Preliminary study on the value of fetal MRI lung volume and mediastinal shift angle for predicting prognosis of left congenital diaphragmatic hernia / 中华放射学杂志

Objective:To explore the value of fetal lung volume and mediastinal shift angle (MSA) based on fetal MRI in predicting the prognosis of congenital diaphragmatic hernia (CDH).Methods:Fetuses with left CDH that did fetal MRI in Xinhua Hospital Affiliated with Shanghai Jiao Tong University School of Medicine from September 2016 to January 2022 were retrospectively collected. There were 65 patients, and their gestational age was 29 (26, 35) weeks when they were diagnosed with left CDH by MRI. Observed fetal lung volume and MSA were measured based on fetal MRI, and observed/expected lung volume (o/eFLV) based on gestational age was calculated. The clinical data were collected from birth to discharge, and patients were divided into survival group and death group in case of prognosis at discharge, with 54 cases in the survival group and 11 cases in the death group. The student′s t test was used to compare the difference of o/eFLV and MSA between the survival group and the death group, and the receiver operating characteristic (ROC) curve was used to evaluate the value of o/eFLV and MSA in predicting the prognosis of left CDH. Results:The o/eFLV of the survival group was 51.5%±18.3%, higher than that of the death group (27.8%±4.4%), and the difference was significant ( t=8.29, P<0.001). The MSA of the survival group was 33.1°±1.2°, lower than that of the death group (41.8°±2.7°), and the difference was significant ( t=-11.15, P<0.001). The area under the ROC curve (AUC) of o/eFLV to predict the fetal survival or death was 0.939 (95%CI 0.851-0.983), the cutoff value was 33.8%, the sensitivity was 100%, the specificity was 88.9%. The AUC of MSA was 0.998 (95%CI 0.941-1.000), the cutoff value was 37.2°, the sensitivity was 100%, the specificity was 98.2%. Conclusions:The o/eFLV and MSA that were measured based on fetal MRI can effectively predict the fetus′s prognosis with left CDH.

Maduración pulmonar fetal en diabetes mellitus pregestacional y complicaciones crónicas / Fetal lung maturation in pregestational diabetes mellitus and chronic complications

Las pacientes embarazadas con diabetes mellitus (DM) pregestacional y complicaciones micro y macroangiopáticas tienen mayor riesgo de empeoramiento de las mismas y de presentar otros trastornos asociados al embarazo. La progresión de la retinopatía diabética ocurre durante el embarazo y el posparto. La nefropatía se asocia con un mayor riesgo de preeclampsia, parto prematuro, restricción del crecimiento fetal y mortalidad perinatal. Cuando hay enfermedad de arterias coronarias o gastroparesia se observa un aumento de la morbilidad materna y fetal. El parto prematuro es una condición prevalente en pacientes con DM. La maduración pulmonar fetal con corticosteroides fue extensamente estudiada, con numerosas pruebas controladas, hasta convertirse en una de las más importantes terapias prenatales basadas en evidencias para reducir la mortalidad perinatal y el síndrome de dificultad respiratoria, la hemorragia intraventricular y la enterocolitis necrosante en los niños prematuros. Sin embargo, en dicha evidencia no se han incluido a embarazadas con DM, por lo cual no se conocen resultados perinatales en este grupo de pacientes.

Pregnant patients with pregestational diabetes mellitus (DM) and micro and macroangiopathic complications have a higher risk of their worsening and of presenting other pregnancyassociated disorders. The progression of diabetic retinopathy occurs during pregnancy and postpartum. Nephropathy is associated with an increased risk of preeclampsia, preterm delivery, fetal growth restriction, and perinatal mortality. When there is coronary artery disease or gastroparesis, an increase in maternal and fetal morbidity is observed Preterm delivery is a prevalent condition in diabetic patients. Corticosteroid fetal lung maturation has been extensively studied, with numerous controlled trials, to become one of the most important evidence-based prenatal therapies to reduce perinatal mortality and decrease respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis, in premature infants. Nevertheless, this evidence did not include patients with DM, for this reason perinatal results are not known in this group of patients.

