliance, checks data on the tile removed from the thermal barrier around the umbilical areas, the external tank attach points, on the underside of Atlantis. The umbilical areas are closed off after ET separation by a door, seen here. The exposed area of each closed door is covered with reusable surface insulation.

ICPSU Install at Mobile Launcher

NASA Image and Video Library

2018-03-14

A colorful sunrise serves as the backdrop for the mobile launcher (ML) at NASA's Kennedy Space Center in Florida. Several launch umbilicals have been installed on the ML tower. Exploration Ground Systems is overseeing installation of umbilicals and launch accessories on the ML to prepare for the first integrated test flight of the Orion spacecraft on the agency's Space Launch System rocket on Exploration Mission-1.

Surface Functionalization of Polymeric Nanoparticles with Umbilical Cord-Derived Mesenchymal Stem Cell Membrane for Tumor-Targeted Therapy.

PubMed

Yang, Na; Ding, Yanping; Zhang, Yinlong; Wang, Bin; Zhao, Xiao; Cheng, Keman; Huang, Yixin; Taleb, Mohammad; Zhao, Jing; Dong, Wen-Fei; Zhang, Lirong; Nie, Guangjun

2018-06-15

Multiple cell plasma membranes have been utilized for surface functionalization of synthetic nanomaterials and construction of biomimetic drug delivery systems for cancer treatment. The natural characters and facile isolation of original cells facilitate the biomedical applications of plasma membranes in functionalizing nanocarriers. Human umbilical cord-derived mesenchymal stem cells (MSC) have been identified to show tropism towards malignant lesions and have great advantages in ease of acquisition, low immunogenicity, and high proliferative ability. Here we developed a poly(lactic-co-glycolic acid) (PLGA) nanoparticle with a layer of plasma membrane from umbilical cord MSC coating on the surface for tumor-targeted delivery of chemotherapy. Functionalization of MSC plasma membrane significantly enhanced the cellular uptake efficiency of PLGA nanoparticles, the tumor cell killing efficacy of PLGA-encapsulated doxorubicin, and most importantly the tumor-targeting and accumulation of the nanoparticles. As a result, this MSC-mimicking nanoformulation led to remarkable tumor growth inhibition and induced obvious apoptosis within tumor lesions. This study for the first time demonstrated the great potential of umbilical cord MSC plasma membranes in functionalizing nanocarriers with inherent tumor-homing features, and the high feasibility of such biomimetic nanoformulations in cancer therapy.

Acquired umbilical hernias in four captive polar bears (Ursus maritimus).

PubMed

Velguth, Karen E; Rochat, Mark C; Langan, Jennifer N; Backues, Kay

2009-12-01

Umbilical hernias are a common occurrence in domestic animals and humans but have not been well documented in polar bears. Surgical reduction and herniorrhaphies were performed to correct acquired hernias in the region of the umbilicus in four adult captive polar bears (Ursus maritimus) housed in North American zoos. Two of the four bears were clinically unaffected by their hernias prior to surgery. One bear showed signs of severe discomfort following acute enlargement of the hernia. In another bear, re-herniation led to acute abdominal pain due to gastric entrapment and strangulation. The hernias in three bears were surgically repaired by debridement of the hernia ring and direct apposition of the abdominal wall, while the large defect in the most severely affected bear was closed using polypropylene mesh to prevent excessive tension. The cases in this series demonstrate that while small hernias may remain clinically inconsequential for long periods of time, enlargement or recurrence of the defect can lead to incarceration and acute abdominal crisis. Umbilical herniation has not been reported in free-ranging polar bears, and it is suspected that factors such as body condition, limited exercise, or enclosure design potentially contribute to the development of umbilical hernias in captive polar bears.

Extending the Capability of Mars Umbilical Technology Demonstrator

NASA Technical Reports Server (NTRS)

Houshangi, Nasser

2001-01-01

The objective of this project is to expand the capabilities of for the Mars Umbilical Technology Demonstrator (MUTD). The MUTD shall provide electrical power and fiber optic data cable connections between two simulated mars vehicles, 1000 in apart. ne wheeled mobile robot Omnibot is used to provide the mobile base for the system. The mate-to umbilical plate is mounted on a Cartesian robot, which is installed on the Omnibot mobile base. It is desirable to provide the operator controlling the Omnibot, the distance and direction to the target. In this report, an approach for finding the position and orientation of the mobile robot using inertial sensors and beacons is investigated. First phase of the project considered the Omnibot being on the flat surface. To deal with the uneven Mars environment, the orientation as well as position needs to be controlled. During local positioning, the information received from four ultrasonic sensors installed at the four corner of the mate-mi plate is used to identify the position of mate-to plate and mate the umbilical plates autonomously. The work proposed is the continuation of the principal investigator research effort as a participant in the 1999 NASA/ASEE Summer Faculty Fellowship Program.

Trace of heavy metals in maternal and umbilical cord blood samples in association with birth outcomes in Baghdad, Iraq

NASA Astrophysics Data System (ADS)

Hasan Rhaif Al-Sahlanee, Mayyadah; Maizan Ramli, Ramzun; Abdul Hassan Ali, Miami; Fadhil Tawfiq, Nada; Zahirah Noor Azman, Nurul; Abdul Rahman, Azhar; Shahrim Mustafa, Iskandar; Noor Ashikin Nik Abdul Razak, Nik; Zakiah Yahaya, Nor; Mohammed Al-Marri, Hana; Syuhada Ayob, Nur; Zakaria, Nabela

2017-10-01

Trace elements are essential nutritional components in humans and inconvenient tissue content that have a significant influence on infant size. The aim of this study is to evaluate the effects of concentration of elements (uranium (U), lead (Pb) and iron (Fe)) and absorption of Pb and Fe on maternal and umbilical cord blood samples. The concentration and absorption of Pb and Fe in blood samples were determined by using atomic absorption spectrophotometry device, while the uranium concentration was determined by using CR-39 detector. Fifty women of age 16-44 years are involved in this study. Results show that the maximum and minimum values of both concentration and absorption in the maternal samples were for Pb and Fe, respectively. In addition, for umbilical cord, the maximum values of concentration and absorption were for Fe and the minimum concentration and absorption were for U and Pb, respectively. A significant correlation between maternal and umbilical cord blood samples was found. This indicates that the Pb, U and Fe elements can easily transfer from maternal to the fetal body which impacts the growth of fetus.

Diameter Versus Mass in the Development of the Orion Life Support Umbilical: A Case Study in Systems Engineering

NASA Technical Reports Server (NTRS)

Jordan, Nicole; Falconi, Eric; Barido, Richard; Lewis, John

2009-01-01

Systems engineering could also be called the art of compromise. At its heart, systems engineering seeks to find that solution which maximizes the utility of the system, usually compromising the performance of each individual subsystem. While seemingly straightforward, systems engineering methodology is complicated when the utility to be maximized is unclear and the costs to each individual subsystem are not - or not easily - quantifiable. In this paper, we explore one such systems engineering problem within the Constellation Program as a case study in applied systems engineering. During suited operations, astronauts within Orion will be connected to an umbilical to receive and return breathing gas. The pressure drop associated with this umbilical must be overcome by the Orion vehicle. A smaller umbilical, which is desirable for crew operations, means a higher pressure drop, resulting in additional mass and power for the vehicle. We outline the technical considerations in the development of this integrated system and discuss the method by which we reached the ultimate solution. This paper, while just one example of the kind of problem solving that happens every day, offers insight into what happens when the theories of systems engineering are put into practice.

Laser-assisted fibrinogen bonding of umbilical vein grafts.

PubMed

Oz, M C; Williams, M R; Souza, J E; Dardik, H; Treat, M R; Bass, L S; Nowygrod, R

1993-06-01

Despite success with autologous tissue welding, laser welding of synthetic vascular prostheses has not been possible. The graft material appears inert and fails to allow the collagen breakdown and electrostatic bonding that results in tissue welding. To develop a laser welding system for graft material, we repaired glutaraldehyde-tanned human umbilical cord vein graft incisions using laser-assisted fibrinogen bonding (LAFB) technology. Modified umbilical vein graft was incised transversely (1.2 cm). Incisions were repaired using sutures, laser energy alone, or LAFB. For LAFB, indocyanine green dye was mixed with human fibrinogen and the compound applied with forceps onto the weld site prior to exposure to 808 nm diode laser energy (power density 4.8 W/cm 2). Bursting pressures for sutured repairs (126.6 +/- 23.4 mm Hg) were similar to LAFB anastomoses (111.6 +/- 55.0 mm Hg). No evidence of collateral thermal injury to the graft material was noted. In vivo evaluation of umbilical graft bonding with canine arteries demonstrates that LAFB can reliably reinforce sutured anastomoses. The described system for bonding graft material with laser exposed fibrinogen may allow creation or reinforcement of vascular anastomoses in procedures where use of autologous tissue is not feasible.

Doubly-focused echos from spheres unfold into a hyperbolic umbilic diffraction catastrophe

NASA Astrophysics Data System (ADS)

Dzikowicz, Ben; Marston, Philip L.

2003-04-01

An underwater spherical target resides in an Airy field formed by reflection off a curved surface representing the sea floor or sea surface. In prior work [B. Dzikowicz and P. L. Marston, J. Acoust. Soc Am. 110, 2778 (2001)] direct returns of a tone burst from the surface reflection focused toward the target were shown to have a dependence on the target position described by an Airy function. The return echo can also be focused again by the surface onto the source and receive transducer. This gives the square of an Airy function for the case of a point target. With a finite sized target (as in the experiment) this goes over to a hyperbolic umbilic catastrophe with symmetric arguments. The arguments of the hyperbolic umbilic function are derived from only the relative return times of a transient pulse. Experiment confirms the predicted merging of transient echoes in the time domain, as well as the hyperbolic umbilic diffraction integral amplitudes for a tone burst. This method would allow for the observation of a target at a greater distance in the presence of a focusing surface. [Research supported by ONR.

Umbilical hernia alloplastic dual-mesh treatment in cirrhotic patients.

PubMed

Guriță, R E; Popa, F; Bălălău, C; Scăunașu, R V

2013-03-15

Abdominal wall hernias represent a pathology with an impressive prevalence among the population of patients with cirrhosis complicated by ascites. The aggressive surgical approach of umbilical hernia for patients with cirrhotic background remains a controversial problem, accompanied by anesthetic and surgical risk. Its indication remains fully justified in case of severe symptoms or life threatening complications: strangulation, incarceration, evisceration. This article evaluates results obtained by using dual-mesh alloplastic materials for surgical treatment of umbilical hernias affecting cirrhotic patients with incipient liver injury. Our lot consists of twelve patients with ages between 45 and 65 years, diagnosed with hepatic cirrhosis, without other associated comorbidities. All patients were admitted for strangulated umbilical hernia. Among the analyzed lot, no decease was encountered, the morbidity being limited to two cases of parietal suppuration, solved conservatively, without the mesh removal. There were no ascitic fistulas. No recurrences were registered for a 12 months tracking period. The presence of cirrhosis implies a high anesthetic and surgical risk, the intervention being grafted by a substantial increase of mortality and morbidity in an emergency setting. The development of new alloplastic materials, together with the modern anesthetic techniques, allows superior results for patients with incipient hepatic injury.

Effect of low-sodium diet on uteroplacental circulation.

PubMed

Delemarre, F M; van Leest, L A; Jongsma, H W; Steegers, E A

2000-01-01

To study the influence of chronic dietary sodium restriction on uteroplacental circulation. In a randomized trial, Doppler flow velocity waveforms of the uterine and umbilical artery were studied at monthly intervals during pregnancy in 59 women on a low-sodium diet and in 68 controls. Pulsatility index (PI), resistance index (RI), and A/B ratio of the uterine artery were significantly lower during sodium restriction, whereas PI, RI, and A/B ratio of the umbilical artery were significantly higher. The lower resistance indices of the uterine artery during sodium restriction might reflect an increase in pulse pressure/impedance ratio as a result of activation of the renin-angiotensin system. The increase in umbilical artery resistance indices supports the hypothesis that fetal circulation might be altered by chronic dietary sodium restriction.

Long Exposure Photos of Mobile Launcher

NASA Image and Video Library

2017-03-14

A long-exposure view of the mobile launcher at NASA's Kennedy Space Center in Florida. Cranes and rigging are being used to lift the bracket for the Orion Service Module Umbilical (OSMU) up for installation on the mobile launcher tower. The tower will be equipped with a number of lines, called umbilicals, that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. EM-1 is scheduled to launch in 2018. The Ground Systems Development and Operations Program is overseeing installation of the umbilicals.

Spontaneous Rupture of Umbilical Hernia in Pregnancy: A Case Report

PubMed Central

Ahmed, Adamu; Stephen, Garba; Ukwenya, Yahaya

2011-01-01

A 28 year old woman presented with a spontaneous rupture of an umbilical hernia in her seventh month of pregnancy. She had four previous unsupervised normal deliveries. There was no history of trauma or application of herbal medicine on the hernia. The hernia sac ruptured at the inferior surface where it was attached to the ulcerated and damaged overlying skin. There was a gangrenous eviscerated small bowel. The patient was resuscitated and the gangrenous small bowel was resected and end to end anastomosis done. The hernia sac was excised and the 12 cm defect repaired. Six weeks later, she had spontaneous vaginal delivery of a live baby. We advocate that large umbilical hernias should be routinely repaired when seen in women of child bearing age. PMID:22043438

DETERMINATION OF MATERNAL SERUM ZINC, IRON, CALCIUM AND MAGNESIUM DURING PREGNANCY IN PREGNANT WOMEN AND UMBILICAL CORD BLOOD AND THEIR ASSOCIATION WITH OUTCOME OF PREGNANCY

PubMed Central

Khoushabi, Fahimeh; Shadan, Mohammad Reza; Miri, Ali; Sharifi-Rad, Javad

2016-01-01

Background: Trace elements and specially minerals are critical for the development of fetus. Many minerals are transferred to the fetus for fetal stores in the latter part of the pregnancy. It has been shown that various trace elements such as Zinc, Iron, Calcium and Magnesium are metabolically interrelated and there is alteration in their concentration during pregnancy. Beyond pregnancy is associated with increased demand of all the nutrients and deficiency of any of these could affect pregnancy, delivery and outcome of pregnancy. Aim: To study the levels of trace elements namely zinc, iron, magnesium and calcium in maternal and umbilical cord blood and their association with pregnancy outcome. Methods: Sixty pregnant women in Zabol, Iran were selected from those who had registered their names for the prenatal care and who had followed up till the 3rd trimester of pregnancy ending in child birth. Biochemical parameters analyzed with help of the biochemical laboratory. Data were analyzed by SPSS software. Results: The mean biochemical profile such, serum calcium, magnesium, zinc and iron in the pregnant women were as follow: in the 1st trimester 8.3, 1.9, 74.9 and 74.4 µg/dl respectively; in the 2nd trimester 8.5, 1.9, 73.1 and 79.3 µg/dl, respectively; in the 3rd trimester 8.6, 1.9, 68.4, and 82.2 µg/dl, respectively. In the umbilical cord blood, the mean serum calcium, magnesium, zinc and iron were 8.5, 1.9, 84.1, and 89.8 µg/dl, respectively. The mean serum calcium and magnesium during the three trimesters of pregnancy were not significantly different from that in the umbilical cord blood, while the mean serum zinc and iron in the umbilical cord blood were significantly different (p<0.05) in the three trimester of pregnancy. The mean birth weight of neonates was 3.1 kg and 12% of neonates showed low birth weight. Our findings showed that, except magnesium, the profile of other biochemical variables, namely, calcium, zinc and iron in the umbilical cord blood of the neonates with normal birth weight (NBW) were significantly higher than in the umbilical cord blood of neonates with low birth weight (LBW). Conclusion: The results suggest that maternal serum zinc, iron and calcium concentration influenced the birth weight of neonates as outcome of pregnancy, and however, there is need for proper, adequate and balanced micronutrient during pregnancy to affect neonates as healthy outcome. PMID:27147914

Hydrogen Vent Ground Umbilical Quick Disconnect - Flight Seal Advanced Development

NASA Technical Reports Server (NTRS)

Girard, Doug; Jankowski, Fred; Minich, Mark C.; Yu, Weiping

2012-01-01

This project is a team effort between NASA Engineering (NE) and Team QNA Engineering personnel to provide support for the Umbilical Systems Development project which is funded by Advanced Exploration Systems (AES) and 21st Century Launch Complex. Specifically, this project seeks to develop a new interface between the PPBE baselined Legacy SSP LH2 Vent Arm QD probe and SLS vent seal.

Umbilical-spinous line: a morphological term that should be included in the anatomical terminology

PubMed Central

Ríos, John

2013-01-01

We argue the need to include in the International Anatomical Terminology the term "Umbilical-spinous line" for its importance as a morphological referent in bioscopic and surface anatomy. Also, in order to avoid using eponyms, it is suggested that the traditional term "McBurney point" be replaced by "supra spinous point" as being more descriptive of location. PMID:24892620

Two-stage laparoscopic approaches for high anorectal malformation: transumbilical colostomy and anorectoplasty.

PubMed

Yang, Li; Tang, Shao-Tao; Li, Shuai; Aubdoollah, T H; Cao, Guo-Qing; Lei, Hai-Yan; Wang, Xin-Xing

2014-11-01

Trans-umbilical colostomy (TUC) has been previously created in patients with Hirschsprung's disease and intermediate anorectal malformation (ARM), but not in patients with high-ARM. The purposes of this study were to assess the feasibility, safety, complications and cosmetic results of TUC in a divided fashion, and subsequently stoma closure and laparoscopic assisted anorectoplasty (LAARP) were simultaneously completed by using the colostomy site for a laparoscopic port in high-ARM patients. Twenty male patients with high-ARMs were chosen for this two-stage procedure. The first-stage consisted of creating the TUC in double-barreled fashion colostomy with a high chimney at the umbilicus, and the loop was divided at the same time, in such a way that the two diverting ends were located at the umbilical incision with the distal end half closed and slightly higher than proximal end. In the second-stage, 3 to 7 months later, the stoma was closed through a peristomal skin incision followed by end-to-end anastomosis and simultaneously LAARP was performed by placing a laparoscopic port at the umbilicus, which was previously the colonostomy site. Umbilical wound closure was performed in a semi-opened fashion to create a deep umbilicus. TUC and LAARP were successfully performed in 20 patients. Four cases with bladder neck fistulas and 16 cases with prostatic urethra fistulas were found. Postoperative complications were rectal mucosal prolapsed in three cases, anal stricture in two cases and wound dehiscence in one case. Neither umbilical ring narrowing, parastomal hernia nor obstructive symptoms was observed. Neither umbilical nor perineal wound infection was observed. Stoma care was easily carried-out by attaching stoma bag. Healing of umbilical wounds after the second-stage was excellent. Early functional stooling outcome were satisfactory. The umbilicus may be an alternative stoma site for double-barreled colostomy in high-ARM patients. The two-stage laparoscopic approaches for high-ARM, TUC and stoma closure with simultaneously LAARP are both technically feasible and safe with excellent cosmetic result. Copyright © 2014 Elsevier Inc. All rights reserved.

Risk of fetal death in growth-restricted fetuses with umbilical and/or ductus venosus absent or reversed end-diastolic velocities before 34 weeks of gestation: a systematic review and meta-analysis.

PubMed

Caradeux, J; Martinez-Portilla, R J; Basuki, T R; Kiserud, T; Figueras, F

2018-02-01

The objective of the study was to establish the risk of fetal death in early-onset growth-restricted fetuses with absent or reversed end-diastolic velocities in the umbilical artery or ductus venosus. A systematic search was performed to identify relevant studies published in English, Spanish, French, Italian, or German using the databases PubMed, ISI Web of Science, and SCOPUS, without publication time restrictions. The study criteria included observational cohort studies and randomized controlled trials of early-onset growth-restricted fetuses (diagnosed before 34 weeks of gestation), with information on the rate of fetal death occurring before 34 weeks of gestation and absent or reversed end-diastolic velocities in the umbilical artery and/or ductus venosus. For quality assessment, 2 reviewers independently assessed the risk of bias using the Newcastle-Ottawa Scale for observational studies and the Cochrane Collaboration's tool for randomized trials. For the meta-analysis, odds ratio for both fixed and random-effects models (weighting by inverse of variance) were used. Heterogeneity between studies was assessed using tau 2 , χ2 (Cochrane Q), and I 2 statistics. Publication bias was assessed by a funnel plot for meta-analyses and quantified by the Egger method. A total of 31 studies were included in this meta-analysis. The odds ratios for fetal death (random-effects models) were 3.59 (95% confidence interval, 2.3-5.6), 7.27 (95% confidence interval, 4.6-11.4), and 11.6 (95% confidence interval, 6.3-19.7) for growth-restricted fetuses with umbilical artery absent end-diastolic velocities, umbilical artery reversed end-diastolic velocities, and ductus venosus absent or reversed end-diastolic velocities, respectively. There was no substantial heterogeneity among studies for any of the analyses. Early-onset growth-restricted fetuses with either umbilical artery or ductus venosus absent or reserved end-diastolic velocities are at a substantially increased risk for fetal death. Copyright © 2017 Elsevier Inc. All rights reserved.

Associations between intrapartum death and piglet, placental, and umbilical characteristics.

PubMed

Rootwelt, V; Reksen, O; Farstad, W; Framstad, T

2012-12-01

Intrapartum death in multiparous gestations in sows (Sus scrofa) is often caused by hypoxia. There is little information in the literature on the assessment of the placenta in relation to intrapartum death in piglets. The aim of this study was to evaluate the impact of the placental area and weight upon piglet birth characteristics and intrapartum death. Litters from 26 Landrace-Yorkshire sows were monitored during farrowing and the status of each piglet was recorded, including blood parameters of piglets and their umbilical veins. Of 413 piglets born, 6.5% were stillborn. Blood concentrations of glucose, lactate, and CO(2) partial pressure were increased in the stillborn piglets (P < 0.05) and corresponding umbilical veins (P < 0.01) vs. live-born piglets, whereas pH and base excess were decreased (P < 0.001). Time from onset of parturition until birth was increased for piglets born dead vs. live (P < 0.001). Mean birth weight for piglets born dead was not different from live-born piglets (P = 0.631), whereas mean body mass index was reduced (P < 0.001). Mean placental area and placental weight belonging to stillborn piglets were not different from live-born piglets (P = 0.662 and P = 0.253, respectively). Blood concentrations of lactate, hemoglobin, and hematocrit recorded in all piglets pooled were associated with placental area (P < 0.05), but not with placental weight (P > 0.2). Piglet BW was positively correlated with placental area and placental weight (P < 0.001). The risk of being born dead increased with increasing birth order group, and broken umbilical cords explained 71% of the stillbirths (P = 0.001). We conclude that placental area and placental weight are both positively associated with piglet birth weight, but not with the probability of being born dead. Placental area was a better predictor of piglet vitality than placental weight. Because umbilical cord rupture and prolonged birth time were associated with being born dead, umbilical cord rupture and placental detachment seem to be probable causes of intrapartum death.

