PMID- 23721663
OWN - NLM
STAT- MEDLINE
DCOM- 20140508
LR  - 20141120
IS  - 1743-9159 (Electronic)
IS  - 1743-9159 (Linking)
VI  - 11
IP  - 7
DP  - 2013
TI  - Pulmonary alveolar and vascular morphometry after gel plug occlusion of the 
      trachea in a fetal rabbit model of CDH.
PG  - 558-61
LID - S1743-9191(13)00147-7 [pii]
LID - 10.1016/j.ijsu.2013.05.033 [doi]
AB  - PURPOSE: Tracheal occlusion (TO) induces lung growth in congenital diaphragmatic 
      hernia (CDH) but is also associated with drawbacks. We devised a temporary gel 
      plug that induced lung growth when placed in the fetal trachea. This study 
      evaluates the effects of temporary versus permanent TO on histologic radial 
      alveolar count (RAC) and vascular morphometrics. METHODS: Experimental CDH was 
      created surgically in 64 New Zealand White rabbit fetuses on gestational day (GD) 
      24. On GD 27, these fetuses were randomized to intratracheal instillation of a 
      fibrin gel plug (GP), tracheal suture ligation (SL), intratracheal instillation 
      of normal saline (NS), or sham amniotomy (SH). Non-manipulated fetuses served as 
      controls (NM). Histologic lung sections were assessed blindly for RAC and 
      relative arterial adventitial thickness (%AT) as a variable for vascular 
      remodelling. Results were statistically compared. RESULTS: RAC was significantly 
      lower in the ipsilateral lung of SH fetuses than in the contralateral lung 
      (p = 0.011). Mean RAC was higher after SL (p < 0.001) and GP (p = 0.03) compared 
      to SH. Furthermore, %AT was higher in GP (50 +/- 28, p < 0.001) and SL (45 +/-2 6, 
      p = 0.003) fetuses than in controls (36 +/- 19). CONCLUSION: Temporary and 
      permanent TO leads to increased RAC; this effect was more pronounced with 
      permanent TO. Both interventions were associated with an increased %AT. These 
      findings may explain the adverse clinical effects of TO, despite causing 
      accelerated lung growth.
CI  - Copyright (c) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights 
      reserved.
FAU - Elattal, Ramy
AU  - Elattal R
AD  - Division of Pediatric Surgery, Weill Cornell Medical College, New York, NY 10065, 
      USA.
FAU - Rich, Barrie S
AU  - Rich BS
FAU - Harmon, Carroll M
AU  - Harmon CM
FAU - Muensterer, Oliver J
AU  - Muensterer OJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130527
PL  - United States
TA  - Int J Surg
JT  - International journal of surgery (London, England)
JID - 101228232
RN  - 0 (Gels)
RN  - 9001-31-4 (Fibrin)
SB  - IM
MH  - Animals
MH  - Arteries/growth & development/physiology
MH  - Disease Models, Animal
MH  - Fetal Therapies/*methods
MH  - Fetus/physiology/surgery
MH  - Fibrin/administration & dosage
MH  - Gels/administration & dosage
MH  - Hernia, Diaphragmatic/surgery
MH  - *Hernias, Diaphragmatic, Congenital
MH  - Lung/blood supply/embryology/growth & development
MH  - Pulmonary Alveoli/embryology/*growth & development/physiology
MH  - Rabbits
MH  - Random Allocation
MH  - Therapeutic Occlusion/*methods
MH  - Trachea/*surgery
OTO - NOTNLM
OT  - Adventitial thickness
OT  - Congenital diaphragmatic hernia
OT  - Gel plug
OT  - Radial alveolar count
OT  - Tracheal occlusion
EDAT- 2013/06/01 06:00
MHDA- 2014/05/09 06:00
CRDT- 2013/06/01 06:00
PHST- 2013/02/02 00:00 [received]
PHST- 2013/05/14 00:00 [revised]
PHST- 2013/05/19 00:00 [accepted]
PHST- 2013/06/01 06:00 [entrez]
PHST- 2013/06/01 06:00 [pubmed]
PHST- 2014/05/09 06:00 [medline]
AID - S1743-9191(13)00147-7 [pii]
AID - 10.1016/j.ijsu.2013.05.033 [doi]
PST - ppublish
SO  - Int J Surg. 2013;11(7):558-61. doi: 10.1016/j.ijsu.2013.05.033. Epub 2013 May 27.