Maduración pulmonar fetal en diabetes mellitus pregestacional y complicaciones crónicas / Fetal lung maturation in pregestational diabetes mellitus and chronic complications

Resumen Las pacientes embarazadas con diabetes mellitus (DM) pregestacional y complicaciones micro y macroangiopáticas tienen mayor riesgo de empeoramiento de las mismas y de presentar otros trastornos asociados al embarazo. La progresión de la retinopatía diabética ocurre durante el embarazo y el posparto. La nefropatía se asocia con un mayor riesgo de preeclampsia, parto prematuro, restricción del crecimiento fetal y mortalidad perinatal. Cuando hay enfermedad de arterias coronarias o gastroparesia se observa un aumento de la morbilidad materna y fetal. El parto prematuro es una condición prevalente en pacientes con DM. La maduración pulmonar fetal con corticosteroides fue extensamente estudiada, con numerosas pruebas controladas, hasta convertirse en una de las más importantes terapias prenatales basadas en evidencias para reducir la mortalidad perinatal y el síndrome de dificultad respiratoria, la hemorragia intraventricular y la enterocolitis necrosante en los niños prematuros. Sin embargo, en dicha evidencia no se han incluido a embarazadas con DM, por lo cual no se conocen resultados perinatales en este grupo de pacientes.

Abstract Pregnant patients with pregestational diabetes mellitus (DM) and micro and macroangiopathic complications have a higher risk of their worsening and of presenting other pregnancyassociated disorders. The progression of diabetic retinopathy occurs during pregnancy and postpartum. Nephropathy is associated with an increased risk of preeclampsia, preterm delivery, fetal growth restriction, and perinatal mortality. When there is coronary artery disease or gastroparesis, an increase in maternal and fetal morbidity is observed Preterm delivery is a prevalent condition in diabetic patients. Corticosteroid fetal lung maturation has been extensively studied, with numerous controlled trials, to become one of the most important evidence-based prenatal therapies to reduce perinatal mortality and decrease respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis, in premature infants. Nevertheless, this evidence did not include patients with DM, for this reason perinatal results are not known in this group of patients.

Histogenesis Of Human Lung - Retrospective Fetal Autopsy Study

Histogenesis of human fetal lung was studied in 40 human fetuses under light microscope after sectioning andstaining with hematoxylin & eosin stain, in fetuses with gestational age ranging from 10 weeks to fetuses above30 weeks. Appearance of various levels of bronchi were identified with the changes in the epithelium at differentlevels of bronchi. The appearance of alveolar ducts and few alveoli were recognized after 25 weeks of gestation.Vascularisation of the fetal lung was observed as early as 10 weeks of gestation. Appearance of various levels ofbronchi were identified with the changes in the epithelium at different ages of gestation

Protective effect of omega 3 and vitamin D in preventing lung-tissue damage of newborn rats exposed to cigarette smoke during intrauterine period / Efecto protector de omega 3 y vitamina D en la prevención del daño en el tejido pulmonar de ratas recién nacidas expuestas al humo del cigarrillo durante el período intrauterino

SUMMARY: This study aimed to investigate the toxic effects of cigarette smoke exposure on lung and the protective role of Omega 3 and Vitamin D against these toxic effects biochemically and histologically. 28 pregnant Wistar Albino rats were divided into four groups. The first group was control group; the second group was exposed to smoke of 10 cigarette by puff device 2 hours/day after pregnancy; the third group was exposed to cigarette smoke together with Omega 3 (0.5 mg/kg/day) and the fourth group was exposed to cigarette smoke together with vitamin D (42 microgram/kg/day). Finally, lung tissue sections of the newborn rats were stained with Hemotoxilen eosine and Masson tricromite. Malondialdehyde (MDA) and Fluorescent Oxidation Products (FOU) levels were measured. Fetal weights and the number of fetuses were significantly lower in the group received only cigarette smoke (both p<0.001). Histopathologically, pulmonary volume, number of developed alveols and parenchyma elasticity decreased significantly, meanwhile interstitial tissue increased, elastin and collagen did not develop adequately. Histopathologic changes significantly decreased in the group given Omega 3 and Vitamin D. Statistically, MDA and FOU levels were found to be higher in the group exposed to cigarette smoke compared to the control group, and MDA and FOU levels were lower in the group given Omega 3 along with cigarette smoke (p<0.001). Cigarette smoke caused histologically significant damage to fetal lung tissue, oxidative stress and increased MDA and FOU levels. This damage was significantly reduced with Omega 3 and Vitamine D supplementation. Omega 3 is an important antioxidant; vitamin D has no significant antioxidant effect.