The umbilical and paraumbilical veins of man.

PubMed Central

Martin, B F; Tudor, R G

1980-01-01

During its transit through the umbilicus structural changes occur in the thick wall of the extra-abdominal segment of the umbilical vein whereby the components of the intra-abdominal segment acquire an essentially longitudinal direction and become arranged in fibro-elastic and fibro-muscular zones. The vein lumen becomes largely obliterated by asymmetrical proliferation of loose subendothelial conective tissue. The latter forms a new inner zone within which a small segment of the lumen persists in an eccentric position. This residual lumen transmits blood to the portal system from paraumbilical and systemic sources, and is retained in the upper part of the vein, even in old age. A similar process of lumen closure is observed in the ductus venosus. In early childhood the lower third of the vein undergoes breakdown, with fatty infiltration, resulting in its complete division into vascular fibro-elastic strands, and in old age some breakdown occurs in the outermost part of the wall of the upper two thirds. The paraumbilical veins are thick-walled and of similar structure to the umbilical vein. Together they constitute an accessory portal system which is confined between the layers of the falciform ligament and is in communication with the veins of the ventral abdominal wall. The constituents form an ascending series, namely, Burow's veins, the umbilical vein, and Sappey's inferior and superior veins. The main channel of Sappey's inferior veins may be the remnant of the right umbilical vein since it communicates with the right rectus sheath and often communicates directly with the portal system within the right lobe of the liver. The results are of significance in relation to clinical usage of the umbilical vein. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Fig. 22 Fig. 23 Fig. 24 Fig. 25 Fig. 26 Fig. 27 Fig. 28 Fig. 29 PMID:7400038

Short beveled sharp cutting needle is superior to facet tip needle for ultrasound-guided rectus sheath block in children with umbilical hernia: a case series.

PubMed

Alsaeed, A; Thallaj, A; Alzahrani, T; Khalil, N; Aljazaeri, A

2014-10-01

The most common peripheral nerve blocks used in umbilical hernia repair are rectus sheath block and regional block (caudal block). Ultrasound guidance of peripheral nerve blocks has reduced the number of complications and improved the quality of blocks. The aim of this study is to assess the post rectus sheath block pain relief in pediatric patients coming for umbilical surgery, and to evaluate the easiness of soft tissue puncture and ultrasonic appearance of two different needle types. Twenty two (22) pediatric patients (age range: 1.5-8 years) scheduled for umbilical hernia repair were included in the study. Following the induction of general anesthesia, the ultrasonographic anatomy of the umbilical region was studied with a 5-16 MHz linear probe. An ultrasound-guided rectus sheath block in the lateral edge of both rectus abdominis muscles (RMs) was performed (total of 44 punctures). A 22 gauge short beveled sharp cutting needle 1.1 x 30 mm needle A (BD Insyte--W, Vialon material. Spain) was used in one side, and a Stimuplex A insulated Needle 22G 50mm (needle B) was used on the other side. Surgical conditions, intraoperative hemodynamic parameters, and postoperative analgesia were evaluated. Ultrasonograghic visualization of the posterior sheath was possible in all patients. Needle A scored 72.7% of excellent needle tip and shaft view (16 out of 22) compared to 63.63% for needle B (14 out of 22). None of the needles scored poor view. The ultrasound guided rectus sheath blockade provided sufficient analgesia in all children with no need for additional analgesia except for one child who postoperatively requested morphine 0.1 mg/kg intravenously in recovery room. There were no complications. Ultrasound guidance enables performances of an effective rectus sheath block for umbilical hernia in the lateral edge of the rectus muscle. Use of the sharp short beveled needle of 22 gauge intravenous (IV) cannula stylet provides easy, less traumatic skin and rectus muscle penetration and better needle visualization by the ultrasound.

Estimation of neonatal outcome artery pH value according to CTG interpretation of the last 60 min before delivery: a retrospective study. Can the outcome pH value be predicted?

PubMed

Kundu, S; Kuehnle, E; Schippert, C; von Ehr, J; Hillemanns, P; Staboulidou, Ismini

2017-11-01

The aim of this study was to analyze whether the umbilical artery pH value can be estimated throughout CTG assessment 60 min prior to delivery and if the estimated umbilical artery pH value correlates with the actual one. This includes analysis of correlation between CTG trace classification and actual umbilical artery pH value. Intra-and interobserver agreement and the impact of professional experience on visual analysis of fetal heart rate tracing were evaluated. This was a retrospective study. 300 CTG records of the last 60 min before delivery were picked randomly from the computer database with the following inclusion criteria; singleton pregnancy >37 weeks, no fetal anomalies, vaginal delivery either spontaneous or instrumental-assisted. Five obstetricians and two midwives of different professional experience classified 300 CTG traces according to the FIGO criteria and estimated the postnatal umbilical artery pH. The results showed a significant difference (p < 0.05) in estimated and actual pH value, independent of professional experience. Analysis and correlation of CTG assessment and actual umbilical artery pH value showed significantly (p < 0.05) diverging results. Intra- and interobserver variability was high. Intraobserver variability was significantly higher for the resident (p = 0.001). No significant differences were detected regarding interobserver variability. An estimation of the pH value and consequently of neonatal outcome on the basis of a present CTG seems to be difficult. Therefore, not only CTG training but also clinical experience and the collaboration and consultation within the whole team is important.

Umbilical vein oxytocin for the treatment of retained placenta (Release Study): a double-blind, randomised controlled trial.

PubMed

Weeks, Andrew D; Alia, Godfrey; Vernon, Gillian; Namayanja, Annette; Gosakan, Radhika; Majeed, Tayyaba; Hart, Anna; Jafri, Hussain; Nardin, Juan; Carroli, Guillermo; Fairlie, Fiona; Raashid, Yasmin; Mirembe, Florence; Alfirevic, Zarko

2010-01-09

Retained placenta is associated with post-partum haemorrhage. Meta-analysis has suggested that umbilical injection of oxytocin could increase placental expulsion without the need for a surgeon or anaesthetic. We assessed the effect of high-dose umbilical vein oxytocin as a treatment for retained placenta. In this double-blind, placebo-controlled trial, haemodynamically stable women with a retained placenta for more than 30 min were recruited from 13 sites in the UK, Uganda, and Pakistan. 577 women were randomly assigned by a computer-generated randomisation list stratified by centre to 30 mL saline containing either 50 IU oxytocin (n=292) or 5 mL water (n=285), which was injected into the placenta through an umbilical vein catheter. All trial participants, study workers, and data handlers were masked to individual allocations. The primary outcome was the need for manual removal of the placenta. Analysis was by intention to treat. This study is registered, number ISRCTN 13204258. The primary outcome was recorded for all participants. We detected no difference between the groups in the need for manual removal of placenta (oxytocin 179/292 [61.3%] vs placebo 177/285 [62.1%]; relative risk 0.98, 95% CI 0.87-1.12; p=0.84). The need for manual removal was higher in the UK (overall 250/361 [69%]) than in Uganda (90/190 [47%]) or Pakistan (16/26 [62%]). Adverse events did not differ between the two groups. Umbilical oxytocin has no clinically significant effect on the need for manual removal for women with retained placenta. WHO, WellBeing of Women, Pakistan Higher Education Commission. Copyright 2010 Elsevier Ltd. All rights reserved.

Doppler Audio Signal Analysis as an Additional Tool in Evaluation of Umbilical Artery Circulation.

PubMed

Thuring, Ann; Källén, Karin; Brännström, K Jonas; Jansson, Tomas; Maršál, Karel

2017-10-01

Purpose  To investigate the predictive capacity of a new method for sound spectrum analysis of Doppler signals recorded from the umbilical artery in high-risk pregnancies. Material and Methods  The retrospective study comprised 127 pregnant women with various pregnancy complications between 23 and 39 gestational weeks. Umbilical artery blood flow velocity waveforms were recorded with Doppler ultrasound and characterized by pulsatility index (PI) and blood flow class (BFC). Doppler audio signals were stored on a digital video recorder and the sound frequency at the energy level 15 dB below its peak (MAX peak-15 dB ) was estimated off-line. The prediction of probability for composite adverse pregnancy outcome (operative delivery for fetal distress, admission to neonatal intensive care unit, perinatal death) was evaluated using the area under the curve (AUC) of the receiver operating characteristics (ROC) curve. Results  With increasing umbilical artery BFC, the MAX peak-15 dB frequencies decreased (p < 0.0001) and the PI increased (p < 0.0001). The ROC AUCs for adverse outcome for MAX peak-15 dB and for PI were 0.842 and 0.836 (p = 0.88), respectively. For the combination of MAX peak-15 dB and PI, the corresponding AUC was 0.894, significantly higher than that of PI (p < 0.03) and of MAX peak-15 dB (p < 0.05). Conclusion  Umbilical artery Doppler sound spectrum analysis might be a useful supplement to PI in the clinical evaluation of fetoplacental circulation. © Georg Thieme Verlag KG Stuttgart · New York.

Post-test probability for neonatal hyperbilirubinemia based on umbilical cord blood bilirubin, direct antiglobulin test, and ABO compatibility results.

PubMed

Peeters, Bart; Geerts, Inge; Van Mullem, Mia; Micalessi, Isabel; Saegeman, Veroniek; Moerman, Jan

2016-05-01

Many hospitals opt for early postnatal discharge of newborns with a potential risk of readmission for neonatal hyperbilirubinemia. Assays/algorithms with the possibility to improve prediction of significant neonatal hyperbilirubinemia are needed to optimize screening protocols and safe discharge of neonates. This study investigated the predictive value of umbilical cord blood (UCB) testing for significant hyperbilirubinemia. Neonatal UCB bilirubin, UCB direct antiglobulin test (DAT), and blood group were determined, as well as the maternal blood group and the red blood cell antibody status. Moreover, in newborns with clinically apparent jaundice after visual assessment, plasma total bilirubin (TB) was measured. Clinical factors positively associated with UCB bilirubin were ABO incompatibility, positive DAT, presence of maternal red cell antibodies, alarming visual assessment and significant hyperbilirubinemia in the first 6 days of life. UCB bilirubin performed clinically well with an area under the receiver-operating characteristic curve (AUC) of 0.82 (95 % CI 0.80-0.84). The combined UCB bilirubin, DAT, and blood group analysis outperformed results of these parameters considered separately to detect significant hyperbilirubinemia and correlated exponentially with hyperbilirubinemia post-test probability. Post-test probabilities for neonatal hyperbilirubinemia can be calculated using exponential functions defined by UCB bilirubin, DAT, and ABO compatibility results. • The diagnostic value of the triad umbilical cord blood bilirubin measurement, direct antiglobulin testing and blood group analysis for neonatal hyperbilirubinemia remains unclear in literature. • Currently no guideline recommends screening for hyperbilirubinemia using umbilical cord blood. What is New: • Post-test probability for hyperbilirubinemia correlated exponentially with umbilical cord blood bilirubin in different risk groups defined by direct antiglobulin test and ABO blood group compatibility results. • Exponential functions can be used to calculate hyperbilirubinemia probability.

Amnioinfusion for umbilical cord compression in labour.

PubMed

Hofmeyr, G J

2000-01-01

Amnioinfusion aims to prevent or relieve umbilical cord compression during labour by infusing a solution into the uterine cavity. The objective of this review was to assess the effects of amnioinfusion on maternal and perinatal outcome for potential or suspected umbilical cord compression or potential amnionitis. The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched. Randomised trials of amnioinfusion compared with no amnioinfusion in women with babies at risk of umbilical cord compression; and women at risk of intrauterine infection. Eligibility and trial quality were assessed by the reviewer. Twelve studies were included. Transcervical amnioinfusion for potential or suspected umbilical cord compression was associated with the following reductions: fetal heart rate decelerations (relative risk 0.54, 95% confidence interval 0.43 to 0.68); caesarean section for suspected fetal distress (relative risk 0.35, 95% confidence interval 0.24 to 0.52); neonatal hospital stay greater than 3 days (relative risk 0.40, 95% confidence interval 0. 26 to 0.62); maternal hospital stay greater than 3 days (relative risk 0.46, 95% 0.29 to 0.74). Transabdominal amnioinfusion showed similar results. Transcervical amnioinfusion to prevent infection in women with membranes ruptured for more than 6 hours was associated with a reduction in puerperal infection (relative risk 0.50, 95% confidence interval 0.26 to 0.97). Amnioinfusion appears to reduce the occurrence of variable heart rate decelerations and lower the use of caesarean section. However the studies were done in settings where fetal distress was not confirmed by fetal blood sampling. The results may therefore only be relevant where caesarean sections are commonly done for abnormal fetal heart rate alone. The trials reviewed are too small to address the possibility of rare but serious maternal adverse effects of amnioinfusion.

Higher cord blood levels of fatty acids in pregnant women with type 1 diabetes mellitus.

PubMed

Djelmis, Josip; Ivaniševic, Marina; Desoye, Gernot; van Poppel, Mireille; Berberovic, Edina; Soldo, Dragan; Oreskovic, Slavko

2018-05-01

Type 1 diabetes mellitus is associated with a disturbance of carbohydrate and lipid metabolism. To determine whether type 1 diabetes mellitus (T1DM) alters maternal and neonatal fatty acid levels. Observational study. Academic hospital. Sixty pregnant women (30 women with T1DM with good glycemic control and 30 healthy women) were included in the study. Maternal blood, umbilical vein and artery blood samples were collected immediately upon delivery. Following lipid extraction, the fatty acid profiles of the total fatty acid pool of maternal serum and umbilical vein and artery serum were determined by gas chromatography. Total fatty acid concentration in maternal serum did not differ between the study groups; it was significantly higher in umbilical vein serum of the T1DM group compared with that in the control group, median (interquartile range), T1DM: 2126.2 (1446.4 - 3181.3), control: 1073.8 (657.5 - 2226.0); (P<0.001) and in umbilical artery vein serum T1DM: 1805.7 (1393.1 - 2125.0), control: 990.0 (643.3 - 1668.0); (P<0.001). Composition of fatty acids in umbilical vein serum fatty acids showed significantly higher concentrations of saturated, monounsaturated and polyunsaturated fatty acids in the T1DM group than in compared with those in the control group (P=0.001). Also cord blood levels of leptin (P<0.001), C-peptide (P<0.001), and insulin resistance (P=0.015) were higher in the T1DM group compared to controls. The neonates born to T1DM mothers had higher concentrations of total fatty acids, saturated and monounsaturated fatty acids, as well as polyunsaturated fatty acids, compared to control group newborns.

Ultrasonographic diagnosis and minimally invasive treatment of a patent urachus associated with a patent omphalomesenteric duct in a newborn

PubMed Central

Bertozzi, Mirko; Recchia, Nicola; Di Cara, Giuseppe; Riccioni, Sara; Rinaldi, Victoria Elisa; Esposito, Susanna; Appignani, Antonino

2017-01-01

Abstract Rational: Patent urachus (PU) is due to an incomplete obliteration of the urachus, whereas patent omphalomesenteric duct (POMD) is due to an incomplete obliteration of the vitelline duct. These anomalies are very rarely associated with one another. We describe a case of a newborn with a PU associated with a POMD, who was diagnosed by an abdominal ultrasound (US) and laparoscopy, and managed with a minimally invasive excision. Patient concern: A 28-day-old male neonate was referred to our hospital to investigate a delay in umbilical healing, with blood-mucinous material spillage for 3 weeks prior to the referral. The baby had no symptoms and was in good general health. Diagnosis: After a thorough cleaning of the umbilical stump, a clear granuloma with a suspected fistula was evident under the seat of the ligature of the stump. An abdominal US examination revealed the formation of a full communication, starting below the umbilical stump and developing along the anterior abdominal wall that connected with the bladder dome. The US also revealed a tubular formation containing air, which was compatible with POMD, in the deepest portion of the same umbilical stump. Considering these findings, the rare diagnosis of a PU associated with a POMD duct was suspected. Interventions: The child was then hospitalized for an elective laparoscopy that confirmed the US picture, and a minimally invasive excision was performed. Outcome: The postoperative course was favorable and uneventful. Lessons: Our case underlines the importance of evaluating all persisting umbilical lesions without delay when conventional pharmacological therapies fail. Using a US as the first approach is valuable and should be supported by laparoscopy to confirm the diagnosis; a minimally invasive excision of the remnants appears to be an effective therapeutic approach. PMID:28746173

Prenatal Arsenic Exposure and DNA Methylation in Maternal and Umbilical Cord Blood Leukocytes

PubMed Central

Baccarelli, Andrea; Hoffman, Elaine; Tarantini, Letizia; Quamruzzaman, Quazi; Rahman, Mahmuder; Mahiuddin, Golam; Mostofa, Golam; Hsueh, Yu-Mei; Wright, Robert O.; Christiani, David C.

2012-01-01

Background: Arsenic is an epigenetic toxicant and could influence fetal developmental programming. Objectives: We evaluated the association between arsenic exposure and DNA methylation in maternal and umbilical cord leukocytes. Methods: Drinking-water and urine samples were collected when women were at ≤ 28 weeks gestation; the samples were analyzed for arsenic using inductively coupled plasma mass spectrometry. DNA methylation at CpG sites in p16 (n = 7) and p53 (n = 4), and in LINE-1 and Alu repetitive elements (3 CpG sites in each), was quantified using pyrosequencing in 113 pairs of maternal and umbilical blood samples. We used general linear models to evaluate the relationship between DNA methylation and tertiles of arsenic exposure. Results: Mean (± SD) drinking-water arsenic concentration was 14.8 ± 36.2 μg/L (range: < 1–230 μg/L). Methylation in LINE-1 increased by 1.36% [95% confidence interval (CI): 0.52, 2.21%] and 1.08% (95% CI: 0.07, 2.10%) in umbilical cord and maternal leukocytes, respectively, in association with the highest versus lowest tertile of total urinary arsenic per gram creatinine. Arsenic exposure was also associated with higher methylation of some of the tested CpG sites in the promoter region of p16 in umbilical cord and maternal leukocytes. No associations were observed for Alu or p53 methylation. Conclusions: Exposure to higher levels of arsenic was positively associated with DNA methylation in LINE-1 repeated elements, and to a lesser degree at CpG sites within the promoter region of the tumor suppressor gene p16. Associations were observed in both maternal and fetal leukocytes. Future research is needed to confirm these results and determine if these small increases in methylation are associated with any health effects. PMID:22466225

What has methylmercury in umbilical cords told us? - Minamata disease.

PubMed

Yorifuji, Takashi; Kashima, Saori; Tsuda, Toshihide; Harada, Masazumi

2009-12-20

Severe methylmercury poisoning occurred in Minamata and neighboring communities in the 1950s and 1960s. The exposed patients manifested neurological signs, and some patients exposed in utero were born with so-called congenital Minamata disease. In a previous report, Nishigaki and Harada evaluated the methylmercury concentrations in the umbilical cords of inhabitants and demonstrated that methylmercury actually passed through the placenta (Nishigaki and Harada, 1975). However, the report involved a limited number of cases (only 35) and did not quantitatively evaluate the regional differences in the transition of methylmercury exposure. Therefore, in the present study, we evaluated the temporal and spatial distributions of methylmercury concentrations in umbilical cords, with an increased number of participants and additional descriptive analyses. Then, we examined whether the methylmercury concentrations corresponded with the history of the Minamata disease incident. A total of 278 umbilical cord specimens collected after birth were obtained from babies born between 1925 and 1980 in four study areas exposed to methylmercury. Then, we conducted descriptive analyses, and drew scatterplots of the methylmercury concentrations of all the participants and separated by the areas. In the Minamata area, where the first patient was identified in 1956, the methylmercury concentration reached a peak around 1955. Subsequently, about 5 years later, the concentrations peaked in other exposed areas with the expected exposure distribution corresponding with acetaldehyde production (the origin of methylmercury). This historical incident several decades ago in Minamata and neighboring communities clearly shows that regional pollution affected the environment in utero. Furthermore, the temporal and spatial distributions of the methylmercury concentrations in the umbilical cords tell us the history of the Minamata disease incident.

The influence of active and passive smoking during pregnancy on umbilical cord blood levels of vitamins A and E and neonatal anthropometric indices.

PubMed

Titova, Olga E; Ayvazova, Elena A; Bichkaeva, Fatima A; Brooks, Samantha J; Chumakova, Galina N; Schiöth, Helgi B; Benedict, Christian

2012-10-28

Smoking during pregnancy has been shown to be detrimental for the developing fetus. The effects of active and passive maternal smoking on umbilical cord serum levels of vitamin A and vitamin E were examined. Secondary measures included anthropometric parameters in the newborn. Maternal and umbilical cord serum levels of vitamins A and E were measured at delivery. The mothers were assigned to three groups: non-smoking (n 12); passive smoking (n 13); active smoking (n 18). Based on multivariate linear regressions, active smoking during pregnancy was associated with increased umbilical cord serum levels of vitamin A and vitamin E. While enhanced circulating levels of vitamin A in cord blood were also found in non-smoking mothers exposed to tobacco smoke during pregnancy, those of vitamin E were not influenced. Further, an inverse association between smoking behaviour during pregnancy and birth length was observed, with shortest length in active smokers followed by passive smoking mothers. Active and passive maternal smoking behaviour during pregnancy increases the fetal demand for antioxidant compounds in order to counteract the oxidative burden by cigarette smoke. Against this background, the observed increase in umbilical cord serum levels of vitamins A and E may subserve antioxidative processes in response to tobacco smoke-induced oxidative stress. This would reduce the availability of vitamins A and E for fetal maturation, which is critical inasmuch as both compounds are indispensable for the developing fetus. However, due to the cross-sectional nature of our observation, this line of reasoning definitely requires validation in cause-effect experiments in the future.

Doppler ultrasound evaluation in preeclampsia

PubMed Central

2013-01-01

Background Worldwide preeclampsia (PE) is the leading cause of maternal death and affects 5 to 8% of pregnant women. PE is characterized by elevated blood pressure and proteinuria. Doppler Ultrasound (US) evaluation has been considered a useful method for prediction of PE; however, there is no complete data about the most frequently altered US parameters in the pathology. The aim of this study was to evaluate the uterine, umbilical, and the middle cerebral arteries using Doppler US parameters [resistance index (RI), pulsatility index (PI), notch (N), systolic peak (SP) and their combinations] in pregnant women, in order to make a global evaluation of hemodynamic repercussion caused by the established PE. Results A total of 102 pregnant Mexican women (65 PE women and 37 normotensive women) were recruited in a cases and controls study. Blood velocity waveforms from uterine, umbilical, and middle cerebral arteries, in pregnancies from 24 to 37 weeks of gestation were recorded by trans-abdominal examination with a Toshiba Ultrasound Power Vision 6000 SSA-370A, with a 3.5 MHz convex transducer. Abnormal general Doppler US profile showed a positive association with PE [odds ratio (OR) = 2.93, 95% confidence interval (CI) = 1.2 - 7.3, P = 0.021)], and a specificity and predictive positive value of 89.2% and 88.6%, respectively. Other parameters like N presence, RI and PI of umbilical artery, as well as the PI of middle cerebral artery, showed differences between groups (P values < 0.05). Conclusion General Doppler US result, as well as N from uterine vessel, RI from umbilical artery, and PI from umbilical and middle cerebral arteries in their individual form, may be considered as tools to determine hemodynamic repercussion caused by PE. PMID:24252303

Single site multiport umbilical laparoscopic appendicectomy versus conventional multiport laparoscopic appendicectomy in acute settings

PubMed Central

Yadav, SP

2014-01-01

Introduction Although conventional multiport laparoscopic appendicectomy (CMLA) is preferred for managing acute appendicitis, the recently developed transumbilical laparoscopic approach is rapidly gaining popularity. However, its wide dissemination seems restricted by technical/technological issues. In this regard, a newly developed method of single site multiport umbilical laparoscopic appendicectomy (SMULA) was compared prospectively with CMLA to assess the former’s efficacy and the technical advantages in acute scenarios. Methods Overall, 430 patients were studied: 212 in the SMULA group and 218 in the CMLA group. The same surgeon performed all the procedures using routine laparoscopic instruments. The SMULA technique entailed three ports inserted directly at the umbilical mound through three distinct strategically placed mini-incisions without raising the umbilical flap. The CMLA involved the traditional three-port technique. Results Both groups were comparable in terms of demographic criteria, indications for surgery, intraoperative blood loss, time to ambulation, length of hospital stay and umbilical morbidity. Although the mean operative time was marginally longer in the SMULA group (43.35 minutes, standard deviation [SD]: 21.16 minutes) than in the CMLA group (42.28 minutes, SD: 21.41 minutes), this did not reach statistical significance. Conversely, the mean pain scores on day 0 and the cosmetic outcomes differed significantly and favoured the SMULA technique. None of the patients developed port site hernias over the follow-up period (mean 2.9 years). Conclusions The favourable outcomes for the SMULA technique are likely to be due to the three small segregated incisions at one place and better trocar ergonomics. The SMULA technique is safe in an acute setting and may be considered of value among the options for transumbilical appendicectomy. PMID:25198978

Accuracy of chest radiography for positioning of the umbilical venous catheter.

PubMed

Guimarães, Adriana F M; Souza, Aline A C G de; Bouzada, Maria Cândida F; Meira, Zilda M A

To evaluate the accuracy of the simultaneous analysis of three radiographic anatomical landmarks - diaphragm, cardiac silhouette, and vertebral bodies - in determining the position of the umbilical venous catheter distal end using echocardiography as a reference standard. This was a cross-sectional, observational study, with the prospective inclusion of data from all neonates born in a public reference hospital, between April 2012 and September 2013, submitted to umbilical venous catheter insertion as part of their medical care. The position of the catheter distal end, determined by the simultaneous analysis of three radiographic anatomical landmarks, was compared with the anatomical position obtained by echocardiography; sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Of the 162 newborns assessed by echocardiography, only 44 (27.16%) had the catheter in optimal position, in the thoracic portion of the inferior vena cava or at the junction of the inferior vena cava with the right atrium. The catheters were located in the left atrium and interatrial septum in 54 (33.33%) newborns, in the right atrium in 26 (16.05%), intra-hepatic in 37 (22.84%), and intra-aortic in-one newborn (0.62%). The sensitivity, specificity and accuracy of the radiography to detect the catheter in the target area were 56%, 71%, and 67.28%, respectively. Anteroposterior radiography of the chest alone is not able to safely define the umbilical venous catheter position. Echocardiography allows direct visualization of the catheter tip in relation to vascular structures and, whenever possible, should be considered to identify the location of the umbilical venous catheter. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Umbilical Hernia Repair and Pregnancy: Before, during, after…

PubMed Central

Kulacoglu, Hakan

2018-01-01

Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable. If the hernia is not complicated, but symptomatic an elective repair should be proposed. When the patient has a small and asymptomatic hernia it may be better to postpone the repair until she gives birth. If the hernia is repaired by suture alone, a high risk of recurrence exists during pregnancy. Umbilical hernia repair during pregnancy can be performed with minimal morbidity to the mother and baby. Second trimester is a proper timing for surgery. Asymptomatic hernias can be repaired, following childbirth or at the time of cesarean section (C-section). Elective repair after childbirth is possible as early as postpartum of eighth week. A 1-year interval can give the patient a very smooth convalescence, including hormonal stabilization and return to normal body weight. Moreover, surgery can be postponed for a longer time even after another pregnancy, if the patients would like to have more children. Diastasis recti are very frequent in pregnancy. It may persist in postpartum period. A high recurrence risk is expected in patients with rectus diastasis. This risk is especially high after suture repairs. Mesh repairs should be considered in this situation. PMID:29435451

Umbilical Hernia Repair and Pregnancy: Before, during, after….

PubMed

Kulacoglu, Hakan

2018-01-01

Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable. If the hernia is not complicated, but symptomatic an elective repair should be proposed. When the patient has a small and asymptomatic hernia it may be better to postpone the repair until she gives birth. If the hernia is repaired by suture alone, a high risk of recurrence exists during pregnancy. Umbilical hernia repair during pregnancy can be performed with minimal morbidity to the mother and baby. Second trimester is a proper timing for surgery. Asymptomatic hernias can be repaired, following childbirth or at the time of cesarean section (C-section). Elective repair after childbirth is possible as early as postpartum of eighth week. A 1-year interval can give the patient a very smooth convalescence, including hormonal stabilization and return to normal body weight. Moreover, surgery can be postponed for a longer time even after another pregnancy, if the patients would like to have more children. Diastasis recti are very frequent in pregnancy. It may persist in postpartum period. A high recurrence risk is expected in patients with rectus diastasis. This risk is especially high after suture repairs. Mesh repairs should be considered in this situation.

Long-term follow-up results of umbilical hernia repair

PubMed Central

Venclauskas, Linas; Zilinskas, Justas; Zviniene, Kristina; Kiudelis, Mindaugas

2017-01-01

Introduction Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery. Aim To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence. Material and methods A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed. Results One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias (< 2 cm) had a recurrence in the suture repair group. Logistic regression analysis showed that body mass index (BMI) > 30 kg/m2, diabetes and wound infection were independent risk factors for umbilical hernia recurrence. Conclusions The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m2, diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence. PMID:29362649

Mesenchymal stem cells from the Wharton's jelly of umbilical cord segments provide stromal support for the maintenance of cord blood hematopoietic stem cells during long-term ex vivo culture.

PubMed

Bakhshi, Tiki; Zabriskie, Ryan C; Bodie, Shamanique; Kidd, Shannon; Ramin, Susan; Paganessi, Laura A; Gregory, Stephanie A; Fung, Henry C; Christopherson, Kent W

2008-12-01

Hematopoietic stem cells (HSCs) are routinely obtained from marrow, mobilized peripheral blood, and umbilical cord blood. Mesenchymal stem cells (MSCs) are traditionally isolated from marrow. Bone marrow-derived MSCs (BM-MSCs) have previously demonstrated their ability to act as a feeder layer in support of ex vivo cord blood expansion. However, the use of BM-MSCs to support the growth, differentiation, and engraftment of cord blood may not be ideal for transplant purposes. Therefore, the potential of MSCs from a novel source, the Wharton's jelly of umbilical cords, to act as stromal support for the long-term culture of cord blood HSC was evaluated. Umbilical cord-derived MSCs (UC-MSCs) were cultured from the Wharton's jelly of umbilical cord segments. The UC-MSCs were then profiled for expression of 12 cell surface receptors and tested for their ability to support cord blood HSCs in a long-term culture-initiating cell (LTC-IC) assay. Upon culture, UC-MSCs express a defined set of cell surface markers (CD29, CD44, CD73, CD90, CD105, CD166, and HLA-A) and lack other markers (CD45, CD34, CD38, CD117, and HLA-DR) similar to BM-MSCs. Like BM-MSCs, UC-MSCs effectively support the growth of CD34+ cord blood cells in LTC-IC assays. These data suggest the potential therapeutic application of Wharton's jelly-derived UC-MSCs to provide stromal support structure for the long-term culture of cord blood HSCs as well as the possibility of cotransplantation of genetically identical, HLA-matched, or unmatched cord blood HSCs and UC-MSCs in the setting of HSC transplantation.

Estudio comparativo de los metodos analitico-sintetico y global en el aprendizaje de la lectura (Comparative Study of the Analytical-Synthetical (Phonics) and Global (Sight) Reading Methods).

ERIC Educational Resources Information Center

Carbonell de Grompone, Maria A.; And Others

An investigation into the phonics and sight methods of reading instruction being taught in Uruguay schools seeks valid predictions in support of each approach. The study, written in Spanish, examines the progressive reading habits and abilities of 12 first-grade classes. Teachers assigned to teach each method uniformly had equivalent training and…

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

A flatbed truck carries a vertical support post (VSP) for NASA's Space Launch System (SLS) rocket to the Mobile Launcher Yard at NASA's Kennedy Space Center in Florida. The two aft skirt electrical umbilicals (ASEUs) and the first of the vehicle support posts underwent a series of tests to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Cord blood clinical processing, cryopreservation, and storage.

PubMed

Elmoazzen, Heidi; Holovati, Jelena L

2015-01-01

Allogeneic umbilical cord blood (UCB) hematopoietic stem cell transplantation has become a crucial advancement in the treatment for a variety of diseases including hematopoietic and non-hematopoietic malignancies, BM failure syndromes, hemoglobinopathies, and metabolic and immunodeficiency disorders. It has been well documented that the success of UCB engraftment is tied to UCB banking processes, and now there are established guidelines for standardization of collection, banking, processing, and cryopreservation for unrelated UCB units with purpose of achieving consistent production of high quality placental and UCB units for administration. In 2011, Canada's Ministry of Health has announced Canada's first national, publicly funded umbilical cord blood bank, which aims to provide altruistic donations for unrelated allogeneic hematopoietic stem cell transplant. In this chapter, we describe specific protocols for clinical processing, cryopreservation, and storage of UCB used by the Canadian Blood Services National Public Umbilical Cord Blood Bank.

Neonatal Cardio-pulmonary Arrest: Emergency Catheterization of Umbilical Vein

PubMed Central

Paes, Bosco A.; Blatz, Susan; Kraftcheck, D.J.

1990-01-01

In an emergency, the physician responsible for neonatal care must be skilled in umbilical catheterization. Several drugs can be given through an endotracheal tube, but some require intravenous administration. The umbilical vein is a better route of administration than peripheral veins because it is easily located and can be entered readily. It allows immediate access to the central circulation, enhancing drug distribution. The authors outline the procedure in a step-by-step description. This pictorial article can be used as a handy reference by physicians needing to administer fluids and drugs during cardio-pulmonary arrest in neonates. Imagesp1136-ap1136-bp1136-cp1136-dp1137-ap1137-bp1137-cp1137-dp1137-ep1138-ap1138-bp1138-cp1138-dp1139-ap1139-bp1139-cp1139-dp1140-ap1140-bp1140-cp1140-d PMID:21233982

Platelet adhesion and human umbilical vein endothelial cell cytocompatibility of biodegradable segmented polyurethanes prepared with 4,4'-methylene bis(cyclohexyl isocyanate), poly(caprolactone) diol and butanediol or dithioerythritol as chain extenders.

PubMed

Chan-Chan, L H; Vargas-Coronado, R F; Cervantes-Uc, J M; Cauich-Rodríguez, J V; Rath, R; Phelps, E A; García, A J; San Román Del Barrio, J; Parra, J; Merhi, Y; Tabrizian, M

2013-08-01

Biodegradable segmented polyurethanes were prepared with poly(caprolactone) diol as a soft segment, 4,4'-methylene bis(cyclohexyl isocyanate) (HMDI) and either butanediol or dithioerythritol as chain extenders. Platelet adhesion was similar in all segmented polyurethanes studied and not different from Tecoflex® although an early stage of activation was observed on biodegradable segmented polyurethane prepared with dithioerythritol. Relative viability was higher than 80% on human umbilical vein endothelial cells in contact with biodegradable segmented polyurethane extracts after 1, 2 and 7 days. Furthermore, both biodegradable segmented polyurethane materials supported human umbilical vein endothelial cell adhesion, spreading, and viability similar to Tecoflex® medical-grade polyurethane. These biodegradable segmented polyurethanes represent promising materials for cardiovascular applications.

Human umbilical cord derived matrix: A scaffold suitable for tissue engineering application.

PubMed

Dan, Pan; Velot, Émilie; Mesure, Benjamin; Groshenry, Guillaume; Bacharouche, Jalal; Decot, Véronique; Menu, Patrick

2017-01-01

Human tissue derived natural extracellular matrix (ECM) has great potential in tissue engineering. We sought to isolate extracellular matrix derived from human umbilical cord and test its potential in tissue engineering. An enzymatic method was applied to isolate and solubilized complete human umbilical cord derived matrix (hUCM). The obtained solution was analyzed for growth factors, collagen and residual DNA contents, then used to coat 2D and 3D surfaces for cell culture application. The hUCM was successfully isolated with trypsin digestion to acquire a solution containing various growth factors and collagen but no residual DNA. This hUCM solution can form a coating on 2D and 3D substrates suitable cell culture. We developed a new matrix derived from human source that can be further used in tissue engineering.

Hepatectomy for cholangiocarcinoma complicated with right umbilical portion: anomalous configuration of the intrahepatic biliary tree.

PubMed

Kaneoka, Y; Yamaguchi, A; Isogai, M; Harada, T

2000-01-01

The right umbilical portion (right-sided round ligament) has been discussed as an intrahepatic portal venous anomaly associated with "left-sided gallbladder" in several reports. We treated two patients with right umbilical portion (RUP) associated with cholangiocarcinoma. Left hepatectomies were performed, preserving the residual hepatic blood flow and biliary continuity. From our experience in these patients we propose the presence of anomalous configuration of the intrahepatic biliary tree in RUP, because both patients showed medial segmental bile ducts ramified from the right and left hepatic ducts. In general, although the medial segmental bile duct ramified from the left, we surmised that this abnormal bilateral drainage pattern may not be a rare phenomenon in RUP. Special attention may be required to focus on the anatomy of the portal tributaries and biliary ramifications in RUP.

Prenatal diagnosis and management of fetal goiter caused by maternal Grave's disease.

PubMed

Hadi, H A; Strickland, D

1995-07-01

We present a case of maternal Grave's disease associated with fetal goitrous hyperthyroidism. Fetal goiter was diagnosed by ultrasound and diagnosis of fetal hyperthyroidism was established by umbilical blood sampling. Fetus was successfully treated by increasing maternal propylthiouracil dosage. Fetal thyroid status was normal at birth. Role of sonography and umbilical blood sampling in management of fetal goiter complicated with maternal Grave's disease is discussed.

Death by Edible Mushroom: First Report of Volvariella volvacea as an Etiologic Agent of Invasive Disease in a Patient following Double Umbilical Cord Blood Transplantation▿

PubMed Central

Salit, R. B.; Shea, Y. R.; Gea-Banacloche, J.; Fahle, G. A.; Abu-Asab, M.; Sugui, J. A.; Carpenter, A. E.; Quezado, M. M.; Bishop, M. R.; Kwon-Chung, K. J.

2010-01-01

We describe a case of invasive fungal infection caused by Volvariella volvacea following double umbilical cord blood transplantation (UCBT). Although infections caused by several mushroom species have been documented, we believe this to be the first published report of invasive infection with Volvariella volvacea, an edible mushroom belonging to Agaricales. PMID:20826647

Optical data transmission technology for fixed and drag-on STS payload umbilicals, volume 2

NASA Technical Reports Server (NTRS)

St.denis, R. W.

1981-01-01

Optical data handling methods are studied as applicable to payload communications checkout and monitoring. Both payload umbilicals and interconnecting communication lines carrying payload data are examined for the following: (1) ground checkout requirements; (2) optical approach (technical survey of optical approaches, selection of optimum approach); (3) survey and select components; (4) compare with conventional approach; and (5) definition of follow on activity.

Anatomy and embryology of umbilicus in newborns: a review and clinical correlations.

PubMed

Hegazy, Abdelmonem A

2016-09-01

Umbilicus is considered a mirror of the abdomen in newborns. Despite its importance, the umbilicus has been stated in literature and textbooks as discrete subjects with many body systems, such as the urinary, digestive, and cardiovascular ones. This article aimed to address the basic knowledge of the umbilicus in relation to clinical disorders under one integrated topic to aid physicians and surgeons in assessing newborns and infants. The umbilicus appears as early as the fourth week of fetal life when the folding of the embryonic plate occurs. The umbilicus appears initially as a primitive umbilical ring on the ventral aspect of the body. The primitive umbilicus contains the connecting stalk, umbilical vessels, vitelline duct and vessels, allantois, and loop of the intestine. Changes occur to form the definitive cord, which contains three umbilical vessels, namely, "one vein and two arteries," embedded in Wharton's jelly. After birth, the umbilical vessels inside the body obliterate and gradually form ligaments. Congenital disorders at the umbilicus include herniation, bleeding, and discharge of mucous, urine, or feces. Some of these disorders necessitate emergent surgical interference, whereas others may be managed conservatively. The umbilicus has many embryological remnants. Thus, the umbilicus is prone to various clinical disorders. Detecting these disorders as early as possible is essential to prevent or minimize possible complications.

Umbilical vein oxytocin in the management of retained placenta: an alternative to manual removal of placenta?

PubMed

Lim, Pei Shan; Singh, Surinder; Lee, Alice; Muhammad Yassin, Muhammad Abdul Jamil

2011-11-01

Retained placenta is potentially life threatening due to possible complications associated with manual removal. Our aim was to determine whether umbilical vein injection of oxytocin in saline reduces the need for manual removal of placenta. This was a randomised controlled trial conducted at a tertiary hospital from December 2002 to March 2004. A total of 61 women delivering singletons, who had no sign of placental separation 20 min after vaginal delivery, were randomised to receive either intra-umbilical oxytocin 100 IU diluted in 30 ml of saline or controlled cord traction only. Manual removal was done if the placenta was not expelled in another 30 min in both arms. There was a significant reduction in the rate of subsequent manual removal of placenta (30 vs. 67.7%, p < 0.05), incidence of uterine atony (3.3 vs. 25.8%, p < 0.05) and the need for uterotonic agents (33.3 vs. 64.5%, p < 0.05) in the oxytocin group when compared with the control group. No significant differences were found in the need for blood transfusion, uterine curettage, incidence of postpartum haemorrhage and haemoglobin level reduction. Intra-umbilical vein oxytocin injection is clinically effective for the management of a retained placenta.

Comparative proteomics of umbilical vein blood plasma from normal and gestational diabetes mellitus patients reveals differentially expressed proteins associated with childhood obesity.

PubMed

Miao, Zhijing; Wang, Jianqing; Wang, Fuqiang; Liu, Lan; Ding, Hongjuan; Shi, Zhonghua

2016-11-01

Offspring obesity is one of long-term complications of gestational diabetes mellitus (GDM). The aim of this study is to identify proteins differentially expressed in the umbilical vein blood plasma, which could become markers for early diagnosis of childhood obesity. Umbilical vein plasma samples were collected from 30 control and 30 GDM patients in 2007-2008 whose offspring were suffering from obesity at 6-7 years old. Multiplexed isobaric tandem mass tag labeling combined with LC-MS/MS was used to identify differentially expressed proteins. Ingenuity pathway analysis was performed to identify canonical pathways, biological functions, and networks of interacting proteins. Western blotting was used to verify the expression of three selected proteins. A total of 318 proteins were identified, of which 12 proteins were upregulated in GDM group while 24 downregulated. Lipid metabolism was the top category identified by ingenuity pathway analysis. Three randomly chosen proteins were validated by Western blotting, which were consistent with LC-MS. There are significant differences of protein profile in the umbilical vein blood plasma between normal and GDM patients with obese offspring. The results indicate that a variety of proteins and biological mechanisms may contribute to childhood obesity. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Therapeutic potential of umbilical cord blood cells for type 1 diabetes mellitus.

PubMed

He, Binbin; Li, Xia; Yu, Haibo; Zhou, Zhiguang

2015-11-01

Type 1 diabetes mellitus (T1DM) is a chronic disorder that results from autoimmune-mediated destruction of pancreatic islet β-cells. However, to date, no conventional intervention has successfully treated the disease. The optimal therapeutic method for T1DM should effectively control the autoimmunity, restore immune homeostasis, preserve residual β-cells, reverse β-cell destruction, and protect the regenerated insulin-producing cells against re-attack. Umbilical cord blood is rich in regulatory T (T(reg)) cells and multiple types of stem cells that exhibit immunomodulating potential and hold promise in their ability to restore peripheral tolerance towards pancreatic islet β-cells through remodeling of immune responses and suppression of autoreactive T cells. Recently, reinfusion of autologous umbilical cord blood or immune cells from cord blood has been proposed as a novel therapy for T1DM, with the advantages of no risk to the donors, minimal ethical concerns, a low incidence of graft-versus-host disease and easy accessibility. In this review, we revisit the role of autologous umbilical cord blood or immune cells from cord blood-based applications for the treatment of T1DM. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Human umbilical cord mesenchymal stromal cells in regenerative medicine.

PubMed

Detamore, Michael S

2013-11-25

Cells of the human umbilical cord offer tremendous potential for improving human health. Cells from the Wharton’s jelly (umbilical cord stroma) in particular, referred to as human umbilical cord mesenchymal stromal cells (HUCMSCs), hold several advantages that make them appealing for translational research. In the previous issue of Stem Cell Research & Therapy, Chon and colleagues made an important contribution to the HUCMSC literature not only by presenting HUCMSCs as an emerging cell source for intervertebral disc regeneration in general and the nucleus pulposus in particular, but also by demonstrating that an extracellular matrix-based strategy might be preferred over the use of growth factors. By culturing HUCMSCs under hypoxia in serum-free conditions in the presence of Matrigel with laminin-111, they were able to achieve intense collagen II staining by 21 days without the addition of exogenous growth factors. There is tremendous translational significance here in that such raw materials may alleviate the need for the use of growth factors in some instances, and this may have important ramifications in reducing product cost and streamlining regulatory approval. Chon and colleagues provide a promising example of the potential of HUCMSCs, demonstrating the ability to guide HUCMSC differentiation even in the absence of serum and growth factors and supporting the use of HUCMSCs as a viable alternative in intervertebral disc regeneration.