RESUMEN: Este estudio tuvo como objetivo investigar los efectos tóxicos de la exposición al humo de cigarrillo en el pulmón, y el papel protector de Omega 3 y la Vitamina D contra esos efectos. 28 ratas Wistar albino preñadas fueron separadas en cuatro grupos. El primer grupo grupo control; el segundo grupo estuvo expuesto al humo de 10 cigarrillos por dispositivo de inhalación 2 horas / día después de la preñez; el tercer grupo se expuso al humo del cigarrillo junto con Omega 3 (0,5 mg / kg / día) y el cuarto grupo se expuso al humo del cigarrillo junto con vitamina D (42 microgramos / kg / día). Secciones de tejido pulmonar de las ratas recién nacidas se tiñeron con Hematoxilina Eosina y tricrómico de Masson. Se midieron los niveles de malondialdehído (MDA) y productos de oxidación fluorescente (POF). Los pesos fetales y el número de fetos fueron significativamente más bajos en el grupo que recibió solamente humo de cigarrillo (ambos p <0,001). Histopatológicamente, el volumen pulmonar, el número de alveolos desarrollados y la elasticidad del parénquima disminuyeron significativamente; mientras que el tejido intersticial aumentó y la elastina y el colágeno no se desarrollaron adecuadamente. Los cambios histopatológicos disminuyeron significativamente en el grupo que recibió Omega 3 y Vitamina D. Estadísticamente, se encontró que los niveles de MDA y POF eran más altos en el grupo expuesto al humo de cigarrillo en comparación con el grupo control, además los niveles de MDA y POF fueron más bajos en el grupo que recibió Omega 3 junto con el humo del cigarrillo (p <0,001). El humo del cigarrillo causó daños histológicamente significativos en el tejido pulmonar fetal, el estrés oxidativo y el aumento de los niveles de MDA y FOU. Este daño se redujo significativamente con los suplementos de Omega 3 y Vitamina D. El omega 3 es un importante antioxidante; la vitamina D no tiene ningún efecto antioxidante significativo.

Morphological Study Of Fissure And Lobes In Fetal Lungs

Background: The lungs are the essential organs of respiration which are divided into lobes and fissures. Fissureshelp in a more uniform expansion of lungs. Knowledge about the fissures is helpful in appreciation of lobaranatomy and for locating bronchopulmonary segments and it is important for anatomists, pediatrician,radiologists, cardiothoracic surgeons and also for clinicians.Materials and methods: 50 spontaneously aborted fetuses were collected from labour room of Obstretrics andGynaecology Department of PSG Institute of Medical Science and Research Centre, Coimbatore and the study wasconducted in the Department of Anatomy. The morphological details of fissures and lobes of the lungs andpresence of any variation in the fissures and accessory fissure were studied.Results: Out of 50 specimens in the age group of 10 weeks to 39 weeks of gestation, the horizontal fissure wasincomplete in 35 fetuses (68%), complete in 14 fetuses (28%), absent in 1 fetus (2%) and accessory fissure wasfound in 1 fetus (2%).Conclusion: Awareness of the variations in the lobes and fissures of the lungs is important for radiologists forproper diagnosis and to surgeons for performing segmental lung resections.