Maternal and neonatal evaluation of derivated reactive oxygen metabolites (d-ROMs) and biological antioxidant potential in the horse.

PubMed

Sgorbini, M; Bonelli, F; Marmorini, P; Biagi, G; Corazza, M; Pasquini, A

2015-01-01

The aim of the present work was to evaluate derivated reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) in mares and foals to study perinatal oxidative status. A total of 60 animals were included in the present study. Maternal and foal venous blood samples were collected immediately after delivery along with a sample drawn from one of the umbilical arteries, and plasma samples were evaluated for lactatemia, d-ROMs, and BAP. The t test for unpaired data was applied between mares versus umbilical artery blood versus foals, both for d-ROMs and BAP. The Pearson test with two-tailed P value and a confidence interval of 95% was performed between d-ROMs and BAP and between d-ROMs and lactatemia, both for mares and foals. Finally, the t test for unpaired data was performed between fillies and colts. The t test showed differences between mares versus their own foals versus umbilical artery blood but not foals versus. umbilical artery blood, both for d-ROMs and BAP. A positive correlation was found both in mares and foals between BAP and d-ROMs and in mares between lactatemia and d-ROM. No differences in gender were found in BAP concentration. Our data are in line to previous studies performed in women and cattle.

A Simplified Model of ARIS for Optimal Controller Design

NASA Technical Reports Server (NTRS)

Beech, Geoffrey S.; Hampton, R. David; Kross, Denny (Technical Monitor)

2001-01-01

Many space-science experiments require active vibration isolation. Boeing's Active Rack Isolation System (ARIS) isolates experiments at the rack (vs. experiment or sub-experiment) level, with multi e experiments per rack. An ARIS-isolated rack typically employs eight actuators and thirteen umbilicals; the umbilicals provide services such as power, data transmission, and cooling. Hampton, et al., used "Kane's method" to develop an analytical, nonlinear, rigid-body model of ARIS that includes full actuator dynamics (inertias). This model, less the umbilicals, was first implemented for simulation by Beech and Hampton; they developed and tested their model using two commercial-off-the-shelf (COTS) software packages. Rupert, et al., added umbilical-transmitted disturbances to this nonlinear model. Because the nonlinear model, even for the untethered system, is both exceedingly complex and "encapsulated" inside these COTS tools, it is largely inaccessible to ARIS controller designers. This paper shows that ISPR rattle-space constraints and small ARIS actuator masses permit considerable model simplification, without significant loss of fidelity. First, for various loading conditions, comparisons are made between the dynamic responses of the nonlinear model (untethered) and a truth model. Then comparisons are made among nonlinear, linearized, and linearized reduced-mass models. It is concluded that these three models all capture the significant system rigid-body dynamics, with the third being preferred due to its relative simplicity.

Risk Factors for the Development of Refeeding Syndrome-Like Hypophosphatemia in Very Low Birth Weight Infants

PubMed Central

Okuno, Takashi; Ohta, Genrei; Tokuriki, Shuko

2017-01-01

Background Refeeding syndrome is characterized by metabolic disturbance including hypophosphatemia and hypokalemia upon reinstitution of nutrition in severely malnourished patients. Objective The present study sought to identify the risk factors for the development of refeeding syndrome-like metabolic disturbance in very low birth weight infants. Methods The correlations of severe hypophosphatemia with the serum levels of potassium and ionized calcium, daily calorie and phosphate intake, and umbilical cord blood flow on ultrasonography were analyzed in 49 very low birth weight infants. Results Fifteen infants (36%) presented with hypophosphatemia during the first postnatal week. Hypophosphatemia was significantly associated with birth weight z score (odds ratio, 1.60; 95% confidence interval, 1.04–2.47; p = 0.034) and umbilical artery resistance index (odds ratio, 7.72E−04; 95% confidence interval, 1.14E−06–0.523; p = 0.031). Multiple regression analysis revealed that umbilical artery resistance index was independently associated with hypophosphatemia. Conclusions Umbilical artery resistance index may serve as a useful marker for future development of refeeding syndrome-like hypophosphatemia in very low birth weight infants. Close monitoring of serum phosphorus and potassium levels and early intervention are important for the management of very low birth weight infants with intrauterine growth restriction due to placental dysfunction. PMID:29104345

Risk Factors for the Development of Refeeding Syndrome-Like Hypophosphatemia in Very Low Birth Weight Infants.

PubMed

Igarashi, Aiko; Okuno, Takashi; Ohta, Genrei; Tokuriki, Shuko; Ohshima, Yusei

2017-01-01

Refeeding syndrome is characterized by metabolic disturbance including hypophosphatemia and hypokalemia upon reinstitution of nutrition in severely malnourished patients. The present study sought to identify the risk factors for the development of refeeding syndrome-like metabolic disturbance in very low birth weight infants. The correlations of severe hypophosphatemia with the serum levels of potassium and ionized calcium, daily calorie and phosphate intake, and umbilical cord blood flow on ultrasonography were analyzed in 49 very low birth weight infants. Fifteen infants (36%) presented with hypophosphatemia during the first postnatal week. Hypophosphatemia was significantly associated with birth weight z score (odds ratio, 1.60; 95% confidence interval, 1.04-2.47; p = 0.034) and umbilical artery resistance index (odds ratio, 7.72 E -04; 95% confidence interval, 1.14 E -06-0.523; p = 0.031). Multiple regression analysis revealed that umbilical artery resistance index was independently associated with hypophosphatemia. Umbilical artery resistance index may serve as a useful marker for future development of refeeding syndrome-like hypophosphatemia in very low birth weight infants. Close monitoring of serum phosphorus and potassium levels and early intervention are important for the management of very low birth weight infants with intrauterine growth restriction due to placental dysfunction.

Is there any role of prolidase enzyme activity in the etiology of preeclampsia?

PubMed

Pehlivan, Mustafa; Ozün Ozbay, Pelin; Temur, Muzaffer; Yılmaz, Ozgur; Verit, Fatma Ferda; Aksoy, Nurten; Korkmazer, Engin; Üstünyurt, Emin

2017-05-01

To evaluate a relationship between preeclampsia and prolidase enzyme activity. A prospective cohort study of 41 pregnant women diagnosed with preeclampsia and 31 healthy pregnant women as control group was selected at Harran University Hospital Department of Obstetrics and Gynecology. The prolidase enzyme activity was analyzed in maternal and umbilical cord plasma, amniotic fluid and placental and umbilical cord tissues by Chinard method in addition to maternal serum levels of lactate dehydrogenase (LDH), serum glutamate pyruvate transaminase (SGPT) and serum glutamate oxaloacetate transaminase (SGOT). A significant relationship was found between plasma prolidase activity (635 ± 83 U/L) (p  = 0.007), umbilical cord plasma prolidase activity (610 ± 90 U/L) (p = 0.013), amniotic fluid prolidase activity (558 ± 100 U/L) (p  = 0.001), umbilical cord tissue prolidase activity (4248 ± 1675 U/gr protein) (p  = 0.013) and placental tissue prolidase activity (2116 ± 601 U/gr protein) (p  = 0.001) in preeclamptic group when compared to healthy pregnant women. There is a strong correlation between prolidase enzyme activity and preeclampsia. Prolidase enzyme activity may play a role in preeclampsia.

Effects of umbilical cord blood stem cells on healing factors for diabetic foot injuries.

PubMed

Çil, N; Oğuz, E O; Mete, E; Çetinkaya, A; Mete, G A

2017-01-01

The use of stem or progenitor cells from bone marrow, or peripheral or umbilical cord blood is becoming more common for treatment of diabetic foot problems. These cells promote neovascularization by angiogenic factors and they promote epithelium formation by stimulating cell replication and migration under certain pathological conditions. We investigated the role of CD34 + stem cells from human umbilical cord blood in wound healing using a rat model. Rats were randomly divided into a control group and two groups with diabetes induced by a single dose of 55 mg/kg intraperitoneal streptozocin. Scarred areas 5 mm in diameter were created on the feet of all rats. The diabetic rats constituted the diabetes control group and a diabetes + stem cell group with local injection into the wound site of 0.5 × 106 CD34 + stem cells from human umbilical cord blood. The newly formed skin in the foot wounds following CD34 + stem cell treatment showed significantly improvement by immunohistochemistry and TUNEL staining, and were closer to the wound healing of the control group than the untreated diabetic animals. The increase in FGF expression that accompanied the local injection of CD34 + stem cells indicates that FGF stimulation helped prevent apoptosis. Our findings suggest a promising new treatment approach to diabetic wound healing.

Anti-tumor and anti-angiogenic ergosterols from Ganoderma lucidum

NASA Astrophysics Data System (ADS)

Chen, Shaodan; Yong, Tianqiao; Zhang, Yifang; Su, Jiyan; Jiao, Chunwei; Xie, Yizhen

2017-10-01

This study was carried out to isolate chemical constituents from the lipid enriched fraction of Ganoderma lucidum extract and to evaluate their anti-proliferative effect on cancer cell lines and human umbilical vein endothelial cells. Ergosterol derivatives (1-14) were isolated from the lipid enriched fraction of G. lucidum. Their structures were established on the basis of spectroscopic analyses or by comparison of mass and NMR spectral data with those reported previously. Amongst, compound 1 was isolated and identified as a new compound. All the compounds were evaluated for their inhibitory effect on tumor cells and human umbilical vein endothelial cells in vitro. Compounds 9-13 displayed inhibitory activity against two tumor cell lines and human umbilical vein endothelial cells, which indicated that these four compounds had both anti-tumor and anti-angiogenesis activities. Compound 2 had significant selective inhibition against two tumor cell lines, while 3 exhibited selective inhibition against human umbilical vein endothelial cells. The structure–activity relationships for inhibiting human HepG2 cells were revealed by 3D-QASR. Ergosterol content in different parts of the raw material and products of G. lucidum was quantified. This study provides a basis for further development and utilization of ergosterol derivatives as natural nutraceuticals and functional food ingredients, or as source of new potential antitumor or anti-angiogenesis chemotherapy agent.

Concurrent Umbilical Hernia Repair at the Time of Liver Transplantation: A Six-Year Experience from a Single Institution

PubMed Central

Perez, A. J.; Haskins, I. N.; Prabhu, A. S.; Krpata, D. M.; Tu, C.; Rosenblatt, S.; Hashimoto, K.; Diago, T.; Eghtesad, B.; Rosen, M. l. J.

2018-01-01

Background: Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define. Objective: To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution. Methods: Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016. 30-day morbidity and mortality outcomes and long-term hernia recurrence were investigated. Results: 59 patients had primary UHR at the time of liver transplantation. All hernias were reducible with no overlying skin breakdown or leakage of ascites. 30-day morbidity and mortality included 5 (8%) superficial surgical site infections, 1 (2%) deep surgical site infection, and 7 (12%) organ space infections. Unrelated to the UHR, 10 (17%) patients had an unplanned return to the operating room, 16 (27%) were readmitted within 30 days of their index operation, and 1 (2%) patient died. With a mean follow-up of 21.8 months, 7 (18%) patients experienced an umbilical hernia recurrence. Conclusion: Despite the high perioperative morbidity associated with the transplant procedure, concurrent primary UHR resulted in an acceptable long-term recurrence rate with minimal associated morbidity. PMID:29531643

Concurrent Umbilical Hernia Repair at the Time of Liver Transplantation: A Six-Year Experience from a Single Institution.

PubMed

Perez, A J; Haskins, I N; Prabhu, A S; Krpata, D M; Tu, C; Rosenblatt, S; Hashimoto, K; Diago, T; Eghtesad, B; Rosen, M L J

2018-01-01

Umbilical hernias are common in patients with end-stage liver disease undergoing liver transplantation. Management of those persisting at the time of liver transplantation is important to define. To evaluate the long-term results of patients undergoing simultaneous primary umbilical hernia repair (UHR) at the time of liver transplantation at a single institution. Retrospective chart review was performed on patients undergoing simultaneous UHR and liver transplantation from 2010 through 2016. 30-day morbidity and mortality outcomes and long-term hernia recurrence were investigated. 59 patients had primary UHR at the time of liver transplantation. All hernias were reducible with no overlying skin breakdown or leakage of ascites. 30-day morbidity and mortality included 5 (8%) superficial surgical site infections, 1 (2%) deep surgical site infection, and 7 (12%) organ space infections. Unrelated to the UHR, 10 (17%) patients had an unplanned return to the operating room, 16 (27%) were readmitted within 30 days of their index operation, and 1 (2%) patient died. With a mean follow-up of 21.8 months, 7 (18%) patients experienced an umbilical hernia recurrence. Despite the high perioperative morbidity associated with the transplant procedure, concurrent primary UHR resulted in an acceptable long-term recurrence rate with minimal associated morbidity.

Umbilical hernia alloplastic dual-mesh treatment in cirrhotic patients

PubMed Central

Guriță, RE; Popa, F; Bălălău, C; Scăunașu, RV

2013-01-01

Rationale. Abdominal wall hernias represent a pathology with an impressive prevalence among the population of patients with cirrhosis complicated by ascites. The aggressive surgical approach of umbilical hernia for patients with cirrhotic background remains a controversial problem, accompanied by anesthetic and surgical risk. Its indication remains fully justified in case of severe symptoms or life threatening complications: strangulation, incarceration, evisceration. Objective. This article evaluates results obtained by using dual-mesh alloplastic materials for surgical treatment of umbilical hernias affecting cirrhotic patients with incipient liver injury. Methods and Results. Our lot consists of twelve patients with ages between 45 and 65 years, diagnosed with hepatic cirrhosis, without other associated comorbidities. All patients were admitted for strangulated umbilical hernia. Among the analyzed lot, no decease was encountered, the morbidity being limited to two cases of parietal suppuration, solved conservatively, without the mesh removal. There were no ascitic fistulas. No recurrences were registered for a 12 months tracking period. Discussion. The presence of cirrhosis implies a high anesthetic and surgical risk, the intervention being grafted by a substantial increase of mortality and morbidity in an emergency setting. The development of new alloplastic materials, together with the modern anesthetic techniques, allows superior results for patients with incipient hepatic injury. PMID:23599831

Mesh repair of umbilical hernia without a visible abdominal scar.

PubMed

Kurpiewski, Waldemar; Kiliańczyk, Michał; Szynkarczuk, Rafał; Tenderenda, Michał

2014-02-01

Experience in the use of Single Incision Laparoscopic Surgery procedures and the persistent urge to improve the cosmetic effect have contributed to the introduction of mesh repair of an umbilical hernia by means of a small incision in the natural position of the umbilicus. The aim of the study was to present the surgical technique and assess its postoperative results. During the period between 24.08.2011 and 01.01.2013, twenty-three umbilical hernia repair operations with the use of a polypropylene mesh by means of a small incision in the natural position of the umbilicus were performed. The synthetic material was placed in the preperitoneal space. The wound was closed and the umbilicus was reconstructed simultaneously, in order to make the scar invisible. Cutaneous stitches were not used. The average duration of the operation was 49 minutes. In one case of an obese patient with coexisting linea alba dehiscence, hernia recurrence was observed. All wounds healed without complications. The cosmetic effect was very good. Based on the presented experience mesh repair of the umbilical hernia by means of a small incision in the natural position of the umbilicus contributes essential benefits, such as a very good cosmetic effect without consecutive increasing costs, as compared to standard treatment by means of an infraumbilical incision.

Incarcerated umbilical hernia leading to small bowel ischemia.

PubMed

Lutwak, Nancy; Dill, Curt

2011-09-19

A 59-year-old male with history of hepatitis C, refractory ascites requiring multiple paracentesis and transjugular intrahepatic portosystemic shunt placement presented to the emergency department with 2 days of abdominal pain. Physical examination revealed blood pressure of 104/66 and pulse of 94. The abdomen was remarkable for distention and a tender incarcerated umbilical hernia. The skin overlying the hernia was pale with areas of necrosis. The patient immediately underwent laparotomy which was successful.

An Artificial Neural System for Autonomous Undersea Vehicles

DTIC Science & Technology

1988-07-01

Neutralization System (MNS) have provided remote operation capability, but suffer from the drag and short range of an umbilical cable. On-board energy ...link altogether. The loss of the hard wire umbilical cables in these two later systems, however, forced the vehicles to carry their own energy supply...submersibles. One is an energy source or renewal strategy that will sustain long-term voyages; the other is an effec- tive on-board computer that will

ICPSU Install at Mobile Launcher

NASA Image and Video Library

2018-03-14

A sliver of the Moon is visible just before sunrise at NASA's Kennedy Space Center in Florida. In view is one of the steel structures of the mobile launcher (ML). Several launch umbilicals have been installed on the ML tower. Exploration Ground Systems is overseeing installation of umbilicals and launch accessories on the ML to prepare for the first integrated test flight of the Orion spacecraft on the agency's Space Launch System rocket on Exploration Mission-1.

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

A construction worker is in view as a flatbed truck passes by carrying a vertical support post (VSP) for NASA's Space Launch System (SLS) rocket to the Mobile Launcher Yard at NASA's Kennedy Space Center in Florida. The two aft skirt electrical umbilicals (ASEUs) and the first of the vehicle support posts underwent a series of tests to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

A flatbed truck carries a vertical support post (VSP) for NASA's Space Launch System (SLS) rocket to the Mobile Launcher Yard at NASA's Kennedy Space Center in Florida. In view is the mobile launcher. The two aft skirt electrical umbilicals (ASEUs) and the first of the vehicle support posts underwent a series of tests to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

Aft Skirt Electrical Umbilical (ASEU) and Vehicle Support Post (

NASA Image and Video Library

2016-12-09

A view from underneath one of the vertical support posts for NASA's Space Launch System rocket. Two after skirt electrical umbilicals (ASEUs) and the first of the vertical support post were transported by flatbed truck from the Launch Equipment Test Facility to the Mobile Launcher Yard as NASA's Kennedy Space Center in Florida. The ASEUs and the VSP underwent a series of tests to confirm they are functioning properly and ready to support the SLS for launch. The ASEUs will connect to the SLS rocket at the bottom outer edge of each booster and provide electrical power and data connections to the rocket until it lifts off from the launch pad. The eight VSPs will support the load of the solid rocket boosters, with four posts for each of the boosters. The center’s Engineering Directorate and the Ground Systems Development and Operations Program are overseeing processing and testing of the umbilicals.

A great lack of knowledge regarding umbilical cord blood banking among pregnant women in Berlin, Germany.

PubMed

Palten, Patricia E; Dudenhausen, Joachim W

2010-11-01

we evaluated what German-speaking women in Berlin know about umbilical cord blood banking (UCBB) and whether a correlation exists between women's knowledge about UCBB and level of education. we used the anonymous questionnaire given to German-speaking women in Berlin, Germany. a total of 300 questionnaires could be evaluated. Although three quarters of our population heard of UCBB, most had no further knowledge about the method. Only about one-third of the interviewed women were informed about whether certain diseases had been treated with umbilical cord blood (UCB) by the time the survey was being conducted, whereas 50-65% did not know how to answer these questions. women in Berlin were poorly educated about the usefulness, the costs and the methods of cryopreservation. To some extent there is a correlation between women's level of education and their knowledge regarding UCB.

Development and validation of a liquid chromatography mass spectrometry assay for the simultaneous quantification of methadone, cocaine, opiates and metabolites in human umbilical cord

PubMed Central

de Castro, Ana; Concheiro, Marta; Shakleya, Diaa M.; Huestis, Marilyn A.

2011-01-01

A liquid chromatography mass spectrometric selected reaction monitoring mode (SRM) method for methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), cocaine, benzoylecgonine (BE), 6-acetylmorphine, morphine and codeine quantification in human umbilical cord was developed and fully validated. Analytes were extracted from homogenized tissue (1 g) by solid phase extraction. Linearity was 2.5–500 ng/g, except for methadone (10–2000 ng/g). Method imprecision was <12.7%CV with analytical recovery 85.9–112.7%, extraction efficiency >59.2%, matrix effect 4.5–39.5%, process efficiency 48.6–92.6% and stability >84.6%. Analysis of an umbilical cord following controlled methadone administration and illicit drug use contained in ng/g, 40.3 morphine, 3.6 codeine, 442 BE, 186 methadone and 45.9 EDDP. PMID:19656745

Development of the Orion Crew-Service Module Umbilical Retention and Release Mechanism

NASA Technical Reports Server (NTRS)

Delap, Damon; Glidden, Joel; Lamoreaux, Christopher

2013-01-01

The Orion Crew-Service Module umbilical retention and release mechanism supports, protects and disconnects all of the cross-module commodities between the spacecraft's crew and service modules. These commodities include explosive transfer lines, wiring for power and data, and flexible hoses for ground purge and life support systems. Initial development testing of the mechanism's separation interface resulted in binding failures due to connector misalignments. The separation interface was redesigned with a robust linear guide system, and the connector separation and boom deployment were separated into two discretely sequenced events. Subsequent analysis and testing verified that the design changes corrected the binding. This umbilical separation design will be used on Exploration Flight Test 1 (EFT-1) as well as all future Orion flights. The design is highly modular and can easily be adapted to other vehicles/modules and alternate commodity sets.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Phospholipase C and perfringolysin O from Clostridium perfringens upregulate endothelial cell-leukocyte adherence molecule 1 and intercellular leukocyte adherence molecule 1 expression and induce interleukin-8 synthesis in cultured human umbilical vein endothelial cells.