Effects of angiogenic factors on lung development in rats with congenital esophageal atresia / 国际儿科学杂志

Objective To investigate the gene expression of Efnb2 and Ephb4 in the lung tissue of congenital esophageal atresia and tracheoesophageal fistula(EA-TEF) rat,and to explore the effect on lung development in EA rat.Methods Twenty-four female Wistar rats were randomly divided into experimental group(EATEF group)and control group(CON group)with 12 rats in each group.Adriamycin(ADR)-treated rats were established by intrapedtoneal injection of adriamycin at 1.75 mg / kg on day E7-9.The rats were sacrificed by caesarean on day 15 (E15),day 18 (El8) and day 21 (E21).The expression of Ephb4 and Efnb2 in fetal lung was detected by Q-PCR and immunohistochemistry.Results (1) It showed significantly higher mRNA expression levels of Efnb2 at the canalicular stage,which decreased and returned to pseudoglandular level at the sacular stage.The trend of Ephb4 mRNA and Efnb2 mRNA in the two groups was basically the same.The expression of Efnb2 mRNA in EA-TEF group(50.65 ± 12.65) was significantly higher than that in control group(23.63 ± 11.31) at the canalicular stage (P ＜ 0.05),but there was no statistical significance between the two groups at both pseudoglandular stage and sacular stage;The expression of Ephb4 mRNA in EA-TEF group (4.32 ± 2.88) was significantly higher than that in control group (1.01 ± 0.19) at the pseudoglandular stage (P ＜ 0.05),but there was no statistical significance between the two groups at both canalicular stage and sacular stage.(2)Efnb2 and Ephb4 proteins were expressed on the surface of vascular epithelium,alveolar and bronchial epithelium at different developmental stages,and there was no statistical significance in the distribution pattern.The expression of Efnb2 (162.70 ± 10.04) and Ephb4 (152.20 ± 12.32) in EA-TEF group was enhanced at the canalicular stage,while returned to normal level at the sacular stage.Conclusion The angiogenesis factor Efnb2 and its receptor Ephb4 can regulate the branching development of fetal lung tissue,which maybe a compensatory mechanism for pulmonary dysplasia in adriamycin-induced EA-TEF model.

Value of Doppler ultrasound in monitoring velocity waveforms in the fetal main pulmonary artery in patients with early onset severe preeclampsia / 中华超声影像学杂志

Objective To explore the change of Doppler velocity waveforms in the fetal main pulmonary artery in patients with early onset severe preeclampsia and to assess its value in fetal lung maturity.Methods A prospective study was conducted to analyze fetal main pulmonary artery velocity waveforms parameters including acceleration time(AT),ejection time(ET),acceleration time/ejection time (AT/ET),peak systolic velocity (PSV) in 30 cases of pregnant women with early onset severe preeclampsia.According to neonatal outcome,these cases were divided into respiratory distress syndrome (RDS) group (18 cases) and non-RDS group (12 cases).Each group was compared with 54 cases and 36 cases that were normal and had corresponding gestational age separately.Doppler parameters were compared between these two groups and their corresponding normal control groups.Results Gestational age at sonographic examination,gestational age at delivery and birth weight of neonates in RDS group were significantly lower than those in non-RDS group(all P ＜0.001).The value of AT,ET,AT/ET,PSV were lower in RDS group than those in gestational age-matched control group(all P ＜0.05),while there were no significant difference between non-RDS group and gestational age-matched control group(all P ＞ 0.05).Conclusions Doppler ultrasound monitoring fetal main pulmonary artery velocity waveforms to evaluate fetal lung maturity in patients with early onset severe preeclampsia has clinical application value.

Ultrasound Observation of Fetal Lung Maturity in Pregnant Women with Preeclampsia / 中国医科大学学报

Objective To study the sonographic features of fetal lung in normal and preeclampic pregnancies,with follow-up on the occurrence of neonatal respiratory distress syndrome (NRDS),as well as,examine the effects of preeclampsia (PE) on fetal lung maturity (FLM).Methods We collected data from 140 cases during the early pregnancy period (29 to ＜34 weeks),100 cases during the late pregnancy period (34 to 39 weeks),as well as 240 cases of normal pregnancies with the same gestational ages for the contwl group.Data included the parameters of fetal lung maturity measured by ultrasound and the incidence of NRDS postpartum.We analyzed the effects of PE on fetal lung maturity.Results The right fetal lung from the early onset PE group was significantly smaller than that of the normal group.There was no difference in the right lung area between the PE group and the normal group of the same gestational age.Compared with the normal group of the same gestational age,the LHR group had no difference in the early and late PE groups.The acceleration time/ejection time of the main pulmonary artery in the early and late PE group was significantly higher than that of the normal group.There was no difference in the incidence of NRDS among all the groups of the same gestational age.Conclusion PE has no significant effect on fetal lung function or maturation of the pulmonary tissues.Lung maturation may precede the same gestational age without PE.