PubMed Central

Bryant, A E; Stevens, D L

1996-01-01

Clostridium perfringens phospholipase C (PLC) and perfringolysin O (PFO) differentially induced human umbilical vein endothelial cell expression and synthesis of endothelial cell-leukocyte adherence molecule-1 (ELAM-1), intracellular leukocyte adherence molecule-1 (ICAM-1), and interleukin-8 (IL-8). PLC strongly induced expression of ELAM-1, ICAM-1, and IL-8, while PFO stimulated early ICAM-1 expression but did not promote ELAM-1 expression or IL-8 synthesis. PLC caused human umbilical vein endothelial cells to assume a fibroblastoid morphology, whereas PFO, in high concentrations or after prolonged low-dose toxin exposure, caused cell death. The toxin-induced expression of proadhesive and activational proteins and direct cytopathic effects may contribute to the leukostasis, vascular compromise, and capillary leak characteristics of C. perfringens gas gangrene. PMID:8557365

A case of incarcerated umbilical hernia in an adult treated by laparoscopic surgery

PubMed Central

Tsushimi, Takaaki; Mori, Hirohito; Nagase, Takashi; Harada, Takasuke; Ikeda, Yoshitaka

2015-01-01

A 42-year-old, obese woman was admitted to our hospital 3 h after the sudden development of abdominal pain. Her umbilical region was swollen and she was diagnosed with incarceration of an umbilical hernia by computed tomography. Although we tried, we were unable to reduce the hernia with a manipulative procedure. We decided to perform an emergency laparoscopy. Once general anesthesia was induced, we achieved hernia reduction. From a laparoscopic view, the portion of strangulated small intestine was neither necrotic nor perforated. The size of the hernial orifice was ∼2 × 2 cm, and thus, we selected a 12 × 12 cm composite mesh to cover the hernia defect by at least 5 cm in all directions. The surgical procedure was uneventful and the total operation time was 112 min. The patient recovered uneventfully and was discharged on postoperative day 9. She remains free of recurrence 20 months after surgery. PMID:25672973

Congenital hernia of cord: an often misdiagnosed entity

PubMed Central

Raju, Rubin; Satti, Mohamed; Lee, Quoc; Vettraino, Ivana

2015-01-01

Congenital hernia of the cord, also known as umbilical cord hernia, is an often misdiagnosed and under-reported entity, easily confused with a small omphalocele. It is different from postnatally diagnosed umbilical hernias and is believed to arise from persistent physiological mid-gut herniation. Its incidence is estimated to be 1 in 5000. Unlike an omphalocele, it is considered benign and is not linked with chromosomal anomalies. It has been loosely associated with intestinal anomalies, suggesting the need for a complete fetal anatomical ultrasound evaluation. We present a case of a fetal umbilical cord hernia diagnosed in a 28-year-old woman at 21 weeks gestation. The antenatal and intrapartum courses were uncomplicated. It was misdiagnosed postnatally as a small omphalocele, causing unwarranted anxiety in the parents. Increased awareness and knowledge of such an entity among health professionals is important to prevent unwarranted anxiety from misdiagnosis, and inadvertent bowel injury during cord clamping at delivery. PMID:25899514

El Demostrativo en Espanol y en Frances Estudio Comparativo y Estructuracion (A Comparative and Structural Study of the Demonstrative in Spanish and French).

ERIC Educational Resources Information Center

Lamiquiz, Vidal

1967-01-01

There are four demonstrative adjectives in Spanish: "este,""ese,""aquel," and "el" (which is the same as the definite article). When "este", "ese," and "aquel" do not modify a noun, they have an accent mark (except in the neuter forms) and have the function of pronouns. The singular and plural articles in Spanish are derived from the Latin…

Umbilical Deployment Device

NASA Technical Reports Server (NTRS)

Shafer, Michael W.; Gallon, John C.; Rivellini, Tommaso P.

2011-01-01

The landing scheme for NASA's next-generation Mars rover will encompass a novel landing technique (see figure). The rover will be lowered from a rocket-powered descent stage and then placed onto the surface while hanging from three bridles. Communication between the rover and descent stage will be maintained through an electrical umbilical cable, which will be deployed in parallel with structural bridles. The -inch (13-mm) umbilical cable contains a Kevlar rope core, around which wires are wrapped to create a cable. This cable is helically coiled between two concentric truncated cones. It is deployed by pulling one end of the cable from the cone. A retractable mechanism maintains tension on the cable after deployment. A break-tie tethers the umbilical end attached to the rover even after the cable is cut after touchdown. This break-tie allows the descent stage to develop some velocity away from the rover prior to the cable releasing from the rover deck, then breaks away once the cable is fully extended. The descent stage pulls the cable up so that recontact is not made. The packaging and deployment technique can store a long length of cable in a relatively small volume while maintaining compliance with the minimum bend radius requirement for the cable being deployed. While the packaging technique could be implemented without the use of break-ties, they were needed in this design due to the vibratory environment and the retraction required by the cable. The break-ties used created a series of load-spikes in the deployment signature. The load spikes during the deployment of the initial three coils of umbilical showed no increase between the different temperature trials. The cold deployment did show an increased load requirement for cable extraction in the region where no break-ties were used. This increase in cable drag was superimposed on the loads required to rupture the last set of break-ties, and as such, these loads saw significant increase when compared to their ambient counterparts. While the loads showed spikes of high magnitude, they were of short duration. Because of this, neither the deployment of the rover, nor the motion of the descent stage, would be adversely affected. In addition, the umbilical was found to have a maximum of 1.2 percent chance for recontact with the ultra-high frequency antenna due to the large margin of safety built in.

Umbilical hernia repair in patients with signs of portal hypertension: surgical outcome and predictors of mortality.

PubMed

Cho, Sung W; Bhayani, Neil; Newell, Pippa; Cassera, Maria A; Hammill, Chet W; Wolf, Ronald F; Hansen, Paul D

2012-09-01

To compare the outcomes of umbilical hernia repair in patients with and without signs of portal hypertension, such as esophageal varices or ascites; to assess the effect of emergency surgery on complication rates; and to identify predictors of postoperative mortality. Database search from January 1, 2005, through December 31, 2009. North American hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program initiative. We studied patients who underwent umbilical hernia repair. Those with congestive heart failure, disseminated malignant tumor, or chronic renal failure while undergoing dialysis were excluded. Preoperative variables and perioperative course were analyzed. Main outcome measures were morbidity and mortality after umbilical hernia repair. A total of 390 patients with ascites and/or esophageal varices formed the study group, and the remaining 22 952 patients formed the control group. The overall morbidity and mortality rates for the study group were 13.1% and 5.1%, whereas these rates were 3.9% and 0.1% for the control group, respectively (P < .001). For the study group, the mortality after elective repair among patients with a model for end-stage liver disease (MELD) score greater than 15 was 11.1% compared with 1.3% in patients with a MELD score of 15 or less. The patients with ascites and/or esophageal varices underwent emergency surgery more frequently than the control group (37.7% vs 4.9%; P < .001). Emergency surgery for the study group was associated with a higher morbidity than elective surgery (20.8% vs 8.3%; P < .001) but not a significantly higher mortality (7.4% vs 3.7%; P = .11). However, logistic regression analysis showed that age older than 65 years, MELD score higher than 15, albumin level less than 3.0 g/dL (to convert to grams per liter, multiply by 10), and sepsis at presentation were more predictive of postoperative mortality. Umbilical hernia repair in the presence of ascites and/or esophageal varices is associated with significant postoperative complication rates. Emergency surgery is associated with higher morbidity rates but not significantly higher mortality rates. Elective repair of umbilical hernia should be avoided for those with adverse predictors, such as age older than 65 years, MELD score higher than 15, and albumin level less than 3.0 g/dL.

Effect of maternal exercises on biophysical fetal and maternal parameters: a transversal study.

PubMed

Santos, Caroline Mombaque Dos; Santos, Wendel Mombaque Dos; Gallarreta, Francisco Maximiliano Pancich; Pigatto, Camila; Portela, Luiz Osório Cruz; Morais, Edson Nunes de

2016-01-01

To evaluate the acute effects of maternal and fetal hemodynamic responses in pregnant women submitted to fetal Doppler and an aerobic physical exercise test according to the degree of effort during the activity and the impact on the well-being. Transversal study with low risk pregnant women, obtained by convenience sample with gestational age between 26 to 34 weeks. The participants carry out a progressive exercise test. After the exercise session, reduced resistance (p=0.02) and pulsatility indices (p=0.01) were identified in the umbilical artery; however, other Doppler parameters analyzed, in addition to cardiotocography and fetal biophysical profile did not achieve significant change. Maternal parameters obtained linear growth with activity, but it was not possible to establish a standard with the Borg scale, and oxygen saturation remained stable. A short submaximal exercise had little effect on placental blood flow after exercise in pregnancies without complications, corroborating that healthy fetus maintains homeostasis even in situations that alter maternal hemodynamics. Avaliar os efeitos agudos de respostas hemodinâmicas maternas e fetais em gestantes submetidas a Doppler fetal e a um teste de exercício físico aeróbio, de acordo com o grau de esforço durante a atividade e o impacto sobre o bem-estar. Estudo transversal desenvolvido com gestantes de baixo risco, por amostra de conveniência com idade gestacional entre 26 e 34 semanas. As participantes realizam um teste de esforço progressivo. Na artéria umbilical, após sessão de exercício físico, identificou-se a redução do índice de resistência (p=0,02) e do índice de pulsatilidade (p=0,01), mas os demais parâmetros Doppler analisados, além da cardiotocografia e do perfil biofísico fetal, não obtiveram alteração significativa. Os parâmetros maternos obtiveram crescimento linear com a atividade, mas não foi possível estabelecer padrão com a escala de Borg, e a saturação de oxigênio se manteve estável. O esforço submáximo curto teve pouco efeito sobre o fluxo de sangue da placenta após o exercício em gestações sem complicações, corroborando que o feto hígido mantém a homeostase mesmo em situações que alterem a hemodinâmica materna.

A 26-Year-Old Retained Demised Abdominal Pregnancy Presenting with Umbilical Fistula

PubMed Central

Daniel, Nnadi; Bashir, Bello; Ibrahim, Ango; Swati, Singh

2014-01-01

This is a report on a 72-year-old postmenopausal woman who presented with passage of fetal bones through an umbilical fistula. She was diagnosed as a case of demised abdominal pregnancy, which had been retained for 26 years. She subsequently had exploratory laparotomy, evacuation of the abdominal pregnancy, hysterectomy, and bowel resection. The patient's condition remained unstable throughout the postoperative period and she died from septicemia on the eleventh day. PMID:24639908

Incarcerated umbilical hernia leading to small bowel ischemia

PubMed Central

Lutwak, Nancy; Dill, Curt

2011-01-01

A 59-year-old male with history of hepatitis C, refractory ascites requiring multiple paracentesis and transjugular intrahepatic portosystemic shunt placement presented to the emergency department with 2 days of abdominal pain. Physical examination revealed blood pressure of 104/66 and pulse of 94. The abdomen was remarkable for distention and a tender incarcerated umbilical hernia. The skin overlying the hernia was pale with areas of necrosis. The patient immediately underwent laparotomy which was successful. PMID:22679256

Umbilical Sepsis Caused by Multidrug Resistant Strain of Kocuria kristinae in a New Born: A Case Report

PubMed Central

Subramanian, Pramodhini; Ramakrishnan, Kalaivani; Seetha, K.S

2016-01-01

Kocuria species were placed previously under the genus Micrococcus, are skin and oropharynx commensals in mammals, including man. A rare bacteria, Kocuria kristinae isolated from a new born with umbilical sepsis. Identification and antibiotic susceptibility was done by Vitek 2 compact system (Biomerieux). The isolate was sensitive to higher antibiotics like vancomycin, teicoplanin and linezolid. As this new pathogen resembles coagulase negative staphylococcus, it should not be misidentified. PMID:27190805

Umbilical Sepsis Caused by Multidrug Resistant Strain of Kocuria kristinae in a New Born: A Case Report.

PubMed

Sivaraman, Umadevi; Subramanian, Pramodhini; Ramakrishnan, Kalaivani; Seetha, K S

2016-04-01

Kocuria species were placed previously under the genus Micrococcus, are skin and oropharynx commensals in mammals, including man. A rare bacteria, Kocuria kristinae isolated from a new born with umbilical sepsis. Identification and antibiotic susceptibility was done by Vitek 2 compact system (Biomerieux). The isolate was sensitive to higher antibiotics like vancomycin, teicoplanin and linezolid. As this new pathogen resembles coagulase negative staphylococcus, it should not be misidentified.

[Persistence of the omphalomesenteric duct. Childhood differential diagnosis of umbilical granuloma].

PubMed

Sánchez-Castellanos, M E; Sandoval-Tress, C; Hernández-Torres, M

2006-01-01

The omphalomesenteric duct is an embryonic structure which communicates the vitelline duct with the midgut. It normally disappears between the fifth and ninth weeks of intrauterine life. Anomalies related with the total or partial absence of this involution are show in 2 % of the population. We report a case of persistence of the omphalomesenteric duct and review the bibliography to establish the differences between this anomaly and umbilical granuloma, which is the main differential diagnosis.

[The cord blood bank at the Instituto Mexicano del Seguro Social].

PubMed

Peñaflor-Juárez, Karina; Guillén-Chan, Sonia Marilyn; Romero-Juárez, Yanín; Luna-Bautista, Fernando; Franco-Gutiérrez, Elizabeth; Arellano-Ocampo, Jesús Salvador; Ibáñez-Sánchez, Rocío; de Lourdes Domínguez-Contreras, María; Guerra-Márquez, Angel

2015-01-01

Hematopoietic stem cells have been used for over 50 years in the treatment of diverse diseases. Umbilical cord blood (UCB) has proved to be a viable source of hematopoietic stem cells for transplantation purposes. The aim was to report the contribution of the umbilical cord blood bank over the past 9 years, in the treatment of various diseases. Since 2005 the number of units of blood from the umbilical cord and their use for transplantation in diverse disease were analyzed. A selection of volunteer pregnant women in labor was performed. Umbilical cord blood was obtained from them, which underwent processing, cryopreservation and validation, as well as compatibility test before using for transplantation. Ten thousand and ninety nine candidates to donation were assessed, from whom 2481 unit of UCB were collected. Of these, 893 unit were processed and cryopreserved for transplantation. In 65% of cases there was histocompatibility between the cord cell and the receptors. Transplantation was done in 87 patients, 67% had hematologic neoplasias, who have received 140 units of UCB in 102 transplants. This Bank of UCB ranks second in the world in productivity according to the rate of utility of units in transplantation (3.3%). Our bank of UCB has been able to develop a cell line (hematopoietic stem cells) with international quality standards and has been beneficial for patients served by our institution with need of a transplant mainly in hemato-oncologic patients.

Evaluation of the use of umbilical artery Doppler flow studies and outcome of pregnancies at a secondary hospital.

PubMed

Hugo, Elizabeth J C; Odendaal, Hein J; Grove, Debbie

2007-03-01

To investigate the use of a personal computer (PC)-based, continuous-wave Doppler machine by a trained midwife at a secondary hospital to assess umbilical artery flow velocity waveforms (FVW) in referred women. Pregnant women referred for suspected poor fetal growth were evaluated from June 2002 through December 2004. The Umbiflow apparatus, consisting of a Pentium 3 PC with an ultrasound transducer plugged into the USB port and software, was used to analyze the FVW of the umbilical artery. Pregnancies in which the resistance index (RI) was <75(th) percentile (P75) were not further evaluated for fetal well-being unless the clinical condition of the mother changed. Pregnancies with an RI >or=P75 were followed up according to a specific protocol. Primary end points were intrauterine death and intrauterine growth restriction. A total of 572 singleton pregnancies were followed up. Significantly more infants were small-for-gestational-age when the RI was >P95 (55.6%) than those between P75 and P95 (41.2%) or P95, respectively. A normal Doppler FVW of the umbilical artery is less likely to be followed by perinatal death.

Folic acid inhibits homocysteine-induced cell apoptosis in human umbilical vein endothelial cells.

PubMed

Cui, Shanshan; Li, Wen; Wang, Pengyan; Lv, Xin; Gao, Yuxia; Huang, Guowei

2017-12-18

Homocysteine may be responsible for vascular endothelial cell injury, which occurs early in the pathology of cardiovascular disease. Homocysteine metabolism requires enzymatic interaction with vitamins such as folic acid, vitamin B12, and vitamin B6. We hypothesized that folic acid alleviated homocysteine-induced vascular injury by regulating the metabolic pathway of apoptosis. Human umbilical vein endothelial cells were incubated for 48 h with folic acid at the concentrations of 0-1000 nmol/L, in combination with either 1000 μmol/L homocysteine or vehicle for the first 24 h. We then assessed cell viability and apoptosis by methyl thiazolyl tetrazolium assay and flow cytometry, respectively. To further investigate how folic acid influenced cell apoptosis, we also analyzed the activities of caspase-3/7 and the mRNA and protein expressions of BCL2, BAX, TP53, CASP3, and CASP8 in human umbilical vein endothelial cells. We showed that folic acid increased cell viability and decreased apoptosis in a dose-dependent manner, and that this effect was mediated by decreased caspase-3/7 activity, upregulated BCL2/BAX ratio, and downregulated TP53, CASP3, and CASP8 expressions. Thus, we conclude that folic acid inhibits cell apoptosis and ameliorates homocysteine toxicity by regulating the expression of apoptosis-related genes in human umbilical vein endothelial cells.

Methylmercury level in umbilical cords from patients with congenital Minamata disease.

PubMed

Harada, M; Akagi, H; Tsuda, T; Kizaki, T; Ohno, H

1999-08-30

A total of 151 umbilical cords during the period from 1950 to 1969 were collected from the residents of the Minamata area (including 25 patients with congenital Minamata disease) for methylmercury (MeHg) analysis. When the MeHg discharge from the Chisso Company's Minamata factory into the Minamata Bay is compared with the incidence of congenital Minamata disease, the abrupt increase of the former in 1952 [Nishimura H. Chem. Today 1998;323:60-66] was found to precede that of the latter by approximately 2 years, thereby indicating that MeHg is the cause of the disaster. This was confirmed by the elevated levels of MeHg in the umbilical cords from residents of the Minamata area [from 0.35 +/- 0.30 (S.D.) ppm in 1952 to 0.96 +/- 0.75 ppm in 1955], the MeHg levels (1.60 +/- 1.00 ppm) in the cords from patients with congenital Minamata disease showing the highest values [P < 0.01 vs. acquired Minamata disease (0.72 +/- 0.65 ppm), mental retardation (0.74 +/- 0.64 ppm), other diseases (0.22 +/- 0.15 ppm), and no symptoms (0.28 +/- 0.20 ppm), respectively]. Thus, in order to fill a gap, which extends over a long period of time, in studies on environmental Hg pollution, umbilical cord samples were considered to be a useful tool.

Construction of biocompatible porous tissue scaffold from the decellularized umbilical artery.

PubMed

Xin, Yi; Wu, Guanghui; Wu, Man; Zhang, Xiaoxia; Velot, Emilie; Decot, Véronique; Cui, Wei; Huang, Yimin; Stoltz, Jean-Francois; Du, Jie; Li, Na

2015-01-01

The scaffolds prepared from the tissue decellularization conserve the porous 3-D structure and provide an optimal matrix for the tissue regeneration. Since decade, the enzymatic digestion, chemical reagent treatment and mechanical actions such as eversion and abrasion have been used to remove the cells from the intact matrix. In this study, we optimized an enzymatic method to decellularize the umbilical artery to construct a 3-D porous scaffold which is suitable for the culture of mesenchymal stem cells (MSCs). The scaffold maintained the interconnected porous structure. It remained the similar high water content 95.3 ± 1% compared to 94.9 ± 0.6% in the intact umbilical artery (p>0.05). The decellularization process decreased the stress from 0.24 ± 0.05 mPa to 0.15 ± 0.06 mPa (p<0.05). However the decellularization did not change the strain of the artery (45 ± 15% vs. 53 ± 10%, p>0.05). When the scaffold was transplanted to the subcutaneous tissue in the wild type mice, there were less T cells appeared in the surrounding tissue which meant the decreased the immunogenicity by decellularization. This scaffold also supported the adhesion and proliferation of the MSCs. In this study, we constructed a biological compatible porous scaffold from the decellularized umbilical artery which may provide a suitable scaffold for cell-matrix interaction studies and for tissue engineering.

LESS living donor nephrectomy: Surgical technique and results

PubMed Central

Alessimi, Abdullah; Adam, Emilie; Haber, Georges-Pascal; Badet, Lionel; Codas, Ricardo; Fehri, Hakim Fassi; Martin, Xavier; Crouzet, Sébastien

2015-01-01

Purpose: We present the findings of 50 patients undergoing pure trans-umbilical laparo-endoscopic single-site surgery (LESS) living donor nephrectomy (LDN), between February 2010 and May 2014. Materials and Methods: Laparo-endoscopic single-site surgery LDN was performed through an umbilical incision. Different trocars were used, namely Gelpoint (Applied Mιdical, Rancho Santa Margarita, CA) SILS port (Covidien, Hamilton, Bermuda), R-port (Olympus Surgical, Orangeburg, NY) and standard trocars, inserted through the same skin incision but using separate fascial punctures. The standard laparoscopic technique was employed. The kidney was pre-entrapped in a retrieval bag and extracted trans-umbilically. Data were collected prospectively including questionnaires containing patient reported oral pain medication duration and time to recovery. Results: LESS LDN was successful in all patients. Mean warm ischemia time was 6.2 min (3–15), mean procedure time was 233.2 min (172–300), and hospitalization stay was 3.94 days (3–7) with a visual analogue pain score at discharge of 1.32 (0–3). No intraoperative complications occurred. The mean time of oral pain medication was 8.72 days (1–20) and final scar length was 4.06 cm (3–5). Each allograft was functional. Conclusion: Although challenging, trans-umbilical LESS LDN seems to be feasible and safe. Hence, LESS has the potential to improve cosmetic results and decrease morbidity. PMID:26229326

Current obstetrical practice and umbilical cord prolapse.

PubMed

Usta, I M; Mercer, B M; Sibai, B M

1999-01-01

The aim of this study was to assess the contribution of current obstetrical practice to the occurrence and complications of umbilical cord prolapse. Maternal and neonatal charts of 87 pregnancies complicated by true umbilical cord prolapse during a 5-year period were reviewed. Twin gestation and noncephalic presentations were common features (14 and 41%, respectively). Eighty-nine percent (77) of infants were delivered by cesarean section of which 29% were classical and 88% were primary. The mean gestational age at delivery was 34.0 +/- 6.0 weeks, and the mean birth weight was 2318 +/- 1159 g. Obstetrical intervention preceded 41 (47%) cases (the obstetrical intervention group): amniotomy (9), scalp electrode application (4), intrauterine pressure catheter insertion (6), attempted external cephalic version (7), expectant management of preterm premature rupture of membranes (14), manual rotation of the fetal head (1), and amnioreduction (1). There were 11 perinatal deaths. Thirty-three percent of the infants (32) had a 5-min Apgar score < 7 and 34% had a cord pH < 7.20. Neonatal seizures, intracerebral hemorrhage, necrotizing enterocolitis, hyaline membrane disease, persistent fetal circulation, sepsis, assisted ventilation, and perinatal mortality were comparable in the "obstetrical intervention" and "no-intervention" groups. Most of the neonatal complications occurred in infants < 32 weeks' gestation. We conclude that obstetrical intervention contributes to 47% of umbilical cord prolapse cases; however, it does not increase the associated perinatal morbidity and mortality.

Umbilical cord vitamin D, ionized calcium and myocardial oxygen demand.

PubMed

Reeves, Inez; Liang, Willie; Asadi, M Sadegh; Millis, Richard M

2014-07-01

Systemic blood vitamin D and total calcium are correlates of birthweight and cardiovascular disease but whether umbilical cord blood vitamin D and ionized calcium are correlates of birthweight and cardiovascular function is not known. This cross-sectional study correlates umbilical cord vitamin D, ionized calcium and birthweight with the heart rate-systolic pressure product (RPP), an indicator of myocardial oxygen demand. Cord blood vitamin D and ionized calcium concentrations were compared for vitamin D normal (≥50 nM, 20 ng/mL) and vitamin D deficiency (<50 nM, 20 ng/mL) in normal weight (≥2500 g) and low birthweight (LBW, <2500 g) newborns. Heart rate and blood pressure were measured during postnatal transition and RPP was computed. RPP was positively correlated with birthweight (r = +0.52, p < 0.001) and with cord ionized calcium level (r = +0.42, p < 0.01) in the normal and LBW newborns. RPP was positively correlated with cord vitamin D level in the LBW newborns (raw r = +0.50, p < 0.05, normalized for birthweight r = +0.73, p < 0.01). Small RPP, an indicator of low myocardial oxygen demand, in LBW newborns appears to correlate with low umbilical cord vitamin D and ionized calcium levels, suggestive of pathological heart development.

Reversible arterial redistribution in a fetus with true umbilical cord knot: case report and review of literature.

PubMed

Navolan, Dan Bogdan; Sas, Ioan; Grigoraş, Dorin; Moldovan, Mihaela; Cîrlan, Casius; Angheloiu Rîcă, Daiana Elena; Levai, Codrina Mihaela

2015-01-01

Umbilical cord knot (UCK) affects around 1% of pregnancies and tightening of UCK is a very rare and highly unpredictable complication of pregnancy that can lead to fetal demise or neonatal death. The majority of authors agree that very little could be done to prevent fetal deaths in pregnancies with undiagnosed tight UCK. We herein report the case of a 39-year-old, gravidity five, parity three, pregnant woman at 40 weeks and five days age of pregnancy, whose pregnancy evolved without complications and who was admitted to hospital for the management of the birth. Although the last ultrasound examination before birth showed a reversible arterial redistribution in the fetus dependent on the postural status of the pregnant women and other factors associated with umbilical cord knot were present, the diagnosis was missed because of the factors' non-specificity. After a spontaneous labor without complications a dead male fetus, weight 3300 g, without heartbeat, Apgar score 0 was delivered. Macroscopic and microscopic findings confirmed that the cause of neonatal death was asphyxia caused by a tight UCK. The aim of our paper is to present the dramatic outcome of a pregnancy with a fetus with a tight umbilical cord knot (UCK), to bring to attention the signs that suggested the diagnosis, and to review the literature on this subject.

Microbiological evaluation of the steam sterilization of assembled laparoscopic instruments.

PubMed

Camargo, Tamara Carolina de; Graziano, Kazuko Uchikawa; Almeida, Alda Graciele Claudio Dos Santos; Suzuki, Karina; Silva, Cely Barreto da; Pinto, Flávia Morais Gomes

2016-11-21

assess the safety of steam sterilization of assembled laparoscopic instruments with challenge contamination. a laboratory experimental study, using as test samples trocars and laparoscopic graspers. Geobacillus stearothermophillus ATCC-7953 was used, with a microbial population of 106UFC/Filter paper substrate, removed from the biological indicator. Three of them were introduced into each instrument at the time of assembly, and sterilized at pressurized saturated steam, 134oC for 5 minutes. After sterilization, the instrument was disassembled and each filter paper substrate was inoculated in soybean casein culture and incubated at 56oC for 21 days. In case of absence of growth, they were subjected to heat shock of 80oC, for 20 minutes and re-incubated for 72 hours. Sample size: 185 graspers and 185 trocars, with 95% power. We paired the experiments with comparative negative control groups (5 graspers and 5 trocars with challenge contamination, sterilized disassembled) and positive control (30 filter paper supports, unsterilized), subject to the same incubation procedures. there was no microbial growth in experimental and negative control. The results of the positive control were satisfactory. this study provided strong scientific evidence to support the safety of steam sterilizing of the assembled laparoscopic instrument. avaliar a segurança da esterilização a vapor, do instrumental laparoscópico montado com desafio da contaminação. estudo experimental laboratorial, cujo corpo de prova foram trocarte e pinça laparoscópica. Utilizou-se esporos Geobacillus stearothermophillus ATCC-7953, com população microbiana de 106UFC/suporte de papel filtro, removidos do indicador biológico. Três deles foram introduzidos no interior de cada instrumento, no momento da montagem, sendo esterilizados a vapor saturado sob pressão, 134oC por 5 minutos. Depois da esterilização, o instrumental foi desmontado, e cada suporte de papel filtro foi inoculado em meio de cultura de caseína soja, incubado a 56oC por 21 dias. Não havendo crescimento, foram submetidos a um choque térmico de 80oC, por 20 minutos e reincubados por 72 horas. Tamanho da amostra, 185 pinças e 185 trocartes, com poder de 95%. Os experimentos foram acompanhados dos grupos controle negativo comparativo (5 pinças e 5 trocartes com contaminação desafio, esterilizados desmontados) e positivo (30 suportes de papel filtro, não esterilizados), submetidos aos mesmos procedimentos de incubação. não houve nenhum crescimento microbiano nos grupos experimental e controle negativo. Os resultados do controle positivo foram satisfatórios. este estudo forneceu fortes evidências científicas para sustentar a segurança da prática de esterilização a vapor do instrumental laparoscópico montado. evaluar la seguridad de la esterilización a través de vapor, de instrumental laparoscópico previamente montado con desafío de contaminación. estudio experimental en laboratorio, cuyo cuerpo de prueba fueron trócarte y pinza laparoscópica. Se utilizó esporas Geobacillus stearothermophilus ATCC-7953, con población microbiana de 106UFC/soporte de papel filtro, removidos del indicador biológico. Tres de ellos fueron introducidos en el interior de cada instrumento, en el momento del montaje, los que fueron esterilizados a vapor saturado bajo presión, 134oC por 5 minutos. Después de la esterilización, el instrumental fue desmontado y cada soporte de papel filtro fue inoculado en medio de una cultura de caseína y soya, incubado a 56oC por 21 días. No habiendo crecimiento, fueron sometidos a un choque térmico de 80oC, por 20 minutos y nuevamente incubados por 72 horas. La muestra estuvo constituida por 185 pinzas y 185 trócartes, con poder de 95%. Los experimentos fueron acompañados en los grupos: control negativo comparativo (5 pinzas y 5 trócartes con contaminación desafío, esterilizados desmontados) y positivo (30 soportes de papel filtro, no esterilizados), sometidos a los mismos procedimientos de incubación. no se encontró crecimiento microbiano en los grupos experimental y control negativo. Los resultados del control positivo fueron satisfactorios. este estudio suministra fuertes evidencias científicas para sustentar que la práctica, de esterilización a vapor del instrumental laparoscópico montado, es segura.

Umbilical vein injection of misoprostol versus normal saline for the treatment of retained placenta: intrapartum placebo-controlled trial.

PubMed

Rajab, Sheelan S; Alalaf, Shahla K

2014-01-21

The third stage of labour may be complicated by retained placenta, which should be managed promptly because it may cause severe bleeding and infection, with a potentially fatal outcome. This study evaluated the effectiveness of umbilical vein injection of misoprostol for the treatment of retained placenta in a hospital setting. This hospital-based placebo-controlled trial was conducted at the Maternity Teaching Hospital, Erbil City, Kurdistan region, Northern Iraq from April 2011 to February 2012. The inclusion criteria were: gestational age of at least 28 weeks, vaginal delivery, and failure of the placenta to separate within 30 minutes after delivery of the infant despite active management of the third stage of labour. Forty-six women with retained placentas were eligible for inclusion. After informed consent was obtained, the women were alternately allocated to receive umbilical vein injection of either 800 mcg misoprostol dissolved in 20 mL of normal saline (misoprostol group) or 20 mL of normal saline only (saline group). The women were blinded to the group allocation, but the investigator who administered the injection was not. The trial was registered by the Research Ethics Committee of Hawler Medical University. After umbilical vein injection, delivery of the placenta occurred in 91.3% of women in the misoprostol group and 69.5% of women in the saline group, which was not a significant difference between the two groups. The median vaginal blood loss from the time of injection until delivery of the placenta was significantly less in the misoprostol group (100 mL) than in the saline group (210 mL) (p value < 0.001). Umbilical vein injection of misoprostol is an effective treatment for retained placenta, and reduces the volume of vaginal blood loss with few adverse effects. Current Controlled Trial HMU: N252.1.2011.

Umbilical vein injection of misoprostol versus normal saline for the treatment of retained placenta: intrapartum placebo-controlled trial

PubMed Central

2014-01-01

Background The third stage of labour may be complicated by retained placenta, which should be managed promptly because it may cause severe bleeding and infection, with a potentially fatal outcome. This study evaluated the effectiveness of umbilical vein injection of misoprostol for the treatment of retained placenta in a hospital setting. Methods This hospital-based placebo-controlled trial was conducted at the Maternity Teaching Hospital, Erbil City, Kurdistan region, Northern Iraq from April 2011 to February 2012. The inclusion criteria were: gestational age of at least 28 weeks, vaginal delivery, and failure of the placenta to separate within 30 minutes after delivery of the infant despite active management of the third stage of labour. Forty-six women with retained placentas were eligible for inclusion. After informed consent was obtained, the women were alternately allocated to receive umbilical vein injection of either 800 mcg misoprostol dissolved in 20 mL of normal saline (misoprostol group) or 20 mL of normal saline only (saline group). The women were blinded to the group allocation, but the investigator who administered the injection was not. The trial was registered by the Research Ethics Committee of Hawler Medical University. Results After umbilical vein injection, delivery of the placenta occurred in 91.3% of women in the misoprostol group and 69.5% of women in the saline group, which was not a significant difference between the two groups. The median vaginal blood loss from the time of injection until delivery of the placenta was significantly less in the misoprostol group (100 mL) than in the saline group (210 mL) (p value < 0.001). Conclusion Umbilical vein injection of misoprostol is an effective treatment for retained placenta, and reduces the volume of vaginal blood loss with few adverse effects. Clinical Trial Registration Current Controlled Trial HMU: N252.1.2011 PMID:24444360

Reduced intensity haplo plus single cord transplant compared to double cord transplant: improved engraftment and graft-versus-host disease-free, relapse-free survival

PubMed Central

van Besien, Koen; Hari, Parameswaran; Zhang, Mei-Jie; Liu, Hong-Tao; Stock, Wendy; Godley, Lucy; Odenike, Olatoyosi; Larson, Richard; Bishop, Michael; Wickrema, Amittha; Gergis, Usama; Mayer, Sebastian; Shore, Tsiporah; Tsai, Stephanie; Rhodes, Joanna; Cushing, Melissa M.; Korman, Sandra; Artz, Andrew

2016-01-01

Umbilical cord blood stem cell transplants are commonly used in adults lacking HLA-identical donors. Delays in hematopoietic recovery contribute to mortality and morbidity. To hasten recovery, we used co-infusion of progenitor cells from a partially matched related donor and from an umbilical cord blood graft (haplo-cord transplant). Here we compared the outcomes of haplo-cord and double-cord transplants. A total of 97 adults underwent reduced intensity conditioning followed by haplo-cord transplant and 193 patients received reduced intensity conditioning followed by double umbilical cord blood transplantation. Patients in the haplo-cord group were more often from minority groups and had more advanced malignancy. Haplo-cord recipients received fludarabine-melphalan-anti-thymocyte globulin. Double umbilical cord blood recipients received fludarabine-cyclophosphamide and low-dose total body irradiation. In a multivariate analysis, haplo-cord had faster neutrophil (HR=1.42, P=0.007) and platelet (HR=2.54, P<0.0001) recovery, lower risk of grade II–IV acute graft-versus-host disease (HR=0.26, P<0.0001) and chronic graft-versus-host disease (HR=0.06, P<0.0001). Haplo-cord was associated with decreased risk of relapse (HR 0.48, P=0.001). Graft-versus-host disease-free, relapse-free survival was superior with haplo-cord (HR 0.63, P=0.002) but not overall survival (HR=0.97, P=0.85). Haplo-cord transplantation using fludarabine-melphalan-thymoglobulin conditioning hastens hematopoietic recovery with a lower risk of relapse relative to double umbilical cord blood transplantation using the commonly used fludarabine-cyclophosphamide-low-dose total body irradiation conditioning. Graft-versus-host disease-free and relapse-free survival is significantly improved. Haplo-cord is a readily available graft source that improves outcomes and access to transplant for those lacking HLA-matched donors. Trials registered at clinicaltrials.gov identifiers 00943800 and 01810588. PMID:26869630

Early functional and morphological brain disturbances in late-onset intrauterine growth restriction.

PubMed

Starčević, Mirta; Predojević, Maja; Butorac, Dražan; Tumbri, Jasna; Konjevoda, Paško; Kadić, Aida Salihagić

2016-02-01

To determine whether the brain disturbances develop in late-onset intrauterine growth restriction (IUGR) before blood flow redistribution towards the fetal brain (detected by Doppler measurements in the middle cerebral artery and umbilical artery). Further, to evaluate predictive values of Doppler arterial indices and umbilical cord blood gases and pH for early functional and/or morphological brain disturbances in late-onset IUGR. This cohort study included 60 singleton term pregnancies with placental insufficiency caused late-onset IUGR (IUGR occurring after 34 gestational weeks). Umbilical artery resistance index (URI), middle cerebral artery resistance index (CRI), and cerebroumbilical (C/U) ratio (CRI/URI) were monitored once weekly. Umbilical blood cord samples (arterial and venous) were collected for the analysis of pO2, pCO2 and pH. Morphological neurological outcome was evaluated by cranial ultrasound (cUS), whereas functional neurological outcome by Amiel-Tison Neurological Assessment at Term (ATNAT). 50 fetuses had C/U ratio>1, and 10 had C/U ratio≤1; among these 10 fetuses, 9 had abnormal neonatal cUS findings and all 10 had non-optimal ATNAT. However, the total number of abnormal neurological findings was much higher. 32 neonates had abnormal cUS (53.37%), and 42 (70.00%) had non-optimal ATNAT. Furthermore, Doppler indices had higher predictive validity for early brain disturbances than umbilical cord blood gases and pH. C/U ratio had the highest predictive validity with threshold for adverse neurological outcome at value 1.13 (ROC analysis), i.e., 1.18 (party machine learning algorithm). Adverse neurological outcome at average values of C/U ratios>1 confirmed that early functional and/or structural brain disturbances in late-onset IUGR develop even before activation of fetal cardiovascular compensatory mechanisms, i.e., before Doppler signs of blood flow redistribution between the fetal brain and the placenta. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Maternal systemic or cord blood inflammation is associated with birth anthropometry in a Tanzanian prospective cohort.

PubMed

Wilkinson, A L; Pedersen, S H; Urassa, M; Michael, D; Andreasen, A; Todd, J; Kinung'hi, S M; Changalucha, J; McDermid, J M

2017-01-01

HIV infection is associated with chronic systemic inflammation, with or without antiretroviral therapy. Consequences for foetal growth are not understood, particularly in settings where multiple maternal infections and malnutrition are common. The study was designed to examine maternal systemic circulating and umbilical cord blood cytokine concentrations in relation to birth anthropometry in a Tanzanian prospective cohort. A 9-plex panel of maternal plasma cytokines in HIV-positive (n = 44) and HIV-negative (n = 70) mothers and the same cytokines in umbilical cord blood collected at delivery was assayed. Linear regression modelled associations between maternal or cord blood cytokines and birth anthropometry. Health indicators (haemoglobin, mid-upper-arm circumference, body mass index) in HIV-positive mothers without considerable immunosuppression did not differ from HIV-negative women. Despite this, HIV-exposed infants had lower birthweight and length. Subgroup analyses indicated that HIV management using HAART was associated with lower plasma TNF-α, as were longer durations of any antiretroviral therapy (≥2 months). Greater maternal plasma TNF-α was associated with earlier delivery (-1.7 weeks, P = 0.039) and lower birthweights (-287 g; P = 0.020), while greater umbilical cord TNF-α (-1.43 cm; P = 0.036) and IL-12p70 (-2.4 cm; P = 0.008) were associated with shorter birth length. Birthweight was inversely associated with cord IL-12p70 (-723 g; P = 0.001) and IFN-γ (-482 g, P = 0.007). Maternal cytokines during pregnancy did not correlate with umbilical cord cytokines at delivery. Systemic inflammation identified in maternal plasma or umbilical cord blood was associated with poorer birth anthropometrics in HIV-exposed and HIV-unexposed infants. Controlling maternal and/or foetal systemic inflammation may improve birth anthropometry. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Study on the relationship between the expression of IGF-1 in umbilical cord blood and abnormal glucose metabolism during pregnancy.

PubMed

Liu, K; Wu, H-Y; Xu, Y-H

2017-02-01

To explore the relationship between the expression of insulin-like growth factor-1 (IGF-1) in neonatal umbilical cord blood and abnormal glucose metabolism during pregnancy. We have selected 63 cases of delivery randomly, term birth and maternal from January 2015 to January 2016 in our hospital, gestational diabetes mellitus for Group A, abnormal gestational glucose tolerance for Group B and normal for Group C with 21 cases in each group. The venous blood samples were collected from all the pregnant females 2 weeks before delivery, and the levels of HbA1c in serum were detected by Elisa method. During the delivery, the umbilical cord blood was collected and the levels of IGF-1 were measured by double site immune enzyme analysis. The neonatal weight was recorded and the correlation analysis was made in respect of the measurement results. The level of HbA1c in Group A was significantly higher than that in Group C (p < 0.05); IGF-1 level and neonatal weight of Group B were significantly higher than that of Group C (p < 0.05), IGF-1 has a significant correlation with neonatal weight in Group C, and HbA1c and IGF-1 were positively correlated (p < 0.05); IGF-1 was positively correlated with neonatal weight in Group A and Group B (p < 0.05). There was a significant positive correlation between the IGF-1 level of neonatal umbilical cord blood and the neonatal weight (p < 0.05). Also, the level of HbA1c was positively correlated with the level of IGF-1 in neonatal umbilical cord blood at the end of pregnancy (p < 0.05). The expression level of IGF-1 in the final stage of pregnant females can be detected to predict the expression level of IGF-1 in newborn infants and then the growth status of the fetus can be obtained.

SUSCEPTIBILITY LOCI FOR UMBILICAL HERNIA IN SWINE DETECTED BY GENOME-WIDE ASSOCIATION.

PubMed

Liao, X J; Lia, L; Zhang, Z Y; Long, Y; Yang, B; Ruan, G R; Su, Y; Ai, H S; Zhang, W C; Deng, W Y; Xiao, S J; Ren, J; Ding, N S; Huang, L S

2015-10-01

Umbilical hernia (UH) is a complex disorder caused by both genetic and environmental factors. UH brings animal welfare problems and severe economic loss to the pig industry. Until now, the genetic basis of UH is poorly understood. The high-density 60K porcine SNP array enables the rapid application of genome-wide association study (GWAS) to identify genetic loci for phenotypic traits at genome wide scale in pigs. The objective of this research was to identify susceptibility loci for swine umbilical hernia using the GWAS approach. We genotyped 478 piglets from 142 families representing three Western commercial breeds with the Illumina PorcineSNP60 BeadChip. Then significant SNPs were detected by GWAS using ROADTRIPS (Robust Association-Detection Test for Related Individuals with Population Substructure) software base on a Bonferroni corrected threshold (P = 1.67E-06) or suggestive threshold (P = 3.34E-05) and false discovery rate (FDR = 0.05). After quality control, 29,924 qualified SNPs and 472 piglets were used for GWAS. Two suggestive loci predisposing to pig UH were identified at 44.25MB on SSC2 (rs81358018, P = 3.34E-06, FDR = 0.049933) and at 45.90MB on SSC17 (rs81479278, P = 3.30E-06, FDR = 0.049933) in Duroc population, respectively. And no SNP was detected to be associated with pig UH at significant level in neither Landrace nor Large White population. Furthermore, we carried out a meta-analysis in the combined pure-breed population containing all the 472 piglets. rs81479278 (P = 1.16E-06, FDR = 0.022475) was identified to associate with pig UH at genome-wide significant level. SRC was characterized as plausible candidate gene for susceptibility to pig UH according to its genomic position and biological functions. To our knowledge, this study gives the first description of GWAS identifying susceptibility loci for umbilical hernia in pigs. Our findings provide deeper insights to the genetic architecture of umbilical hernia in pigs.

A case of splenic rupture within an umbilical hernia with loss of domain.

PubMed

Fernando, Emil J; Guerron, Alfredo D; Rosen, Michael J

2015-04-01

Massive ventral hernia with loss of abdominal domain is a particularly complex disease. We present a case of a massive umbilical hernia with loss of abdominal domain containing the small bowel, colon, and spleen that presented with spontaneous splenic rupture. The patient was an 82-year-old Caucasian female with multiple comorbidities, on anti-coagulation for cardiac dysrhythmia with a congenital umbilical hernia with loss of abdominal domain which had progressed over multiple years. She presented to an outside hospital with history of a left-sided abdominal pain accompanying fatigue and weakness.A CT scan of the abdomen revealed an umbilical hernia with loss of abdominal domain containing the patient's entire small bowel, colon, pancreas, and the spleen. The spleen had ruptured with associated hemorrhage and hematoma in the hernia sac.Management included a multidisciplinary approach with particular attention to comorbidities and hemodynamic monitoring due to splenic rupture. Given the need for lifetime anticoagulation, a splenectomy was planned along with simultaneous abdominal wall reconstruction. The patient underwent an exploratory laparotomy, splenectomy, bilateral posterior component separation with transversus abdominis release, and a retrorectus/preperitoneal placement of heavy weight polypropylene mesh.During the postoperative period, the patient remained intubated initially due to elevated airway pressures before transferring to the regular nursing floor. The remainder of the patient's hospital stay was complicated by a postoperative ileus requiring nasogastric tube decompression and a DVT and PE necessitating anticoagulation. The ileus eventually resolved and diet was slowly advanced. The patient was discharged on POD17. To our knowledge, this is the first report in the literature describing a splenic rupture that occurred within the hernia sac of a congenital umbilical hernia. This report serves to highlight that even with novel cases of massive and atypical hernias, posterior component separation with transversus abdominis release is a reproducible repair that can be performed with good result in a variety of circumstances.