Quantitative ultrasound analysis in evaluation of fetal lung maturity / 中国介入影像与治疗学

Objective To investigate the application value of DFY-Ⅱ ultrasound imaging analysis software in evaluation of fetal lung maturity in different pregnancy.Methods Totally 315 cases of healthy single pregnancies (24-41 weeks) were collected.The sonographic views of fetal right side sagittal plane were obtained.The echo intensity of fetal lung and liver were analyzed and the ratio was canculated with DFY-Ⅱ ultrasound imaging analysis software.Results The ratio of echo intensity from fetal lung and liver had positive correlation with gestational weeks (r=0.94,P＜0.05),the linear regression equation was Y=0.60+0.07X (r2 =0.883).Conclusion The ratio of echo intensity by fetal lung and liver analyzed with DFY-Ⅱ ultrasound imaging analysis software can be an effective method to evaluate fetal lung maturity.

Effects of DNA methylation of thymocyte differentiation antigen-1 in beryllium sulfate induced human fetal lung fibroblast fibrosis / 中国职业医学

OBJECTIVE: The change of DNA methylation of thymocyte differentiation antigen-1( Thy-1) was observed in beryllium sulfate( Be SO4) stimulated human fetal lung fibroblast( MRC-5 cell) to explore the effects of Thy-1 in Be SO4 induced lung fibrosis. METHODS: MRC-5 cell culture in vitro model was used. The final concentrations of Be SO4were1. 0,10. 0 and 100. 0 μmol / L( low-,medium- and high-dose groups). The control was untreated. Other 2 intervention groups were the 5-azacytidine( AZC) intervention group( 10. 0 μmol / L of AZC and 10. 0 μmol / L Be SO4) and the trichostatin A( TSA) intervention group( 0. 5 μmol / L of TSA and 10. 0 μmol / L Be SO4). The cells were collected 24,48 and 72 hours after exposure. Real-time quantitative polymerase chain reaction( PCR) was used to determine the relative expression of collagen typeⅠ( Col Ⅰ),collagen type Ⅲ( Col Ⅲ),α-smooth muscle actin( α-SMA) and Thy-1 mRNA.The nested landed methylation specific PCR was used to detect the Thy-1 DNA methylation level. RESULTS: At 24 hours,the relative expression level of Col Ⅲ mRNA in MRC-5 cells showed an increasing trend with increasing dose( P < 0. 05);at 48 and 72 hours,the relative expression levels of Col Ⅰ,Col Ⅲ and α-SMA mRNA in MRC-5 cells increased with the increasing dose( P < 0. 05). All these 3 indicators in MRC-5 cells of 3 dose groups increased with the increase of expose time( P < 0. 05). The relative expression level of Thy-1 mRNA in MRC-5 cells of all 3 dose groups were lower than that in control( P < 0. 05). The relative expression level of Thy-1 mRNA of the high-dose group was lower than that of the lowdose group( P < 0. 05). The Thy-1 DNA methylation levels in the medium- and high-dose groups were both higher than that of the control( P < 0. 05). The Thy-1 DNA methylation levels of the 3 dose groups increased with the increasing dose( P < 0. 05). The Thy-1 DNA methylation levels of MRC-5 cells in the 2 intervention groups were higher than that of the control( P < 0. 05),but there was no significant difference when compared with the medium-dose group( P > 0. 05).CONCLUSION: Be SO4 stimulation can induce the fibrosis of MRC-5 cells. In this process,the Thy-1 DNA methylation level increases,while the Thy-1 mRNA expression level decrease. Thy-1 DNA methylation might be one of the important mechanisms of lung fibrosis induced by Be SO4.