Mesenchymal stem cells from the Wharton’s jelly of umbilical cord segments provide stromal support for the maintenance of cord blood hematopoietic stem cells during long-term ex vivo culture

PubMed Central

Bakhshi, Tiki; Zabriskie, Ryan C.; Bodie, Shamanique; Kidd, Shannon; Ramin, Susan; Paganessi, Laura A.; Gregory, Stephanie A.; Fung, Henry C.; Christopherson, Kent W.

2012-01-01

BACKGROUND Hematopoietic stem cells (HSCs) are routinely obtained from marrow, mobilized peripheral blood, and umbilical cord blood. Mesenchymal stem cells (MSCs) are traditionally isolated from marrow. Bone marrow–derived MSCs (BM-MSCs) have previously demonstrated their ability to act as a feeder layer in support of ex vivo cord blood expansion. However, the use of BM-MSCs to support the growth, differentiation, and engraftment of cord blood may not be ideal for transplant purposes. Therefore, the potential of MSCs from a novel source, the Wharton’s jelly of umbilical cords, to act as stromal support for the long-term culture of cord blood HSC was evaluated. STUDY DESIGN AND METHODS Umbilical cord–derived MSCs (UC-MSCs) were cultured from the Wharton’s jelly of umbilical cord segments. The UC-MSCs were then profiled for expression of 12 cell surface receptors and tested for their ability to support cord blood HSCs in a long-term culture-initiating cell (LTC-IC) assay. RESULTS Upon culture, UC-MSCs express a defined set of cell surface markers (CD29, CD44, CD73, CD90, CD105, CD166, and HLA-A) and lack other markers (CD45, CD34, CD38, CD117, and HLA-DR) similar to BM-MSCs. Like BM-MSCs, UC-MSCs effectively support the growth of CD34+ cord blood cells in LTC-IC assays. CONCLUSION These data suggest the potential therapeutic application of Wharton’s jelly–derived UC-MSCs to provide stromal support structure for the long-term culture of cord blood HSCs as well as the possibility of cotransplantation of genetically identical, HLA-matched, or unmatched cord blood HSCs and UC-MSCs in the setting of HSC transplantation. PMID:18798803

Ex vivo expansion of human umbilical cord blood-derived T-lymphocytes with homologous cord blood plasma.

PubMed

Kim, Yong-Man; Jung, Min-Hyung; Song, Ha-Young; Yang, Hyun Ok; Lee, Sung-Tae; Kim, Jong-Hyeok; Kim, Young-Tak; Nam, Joo-Hyun; Mok, Jung-Eun

2005-02-01

This study was designed to establish a more effective and safe culture system for adoptive immunotherapy by investigating the use of homologous cord blood plasma (HCBP) instead of fetal bovine serum (FBS), which has various limitations including ethical problems for the ex vivo expansion of human umbilical T lymphocytes. Fresh human umbilical mononuclear cell fractions were isolated by Ficoll-Hypaque density centrifugation. Nonadherent mononuclear cell fractions were cultured with anti-CD3 antibody (5 microg/ml), IL-2 (175 U/ml), and either 10% FBS or 10% HCBP. On day 8, the cellular proliferation rate and cell surface markers were assessed. There was no significant difference in proliferation when human umbilical cord blood T lymphocytes were grown in medium supplemented with FBS or HCBP (p > 0.05). In medium containing FBS, the proportion of CD3(+)CD4(+) (markers for helper T cell), CD3(+)CD8(+) (cytotoxic T cell), CD3(+)CD25(+) (activated T cell), CD3(+)CD38(+) (immature T cell), and CD3(+)CD45RO(+) (memory T cell) cells was significantly increased (p < 0.05), whereas proportion of CD3(+)CD45RA(+) (naive T cell) and CD16(+)CD56(+) (NK cell) cells was significantly decreased (p < 0.05). In HCBP supplemented medium, the proportion of CD3(+)CD8(+), CD3(+)CD25(+), CD3(+)CD45RA(+), and CD3(+)CD45RO(+) cells was significantly increased (p < 0.05). The proportion of CD3(+)CD4(+), CD3(+)CD45RO(+) and CD3(+)CD38(+) cells was significantly higher, but proportion of CD3(+)CD45RA(+) and CD3(+)CD8(+) cells was significantly lower in FBS compared with HCBP supplemented medium (p < 0.05). Our results support the feasibility of ex vivo expansion of human umbilical cord blood T lymphocytes in medium supplemented with HCBP for future adoptive cellular immunotherapy.

Toxicity of Aluminum Silicates Used in Hemostatic Dressings Toward Human Umbilical Veins Endothelial Cells, HeLa Cells, and RAW267.4 Mouse Macrophages

DTIC Science & Technology

2011-09-01

ORIGINAL ARTICLE Toxicity of Aluminum Silicates Used in Hemostatic Dressings Toward Human Umbilical Veins Endothelial Cells, HeLa Cells, and RAW267.4...not known. Clay minerals are generally considered nontoxic to humans and have been widely used in cosmetics and as excipient in drugs and foods...Bentonite, which has a long history in pharmaceutical formulations,7 along with kaolin are listed in the US Pharmacopeia.8 The sensitivity of some human

Effect of allo- and xenotransplantation of embryonic nervous tissue and umbilical cord blood-derived stem cells on structural and functional state of cerebral cortex of albino rats in posttraumatic period.

PubMed

Ereniev, S I; Semchenko, V V; Sysheva, E V; Bogdashin, I V; Shapovalova, V V; Khizhnyak, A S; Gasanenko, L N

2005-11-01

Comparative study of the structural and functional state of cerebral cortex of adult albino rats after intracerebral allo- and xenotransplantation of embryonic nervous tissue and intravenous injection of umbilical cord blood-derived stem cells at different terms after diffuse-focal cerebral trauma revealed the best cerebroprotective effect on day 7 of posttraumatic period in animals receiving embryonic nervous tissue.

KSC-99pp1072

NASA Image and Video Library

1999-06-18

At the Launch Equipment Test Facility, , Will Reaves and Mike Solomon (kneeling), both with Lockheed Martin Technical Operations, observe parts of the X-33 umbilical system during testing. A team of Kennedy Space Center experts developed the umbilical system, comprising panels, valves and hoses that provide the means to load the X-33 with super-cold propellant. The X-33, under construction at Lockheed Martin Skunk Works in Palmdale, Calif., is a half-scale prototype of the planned operational reusable launch vehicle dubbed VentureStar

KSC-99pp1073

NASA Image and Video Library

1999-06-18

At the Launch Equipment Test Facility, Mike Solomon (left) and Will Reaves (right), both with Lockheed Martin Technical Operations, move in for a close look at part of the X-33 umbilical system. A team of Kennedy Space Center experts developed the umbilical system, comprising panels, valves and hoses that provide the means to load the X-33 with super-cold propellant. The X-33, under construction at Lockheed Martin Skunk Works in Palmdale, Calif., is a half-scale prototype of the planned operational reusable launch vehicle dubbed VentureStar

Amnioinfusion for potential or suspected umbilical cord compression in labour.

PubMed

Hofmeyr, G Justus; Lawrie, Theresa A

2012-01-18

Amnioinfusion aims to prevent or relieve umbilical cord compression during labour by infusing a solution into the uterine cavity. To assess the effects of amnioinfusion for potential or suspected umbilical cord compression on maternal and perinatal outcome . We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2011). Randomised trials of amnioinfusion compared with no amnioinfusion in women with babies at risk of umbilical cord compression in labour. The original review had one author only (Justus Hofmeyr (GJH)). For this update, two authors (GJH and T Lawrie) assessed 13 additional trial reports for eligibility and quality. We extracted data and checked for accuracy. We have included 19 studies, with all but two studies having fewer than 200 participants. Transcervical amnioinfusion for potential or suspected umbilical cord compression was associated with the following reductions: caesarean section overall (13 trials, 1493 participants; average risk ratio (RR) 0.62, 95% confidence interval (CI) 0.46 to 0.83); fetal heart rate (FHR) decelerations (seven trials, 1006 participants; average RR 0.53, 95% CI 0.38 to 0.74); Apgar score less than seven at five minutes (12 trials, 1804 participants; average RR 0.47, 95% CI 0.30 to 0.72); meconium below the vocal cords (three trials, 674 participants, RR 0.53, 95% CI 0.31 to 0.92); postpartum endometritis (six trials, 767 participants; RR 0.45, 95% CI 0.25 to 0.81) and maternal hospital stay greater than three days (four trials, 1051 participants; average RR 0.45, 95% CI 0.25 to 0.78). Transabdominal amnioinfusion showed similar trends, though numbers studied were small.Mean cord umbilical artery pH was higher in the amnioinfusion group (seven trials, 855 participants; average mean difference 0.03, 95% CI 0.00 to 0.06) and there was a trend toward fewer neonates with a low cord arterial pH (less than 7.2 or as defined by trial authors) in the amnioinfusion group (eight trials, 972 participants, average RR 0.58, 95% CI 0.29 to 1.14). The use of amnioinfusion for potential or suspected umbilical cord compression may be of considerable benefit to mother and baby by reducing the occurrence of variable FHR decelerations, improving short-term measures of neonatal outcome, reducing maternal postpartum endometritis and lowering the use of caesarean section, although there were methodological limitations to the trials reviewed here. In addition, the trials are too small to address the possibility of rare but serious maternal adverse effects of amnioinfusion. More research is needed to confirm the findings, assess longer-term measures of fetal outcome, and to assess the impact on caesarean section rates when the diagnosis of fetal distress is more stringent. Trials should assess amnioinfusion in specific clinical situations, such as FHR decelerations, oligohydramnios or prelabour rupture of membranes.

[Activity of agglutinin inhibitor of the kujavian pea (Pisum sativum L.) in mothers' blood and umbilical cord blood considering the course of pregnancy and delivery].

PubMed

Lange-Konior, K

1999-01-01

The aim of the paper was to evaluate the activity of inhibitor of the phytoagglutinin Pisum sativum (IfPs) in sera of mothers' and umbilical blood of their newborns in confrontation with the course of pregnancy and delivery. The investigations involved 152 tests of sera collected from women delivering at Department of Obstetrics and Perinatology in the Institute of Gynecology and Obstetrics PMU in Szczecin in the years 1992-1993, as well as 156 samples of sera stemming from their newborn infants and were taken from the umbilical cord vessels. The method of investigations being used in the paper was the reaction of inhibiting the phytohemagglutination, wherein the inhibiting action of sera in bearing women and of sera in umbilical blood exerted on agglutinating one was assessed in relation to human erythrocytes of the group 0 with Pisum sativum lectin properties. The accepted titer of inhibitor of the agglutinin Pisum sativum (IfPs) was expressed as the highest dilution of serum, at which complete inhibition of phytohemagglutination was still preserved. The performed investigations have disclosed statistically significant differences between the activity of IfPs occurring in sera of the mothers and the inhibiting factor in umbilical blood sera of the newborns (Tab. 1). No effect of the duration of pregnancy and the course of pregnancy on the IfPs activity in sera of mothers was disclosed. The absence of inhibitor of Pisum sativum lectin in umbilical blood sera was essentially frequently recorded in premature termination of pregnancy between 31-37 weeks of its duration as well as in sera of newborns born by cesarean section and newborns with birth mass being equal or lower than 2500 g in comparison to sera of full term newborns born by forces of nature (Tab. 2, 3, 5). The birth status of newborns according to Apgar scale did not have any influence of IfPs activity in their sera, however, IfPs activity in sera of umbilical blood was statistically significantly more frequent in cases of deliveries lasting longer than 4 hours as compared to its activity in cases of deliveries being shorter than 4 hours (Tab. 4). On the basis of results of the performed investigations it has been revealed that at the period of intensive divisions of cells, their differentiation (intrauterine period of fetal development) the activity of the inhibitors of phytohemagglutination appearing in body fluids of human being is residual only or does not appear at all. The IfPs activity was intensifying with the progress of intrauterine maturation of the fetus. In the paper closer attention was focussed on the new point of view concerning the role of phytoagglutinins and endogenic lectins as well as their inhibitors in various pathological processes particularly neoplastic ones.

Mesh versus suture repair of umbilical hernia in adults: a randomised, double-blind, controlled, multicentre trial.

PubMed

Kaufmann, Ruth; Halm, Jens A; Eker, Hasan H; Klitsie, Pieter J; Nieuwenhuizen, Jeroen; van Geldere, Dick; Simons, Maarten P; van der Harst, Erwin; van 't Riet, Martijne; van der Holt, Bronno; Kleinrensink, Gert Jan; Jeekel, Johannes; Lange, Johan F

2018-03-03

Both mesh and suture repair are used for the treatment of umbilical hernias, but for smaller umbilical hernias (diameter 1-4 cm) there is little evidence whether mesh repair would be beneficial. In this study we aimed to investigate whether use of a mesh was better in reducing recurrence compared with suture repair for smaller umbilical hernias. We did a randomised, double-blind, controlled multicentre trial in 12 hospitals (nine in the Netherlands, two in Germany, and one in Italy). Eligible participants were adults aged at least 18 years with a primary umbilical hernia of diameter 1-4 cm, and were randomly assigned (1:1) intraoperatively to either suture repair or mesh repair. In the first 3 years of the inclusion period, blocked randomisation (of non-specified size) was achieved by an envelope randomisation system; after this time computer-generated randomisation was introduced. Patients, investigators, and analysts were masked to the allocated treatment, and participants were stratified by hernia size (1-2 cm and >2-4 cm). At study initiation, all surgeons were invited to training sessions to ensure they used the same standardised techniques for suture repair or mesh repair. Patients underwent physical examinations at 2 weeks, and 3, 12, and 24-30 months after the operation. The primary outcome was the rate of recurrences of the umbilical hernia after 24 months assessed in the modified intention-to-treat population by physical examination and, in case of any doubt, abdominal ultrasound. This trial is registered with ClinicalTrials.gov, number NCT00789230. Between June 21, 2006, and April 16, 2014, we randomly assigned 300 patients, 150 to mesh repair and 150 to suture repair. The median follow-up was 25·1 months (IQR 15·5-33·4). After a maximum follow-up of 30 months, there were fewer recurrences in the mesh group than in the suture group (six [4%] in 146 patients vs 17 [12%] in 138 patients; 2-year actuarial estimates of recurrence 3·6% [95% CI 1·4-9·4] vs 11·4% (6·8-18·9); p=0·01, hazard ratio 0·31, 95% CI 0·12-0·80, corresponding to a number needed to treat of 12·8). The most common postoperative complications were seroma (one [<1%] in the suture group vs five [3%] in the mesh group), haematoma (two [1%] vs three [2%]), and wound infection (one [<1%] vs three [2%]). There were no anaesthetic complications or postoperative deaths. This is the first study showing high level evidence for mesh repair in patients with small hernias of diameter 1-4 cm. Hence we suggest mesh repair should be used for operations on all patients with an umbilical hernia of this size. Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands. Copyright © 2018 Elsevier Ltd. All rights reserved.

Pregnancy complicated with Alport syndrome: a good obstetric outcome and failure to diagnose an infant born to a mother with Alport syndrome by umbilical cord immunofluorescence staining.

PubMed

Matsubara, Shigeki; Ueda, Yoshihiko; Takahashi, Hisako; Nagai, Takashi; Kuwata, Tomoyuki; Muto, Shigeaki; Yamaguchi, Takehiko; Takizawa, Toshihiro; Suzuki, Mitsuaki

2009-12-01

Alport syndrome is a familial progressive nephritis. The most frequent type is X-linked Alport syndrome, caused by genetic abnormalities in the alpha 5 chain of type IV collagen. Skin biopsy is a useful tool for diagnosing this disease. It is not well known how this syndrome affects pregnancy and how it is affected by pregnancy, or whether the umbilical cord may provide material for detecting this collagen abnormality. We report a primigravida with Alport syndrome with mild proteinuria who gave birth abdominally to a term male infant without deteriorating renal function during pregnancy. The umbilical cord from not only this infant but also from an Alport (-) control infant showed negative immunofluorescence staining for the alpha 5 chain of type IV collagen. Women with Alport syndrome without renal dysfunction may follow an uneventful obstetrical course until term. The cord may not be suitable for diagnosing Alport syndrome with immunofluorescence staining.

Ultrasound predictors of neonatal outcome in intrauterine growth restriction.

PubMed

Craigo, S D; Beach, M L; Harvey-Wilkes, K B; D'Alton, M E

1996-11-01

Our purpose was to assess the value of commonly performed ultrasound parameters in predicting neonatal outcome of fetuses with intrauterine growth restriction (IUGR). One hundred twenty-seven patients were identified on ultrasound examination to have IUGR. Estimated weight percentile, amniotic fluid volume, umbilical artery Doppler velocimetry, and head circumference/abdominal circumference ratio were compared with neonatal outcome. Thirty infants had severely adverse courses. The degree of growth restriction was strongly associated with adverse outcome and neonatal death. Umbilical artery Doppler waveforms with absent or reverse end-diastolic flow were predicted of neonatal death, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and adverse outcome in general. Oligohydramnios was predictive of adverse outcome and neonatal death. Logistic regression also showed that absent or reverse end-diastolic flow and oligohydramnios were independent predictors of adverse outcome. Ultrasound findings of low estimated weight percentile, absent or reverse end-diastolic umbilical blood flow, and oligohydramnios are independent predictors of adverse neonatal outcome of growth restricted fetuses.

[Plug-technique for umbilical hernia repair in the adult].

PubMed

Brancato, G; Privitera, A; Gandolfo, L; Donati, M; Caglià, P

2002-02-01

Umbilical hernia represents 6% of all abdominal wall hernias in the adult. Surgical repair should always be carried out due to possible occurrence of complications. Aim of this paper is to evaluate the efficacy of the plug-technique. From October 1995 to April 2000, the authors performed 21 operations for acquired umbilical hernia with a defect smaller than 4 cm. Local anesthesia was used and a light intravenous sedation added in particularly anxious patients. The repair was achieved by insertion of a polypropylene dart plug sutured to the margins of the hernial defect. All patients were up and about straightaway and were discharged within 24 hours of surgery. Postoperative pain was mild and required hospital analgesia in only 19% of cases and domiciliary analgesia in 24%. During a follow-up ranging from 6 to 60 months (mean 30), only one recurrence has been recorded. This tension-free technique allows immediate rehabilitation, with few complications and a low recurrence rate.

Intestinal atresia and ectopia in a bovine fetus.

PubMed

Lejeune, B; Miclard, J; Stoffel, M H; Meylan, M

2011-07-01

A 2-year-old Red Holstein cow was presented with uterine torsion at 235 days of pregnancy. The fetus extracted by cesarean section had weak vital signs and marked abdominal distention. An edematous pouch that contained tubular structures with peristaltic activity was associated with the umbilical cord. Because of poor prognosis, both dam and fetus were euthanized. At necropsy, the fetus had severe distention of the forestomachs, abomasum, and proximal small intestine; absence of distal small intestine, cecum, and proximal colon; atresia of the 2 blind ends of the intestine; and atrophy of distal colon and rectum. The tubular structures associated with the umbilical cord were identified as the segments of intestine that were absent in the fetus. Intestinal atresia combined with ectopia may be caused by local ischemia during temporary herniation and rotation of the fetal gut into the extraembryonic coelom. The close connection between ectopic intestine and amniotic sheath of the umbilical cord in this case may have facilitated vascularization and allowed development and viability of the ectopic intestine. © The Authors 2011

Polychlorinated biphenyls in umbilical cord serum of newborns from Rio Grande do Sul state, Brazil.

PubMed

Mohr, Susana; Sifuentes dos Santos, Joice; Schwanz, Thiago Guilherme; Wagner, Roger; Mozzaquatro, Joseane Oliveira; Lorenzoni, Alessandra Scherer; Costabeber, Ijoni Hilda

2015-12-07

Polychlorinated biphenyls (PCBs) are food-chain contaminants that have been shown to contaminate foods worldwide. The newborn are exposed to these organochlorine compounds across the placenta and through breastfeeding. They are proven to be carcinogenic and may contribute to congenital malformation etiology. This study examined levels of five PCB congeners (28, 52, 138, 153 and 180) in umbilical cord serum samples from 148 newborns from Rio Grande do Sul state, Brazil. Serum concentrations of PCBs were analyzed by gas chromatography with electron capture detection and mass spectrometry. Levels of ∑PCBs ranged from 0.35 to 55.17 ng/ml in umbilical cord serum positive samples, and PCB 138 was the most prevalent congener. Only 7.4% of samples presented no PCB congener. Some PCB congener cord serum levels were related to the locale of the mothers' residence, smoking and drinking habits, fruit consumption, and congenital malformation. Copyright © 2015 Elsevier B.V. All rights reserved.

Relationship between the tensile strengths and diameters of human umbilical cords.

PubMed

Fernando, D M G; Gamage, S M K; Ranmohottige, S; Weerakkody, I; Abeyruwan, H; Parakrama, H

2018-05-01

Mothers of alleged infanticides might claim that umbilical cord broke during precipitate delivery causing injuries detected on baby at autopsy. There is paucity of evidence regarding this possibility. The objective of the study was to determine relationship between tensile strength and diameter or weight per unit length of cord. Diameters and weights per unit length of fresh umbilical cords were determined. Tensile strengths were measured by Hounsfield Testing Machine. Relationship between tensile strength versus cord diameter and weight per unit length were analyzed. Of 122 cords, average tensile strength, diameter and weight per centimeter were 50.4 N, 7.73 mm and 6.87 g respectively. The tensile strengths were directly proportional to diameter. There was no association between tensile strength and weight per centimeter. Measurement of the diameter of cord is important during autopsy to predict tensile strength and thereby to presume whether cord could have broken by the weight of the baby. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Mycobacterium fortuitum Infection at Umbilical Hernioplasty Site

PubMed Central

Chogtu, Bharti; Malik, Daliparty Vasudev; Shenoy, Vishnu Prasad

2017-01-01

Non Tuberculous Mycobacteria (NTM) are a group of rapidly growing mycobacteria and are generally considered to be of low virulence. Of late, there has been an increase in incidence of infections due to these organisms. Among them, Mycobacterium fortuitum, M. chelonae and M. abscessus are the common species which have been identified. Though they are occasionally implicated in pulmonary infections, NTM are very commonly associated with cutaneous infections, especially surgical site infections. Identification of NTM infection at such sites should be suspected when there is delayed healing of the wound. Histopathological Examination (HPE) of the wound site may reveal a classical picture of granulomas, epithelioid cells and giant cells which may lead to a suspicion of tuberculosis. It is important to perform mycobacterial culture and sensitivity testing of the wound tissue as this helps to differentiate tuberculous and non tuberculous infections. Here, we present a case of a patient who underwent mesh hernioplasty for umbilical hernia and was diagnosed with M. fortuitum infection at the site of umbilical hernioplasty. PMID:29207758

Global Methylation in the Placenta and Umbilical Cord Blood From Pregnancies With Maternal Gestational Diabetes, Preeclampsia, and Obesity

PubMed Central

Lambertini, Luca; Rialdi, Alexander; Lee, MenJean; Mystal, Elana Ying; Grabie, Mordy; Manaster, Isaac; Huynh, Nancy; Finik, Jackie; Davey, Mia; Davey, Kei; Ly, Jenny; Stone, Joanne; Loudon, Holly; Eglinton, Gary; Hurd, Yasmin; Newcorn, Jeffrey H.; Chen, Jia

2014-01-01

Emerging evidence indicates that maternal medical risk during pregnancy, such as gestational diabetes mellitus (GDM), preeclampsia, and obesity, predisposes the offspring to suboptimal development. However, the underlying biological/epigenetic mechanism in utero is still unknown. The current pilot study (N = 50) compared the levels of global methylation in the placenta and umbilical cord blood among women with and without each risk condition (GDM, preeclampsia, and obesity) and explored whether the levels of global methylation were associated with fetal/infant growth. Results show that global methylation levels in the placenta were lower in patients with gestational diabetes (P = .003) and preeclampsia (P = .05) but higher with obesity (P = .01). Suggestive negative associations were found between global methylation level in the placenta and infant body length and head circumference. While preliminary, it is possible that the placenta tissue, but not umbilical cord blood, may be epigenetically programmed by maternal GDM, preeclampsia, and obesity to carry out its own specific functions that influence fetal growth. PMID:23765376

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. The test team gathered for an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. Patrick Simpkins, director of Engineering, speaks to the test team during an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. The test team gathered with a special banner during an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. One of the test team members signs a banner during an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Service Module Umbilical (OSMU) Testing Complete

NASA Image and Video Library

2016-10-19

Testing of the Orion Service Module Umbilical (OSMU) was completed at the Launch Equipment Test Facility at NASA’s Kennedy Space Center in Florida. The OSMU was attached to Vehicle Motion Simulator 1 for a series of simulated launch tests to validate it for installation on the mobile launcher. The test team signed a special banner during an event to mark the end of testing. The mobile launcher tower will be equipped with a number of lines, called umbilicals that will connect to the Space Launch System rocket and Orion spacecraft for Exploration Mission-1 (EM-1). The OSMU will be located high on the mobile launcher tower and, prior to launch, will transfer liquid coolant for the electronics and air for the Environmental Control System to the Orion service module that houses these critical systems to support the spacecraft. Kennedy's Engineering Directorate is providing support to the Ground Systems Development and Operations Program for testing of the OSMU. EM-1 is scheduled to launch in 2018.

Orion Crew Module / Service Module Structural Weight and Center of Gravity Simulator and Vehicle Motion Simulator Hoist Structure for Orion Service Module Umbilical Testing

NASA Technical Reports Server (NTRS)

Ascoli, Peter A.; Haddock, Michael H.

2014-01-01

An Orion Crew Module Service Module Structural Weight and Center of Gravity Simulator and a Vehicle Motion Simulator Hoist Structure for Orion Service Module Umbilical Testing were designed during a summer 2014 internship in Kennedy Space Centers Structures and Mechanisms Design Branch. The simulator is a structure that supports ballast, which will be integrated into an existing Orion mock-up to simulate the mass properties of the Exploration Mission-1 flight vehicle in both fueled and unfueled states. The simulator mimics these configurations through the use of approximately 40,000 lbf of steel and water ballast, and a steel support structure. Draining four water tanks, which house the water ballast, transitions the simulator from the fueled to unfueled mass properties. The Ground Systems Development and Operations organization will utilize the simulator to verify and validate equipment used to maneuver and transport the Orion spacecraft in its fueled and unfueled configurations. The second design comprises a cantilevered tripod hoist structure that provides the capability to position a large Orion Service Module Umbilical in proximity to the Vehicle Motion Simulator. The Ground Systems Development and Operations organization will utilize the Vehicle Motion Simulator, with the hoist structure attached, to test the Orion Service Module Umbilical for proper operation prior to installation on the Mobile Launcher. Overall, these two designs provide NASA engineers viable concepts worthy of fabricating and placing into service to prepare for the launch of Orion in 2017.

Potential substitution of cord blood for infant blood in the neonatal sepsis evaluation.

PubMed

Hansen, Anne; Forbes, Peter; Buck, Rosanne

2005-01-01

Evaluation of sepsis accounts for one third of all nursery triage admissions. If umbilical cord blood could be accurately substituted for infant blood, it would spare infants the discomfort of an invasive procedure and save both time and resources. While awaiting 48-hour blood culture results, we decide on clinical management based on whether the white blood cell (WBC) immature to total (I:T) granulocyte ratio is >or=0.2. Our goal was to assess the correlation of complete blood count (CBC), I:T ratio and blood culture results between umbilical cord and infant blood. We conducted a prospective cohort study comparing CBC/differential and blood culture results of paired samples of umbilical cord and infant blood from term newborns. We sent 113 paired samples of cord and infant venous blood for CBC/differential and blood culture. All 113 umbilical cord and infant blood cultures were negative, yielding a false-positive blood culture rate of zero. For 92% of babies, both the cord and infant blood I:T ratio were <0.2 or both were >or=0.2. Cord and infant WBC, hematocrit and platelet counts were moderately to highly correlated. We conclude that cord blood can be safely substituted for infant blood in routine sepsis evaluations of asymptomatic, term infants based on both the low false-positive cord blood culture rate and the significant association between high I:T ratios in cord and infant blood. Copyright (c) 2005 S. Karger AG, Basel.

Effective conservative treatment of umbilical pilonidal sinus disease: Silver nitrate? Salt?

PubMed

Sözen, Selim; Kanat, Burhan Hakan; Kanat, Zekiye; Bali, Ilhan; Polat, Yilmaz

2015-01-01

The aim of this study was to compare the three different treatment methods and investigate The effectiveness of the therapeutic effect of common salt. This retrospective study involved patients who were treated in our clinic for umbilical pilonidal sinus disease between January 2010 and December 2011. The patients were divided to three subgroups according to treatment methods. Group I: Cases treated with only local debridement and systemic antibiotic, group II: cases treated with local debridement, systemic antibiotic and silver nitrate, group 3: cases treated with debridement, systemic antibiotic and salt. In this study, 63 patients with the diagnosis of UPS were treated in our clinic. The patients were classified into three groups; group I included 20 patients, group II included 18 patients and group III included 18 patients. During 16-24 months of follow-up, 4 (20%) recurrences in group1 and 2 (11.1%) recurrences in group 2 were detected. Recurrence rate of group 3 was significantly different (5.55%) when compared to group 2. The mean period for returning to daily activities and work was 1 day for the patients. In conclusion, we suggest that pilonidal sinus cases which are not complicated by abcess and cellulitis can be treated by local removal of umbilical hairs, debridement and dressing without surgery. We conclude that application of common salt (table/ cooking salt) to umbilical pilonidal sinus with granuloma is a simple and highly effective way of treatment without any relapse and complications. Conservative treatment, Local debridement, Umblical pilonidal sinus.

Postnatal extra-embryonic tissues as a source of multiple cell types for regenerative medicine applications.

PubMed

Gubar, O S; Rodnichenko, A E; Vasyliev, R G; Zlatska, A V; Zubov, D O

2017-09-01

We aimed to isolate and characterize the cell types which could be obtained from postnatal extra-embryonic tissues. Fresh tissues (no more than 12 h after delivery) were used for enzymatic or explants methods of cell isolation. Obtained cultures were further maintained at 5% oxygen. At P3 cell phenotype was assessed by fluorescence-activated cell sorting, population doubling time was calculated and the multilineage differentiation assay was performed. We have isolated multiple cell types from postnatal tissues. Namely, placental mesenchymal stromal cells from placenta chorionic disc, chorionic membrane mesenchymal stromal cells (ChM-MSC) from free chorionic membrane, umbilical cord MSC (UC-MSC) from whole umbilical cord, human umbilical vein endothelial cells (HUVEC) from umbilical vein, amniotic epithelial cells (AEC) and amniotic MSC (AMSC) from amniotic membrane. All isolated cell types displayed high proliferation rate together with the typical MSC phenotype: CD73 + CD90 + CD105 + CD146 + CD166+CD34 - CD45 - HLA-DR - . HUVEC constitutively expressed key markers CD31 and CD309. Most MSC and AEC were capable of osteogenic and adipogenic differentiation. We have shown that a wide variety of cell types can be easily isolated from extra-embryonic tissues and expanded ex vivo for regenerative medicine applications. These cells possess typical MSC properties and can be considered an alternative for adult MSC obtained from bone marrow or fat, especially for allogeneic use.

Prospective Observational Study of Single-Site Multiport Per-umbilical Laparoscopic Endosurgery versus Conventional Multiport Laparoscopic Cholecystectomy: Critical Appraisal of a Unique Umbilical Approach

PubMed Central

Jategaonkar, Priyadarshan Anand; Yadav, Sudeep Pradeep

2014-01-01

Purpose. This prospective observational study compares an innovative approach of Single-Site Multi-Port Per-umbilical Laparoscopic Endo-surgery (SSMPPLE) cholecystectomy with the gold standard—Conventional Multi-port Laparoscopic Cholecystectomy (CMLC)—to assess the feasibility and efficacy of the former. Methods. In all, 646 patients were studied. SSMPPLE cholecystectomy utilized three ports inserted through three independent mini-incisions at the umbilicus. Only the day-to-day rigid laparoscopic instruments were used in all cases. The SSMPPLE cholecystectomy group had 320 patients and the CMLC group had 326 patients. The outcomes were statistically compared. Results. SSMPPLE cholecystectomy had average operative time of 43.8 min and blood loss of 9.4 mL. Their duration of hospitalization was 1.3 days (range, 1–5). Six patients (1.9%) of this group were converted to CMLC. Eleven patients had controlled gallbladder perforations at dissection. The Visual Analogue Scores for pain on postoperative days 0 and 7, the operative time, and the scar grades were significantly better for SSMPPLE than CMLC. However, umbilical sepsis and seroma outcomes were similar. We had no bile-duct injuries or port-site hernias in this study. Conclusion. SSMPPLE cholecystectomy approach complies with the principles of laparoscopic triangulation; it seems feasible and safe method of minimally invasive cholecystectomy. Overall, it has a potential to emerge as an economically viable alternative to single-port surgery. PMID:24876955

Phloretin attenuates hyperuricemia-induced endothelial dysfunction through co-inhibiting inflammation and GLUT9-mediated uric acid uptake.

PubMed

Liu, Shuyun; Yuan, Yujia; Zhou, Yijie; Zhao, Meng; Chen, Younan; Cheng, Jingqiu; Lu, Yanrong; Liu, Jingping

2017-10-01

Hyperuricemia is an important risk factor for cardiovascular and renal diseases. Phloretin had shown antioxidant and anti-inflammatory properties, but its role in endothelial injury is rarely reported. In this study, we aimed to investigate the protective effect of phloretin on UA-induced injury in human umbilical vein endothelial cells. The effects of UA and phloretin on cell viability, inflammation, THP-1 monocyte adhesion, endothelial cell tube formation, GLUT9 expression and UA uptake in human umbilical vein endothelial cells were evaluated. The changes of nuclear factor-kappa B/extracellular regulated protein kinases signalling were also analysed. Our results showed that UA reduced cell viability and tube formation, and increased inflammation and monocytes adhesion in human umbilical vein endothelial cells in a dose-dependent manner. In contrast, phloretin significantly attenuated pro-inflammatory factors expression and endothelial injury induced by UA. Phloretin inhibited the activation of extracellular regulated protein kinases/nuclear factor-kappa B pathway, and reduced GLUT9 and it mediated UA uptake in human umbilical vein endothelial cells. These results indicated that phloretin attenuated UA-induced endothelial injury via a synergic mechanism including direct anti-inflammatory effect and lowering cellular UA uptake. Our study suggested that phloretin might be a promising therapy for hyperuricemia-related cardiovascular diseases. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

Effect of human umbilical cord mesenchymal stem cells transplantation on nerve fibers of a rat model of endometriosis.

PubMed

Chen, Yan; Li, Dong; Zhang, Zhe; Takushige, Natsuko; Kong, Bei-Hua; Wang, Guo-Yun

2015-01-01

Endometriosis is a common, benign, oestrogen-dependent, chronic gynaecological disorder associated with pelvic pain and infertility. Some researchers have identified nerve fibers in endometriotic lesions in women with endometriosis. Mesenchymal stem cells (MSCs) have attracted interest for their possible use for both cell and gene therapies because of their capacity for self-renewal and multipotentiality of differentiation. We investigated how human umbilical cord-MSCs (hUC-MSCs) could affect nerve fibers density in endometriosis. In this experimental study, hUC-MSCs were isolated from fresh human umbilical cord, characterized by flow cytometry, and then transplanted into surgically induced endometriosis in a rat model. Ectopic endometrial implants were collected four weeks later. The specimens were sectioned and stained immunohistochemically with antibodies against neurofilament (NF), nerve growth factor (NGF), NGF receptor p75 (NGFRp75), tyrosine kinase receptor-A (Trk-A), calcitonin gene-related peptide (CGRP) and substance P (SP) to compare the presence of different types of nerve fibers between the treatment group with the transplantation of hUC-MSCs and the control group without the transplantation of hUC-MSCs. There were significantly less nerve fibers stained with specific markers we used in the treatment group than in the control group (p<0.05). MSC from human umbilical cord reduced nerve fiber density in the treatment group with the transplantation of hUC-MSCs.

Study of Umbilical Cord Blood Culture in Diagnosis of Early-onset Sepsis Among Newborns with High-risk Factors.

PubMed

Kalathia, Mitul Babubhai; Shingala, Prakash Ashokbhai; Parmar, Parin Niranjanbhai; Parikh, Yogesh Narenedrabhai; Kalathia, Ila Mitulkumar

2013-10-01

Blood culture is gold standard for diagnosis of neonatal sepsis. Low sensitivity of blood culture is usually due to small volume of blood sample, intrapartum antibiotics, and antibiotics given to newborn before sampling. We evaluated use of Umbilical cord blood culture (UCBC) in diagnosis of neonatal sepsis as compared to peripheral venous blood culture. This study was done in tertiary care teaching hospital during May-June 2012. A total of 45 newborns with presence of two or more risk factors of sepsis were included. Blood sample from placental end of umbilical cord was collected and cultured. Primary outcome was diagnosis of neonatal sepsis by use of umbilical cord blood sample as compared with venous blood sample. Secondary outcome was to compare organisms identified by UCBC and venous blood culture. Sensitivity, specificity, positive and negative predictive values of UCBC were calculated. A total of 24.44% (11 out of 45) high-risk newborns had positive UCBC. A total of 17.8% (8 out of 45) newborns had positive blood culture report. Organisms grown in UCBC were Pseudomonas (45%, 5 out of 11), Acinetobacter (27.27%, 3 out of 11), Escherichia coli (18.18%, 2 out of 11), and Klebsiella (9%, 1 out of 11). UCBC is a good method for diagnosis of neonatal sepsis among high-risk newborns as compared to venous blood culture with a sensitivity of 80% and specificity of 91.43%. Organisms grown are comparable to blood culture samples.

Percutaneous ultrasound-guided vs. intraoperative rectus sheath block for pediatric umbilical hernia repair: A randomized clinical trial.

PubMed

Litz, Cristen N; Farach, Sandra M; Fernandez, Allison M; Elliott, Richard; Dolan, Jenny; Patel, Nikhil; Zamora, Lillian; Colombani, Paul M; Walford, Nebbie E; Amankwah, Ernest K; Snyder, Christopher W; Danielson, Paul D; Chandler, Nicole M

2017-06-01

Regional anesthesia is commonly used in children. Our hypothesis was that percutaneous ultrasound-guided (PERC) rectus sheath blocks would result in lower postoperative pain scores compared to intraoperative (IO) rectus sheath blocks following umbilical hernia repair. A single-institution randomized blinded trial was conducted in pediatric patients undergoing elective umbilical hernia repair. The primary outcome was mean postoperative Wong-Baker pain score. Secondary outcomes included narcotic requirements and length of postoperative stay. Fifty-eight patients were included: 28 PERC and 30 IO. Operating room time was significantly longer in the PERC group (41 vs. 35min, p<0.01). Mean postoperative pain scores (PERC-2.6 vs. IO-3.3, p=0.11), morphine equivalents intraoperatively (PERC-0 vs. IO-0.04mg/kg, p=0.29) and postoperatively (PERC-0.04 vs. IO-0.09mg/kg, p=0.17), time to first postoperative narcotic dose (PERC-30 vs. IO-22min, p=0.33, log-rank test), and postoperative length of stay (PERC-76 vs. IO-80min, p=0.44) were similar. Following umbilical hernia repair in children, percutaneous ultrasound-guided and intraoperative rectus sheath blocks resulted in similar mean postoperative pain scores. There were no differences in secondary outcomes such as time to first narcotic, narcotic requirements, and length of stay. The additional resources required to complete a percutaneous ultrasound-guided rectus sheath block may not be warranted. Randomized controlled trial. Level I. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of feline uterine and umbilical arteries blood flow in a pharmacologically induced abnormal gestation model.

PubMed

Blanco, P G; Vercellini, R; Rube, A; Rodríguez, R; Arias, D O; Gobello, C

2016-12-01

The aim of this study was to describe resistance index (RI) and systolic/diastolic ratio (S/D ratio) of uterine and umbilical arteries in an experimental model of abnormal pregnancy in felids. On days 30 to 35 (32 ± 2.9) after mating, 20 domestic short-hair pregnant queens were randomly assigned to one of the following treatment groups: a treated group (TG; n = 8), which received 10 mg/kg of aglepristone subcutaneously twice, 24 hours apart, and a control nontreated group (CG; n = 12). M-mode and Doppler ultrasonographic evaluations were performed at the initiation of the treatment (Day 0) and then every other day during 8 days. In both groups, uterine and umbilical arteries were evaluated by Doppler ultrasound, whereas fetal heart rate was assessed by M-mode ultrasound. Resistance index of uterine artery augmented in TG from Day 2 onward, conversely it decreased in CG (P < 0.01). On Day 8, RI values were 0.64 ± 0.05 vs 0.37 ± 0.01 for TG and CG, respectively. Additionally, S/D ratio of the same artery presented an increase in TG, whereas this ratio diminished in CG (P < 0.01). On Day 8, this parameter showed values of 2.98 ± 0.4 vs 1.62 ± 0.06 for TG and CG, respectively. Resistance index of umbilical artery remained almost unchanged in TG from Day 6 onward, whereas it progressively decreased in CG throughout the course of the study (P < 0.05). On Day 8, RI were 0.89 ± 0.04 and 0.82 ± 0.01, for TG and CG, respectively. Furthermore, on Day 8, S/D ratio of umbilical artery progressively diminished in CG but not in TG (P < 0.01), being 14.7 ± 9.1 vs 5.9 ± 0.3 for TG and CG, respectively. Fetal heart rate was higher in TG than in CG (P < 0.05). Group differences in Doppler parameters appeared on Day 2, when the other clinical or ultrasonographic signs were still absent. It is concluded that blood flow of the uterine and umbilical arteries differed between these normal and abnormal gestations predicting an adverse obstetric outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

A study report of 174 units of placental umbilical cord whole blood transfusion in 62 patients as a rich source of fetal hemoglobin supply in different indications of blood transfusion.

PubMed

Bhattacharya, N; Mukherijee, K; Chettri, M K; Banerjee, T; Mani, U; Bhattacharya, S

2001-01-01

In the animal kingdom, even herbivorous animals swallow the placenta after the birth of the baby (for example, the cow). In the human system, we do not know about the proper utilization of the placenta and membranes although there are suggestions regarding this on the basis of research on placental umbilical cord blood stem cells as an alternative to bone marrow transplantation. In this present series of placental umbilical cord whole blood transfusions, we wanted to examine the safety aspect of other components of cord blood transfusion, e.g., fetal RBC, growth factors and cytokine filled plasma, etc., in different indications of blood transfusion, from the pediatric to the geriatric age group, in malignant and non-malignant disorders affecting our patients. One hundred and seventy-four units of umbilical cord whole blood were collected aseptically from the umbilical vein after caesarean section in standard pediatric blood transfusion bags, after the removal of the baby from the operative field and after confirming the stable condition of the mother. The volume of cord blood varied from 50 ml to 140 ml with a mean of 86 ml+/-16 ml. The cord blood was transfused immediately (within three days of collection) to 62 patients from nine years to 78 years of age, of whom 32 were suffering from varying stages and grades of malignancy from 1 April 1999 till date i.e., 11 Aug 2000, after obtaining adequate consent and following the precautions of standard blood transfusion protocol. The remaining 30 patients included patients suffering from thalassemia major, aplastic anemia, systemic lupus erythematosus, chronic renal failure, rheumatoid arthritis, ankylosing spondylitis and a geriatric group of patients with benign prostatic hypertrophy. All have tolerated the procedure without any immunological or non-immunological reactions. On the basis of our experience with 174 units of placental umbilical cord whole blood transfusion in malignant and non-malignant conditions (within three days of collection and preservation at 1-6 degrees C in a refrigerator), we are of the opinion that this is a safe transfusion protocol which takes advantage of the safety of nature's finest biological sieve, i.e., the placenta, as an alternative to adult whole blood transfusion. It also has the advantage of a higher oxygen carrying capacity of fetal hemoglobin in addition to many growth factors and other cytokine filled cord blood plasma along with its hypoantigenicity.

The Iberian Peninsula in the Atlantic Community: Problems and Prospects.

DTIC Science & Technology

1983-05-09

Militares - Terceiro Encontro de Estudos Militares, 1979, pp. 23-24. 9. Horacio Rivero, "Spain: Free World Asset", Strategic Review, Spring 1976, p...34, Instituto de Altos Estudos Militares - Terceiro Encontro de Estudos Militares, 1979, pp. 66-68. 16. Thomas Carothers, "Spain, NATO and Democracy", The