Madurez pulmonar fetal: evaluación ecográfica, ¿es confiable?

El objetivo de la presente comunicación es revisar la importancia del tema de la madurez fetal mediante procedimientos no invasivos empleando los ultrasonidos en sus variantes de flujometria Doppler y escala de grises. Los autores destacan la importancia de precisar con la mayor exactitud el grado de madurez pulmonar alcanzada por el feto a la hora de tomar la decisión de interrumpir la gestación por diversas indicaciones. Todo ello con la finalidad de evitar las consecuencias de la prematuridad que incluyen el síndrome de dificultad respiratoria (SOR) del recién nacido ocasionado por la ausencia de surfactante pulmonar que pudiera inclusive llevarlo a la muerte. Coinciden los autores en que se trata de un diagnóstico multiparamétrico que tiene como punto de partida el cálculo de la edad gestacional a partir de un primer estudio ultrasonográfico realizado entre las 5 y 10 semanas, luego la evaluación de la impedancia vascular del lecho pulmonar por medio del Doppler, acompañado de otros parámetros tales como la madurez intestinal, el grado de corticalización cerebral, la presencia de núcleos de osificación, la edad biométrica fetal actual y la estimación del peso. Concluyen enfatizando que ante la duda y la existencia de un feto sano, con crecimiento adecuado, perfil biofísico y hemodinámico normal, la conducta más sensata es la de esperar la culminación de la gestación según los nuevos criterios que redefinen la duración del embarazo y que han sido propuestos por la ACOG.

The purpose of this communication is to review the importance of fetal maturity determination by non-invasive procedures using ultrasound Doppler velocimetry and grayscale. The authors emphasize the importance of precisely specifying fetal lung maturity when deciding to terminate pregnancyfor various indications in order to avoid consequences of prematurity including newborn's respiratory distress syndrome (ROS) due to absence of lung su rfactant that could lead even to death. The authors coincide that a multiparameter diagnosis of gestational age calculation starts from a first ultrasound study between 5 and 10 weeks, assessment of lung vascular impedance by Doppler accompanied by intestinal maturity, degree of cerebral corticalization, presence of nuclei ossification, current biometric fetal age and estimation of weight. They conclude emphasizing that in doubt and presence of a healthy fetus, with good growth, and normal hemodynamic biophysical profile, the more sensible course is to wait for the completion of gestation according to new criteria that redefine the duration of pregnancy and has been proposed by the ACOG.

Actualización en la evaluación de la madurez pulmonar fetal por ultrasonido

El síndrome de dificultad respiratoria (SDR) del recién nacido persiste como una de las principales causas de morbilidad y mortalidad en neonatos prematuros. A pesar que la evidencia científica reciente cuestiona la utilidad de las pruebas para evaluar la madurez pulmonar fetal para determinar el momento más adecuado para el parto en ciertas complicaciones obstétricas, existe un conjunto de indicaciones relativas en las cuales una prueba no invasiva puede encontrar aplicación. El objetivo del presente trabajo es revisar los trabajos publicados en la literatura sobre el empleo de la ecografía como método para predecir la morbilidad respiratoria neonatal, utilizando la evaluación Doppler de la arteria pulmonar y el análisis cuantitativo de la textura ecográfica del pulmón fetal.

Respiratory distress syndrome (RDS) of the newborn remains a major cause of morbidity and mortality in preterm infants. Although the latest scientific evidence questions the utility of fetal lung maturity testing to determine the most suitable moment for delivery in certain obstetrical complications, there is a set of relative indications in which a non-invasive test can find application. The aim ofthis paper is to review studies published on the use of ultrasound as a method to predict neonatal respiratory morbidity, using both Doppler evaluation ofthe pulmonary artery and ultrasound quantitative analysis of fetallung texture.

Evaluación del índice Doppler tiempo de aceleración/tiempo de eyección sistólico de la arteria pulmonar como indicador de desarrollo pulmonar en fetos pretérmino

Objetivos: Evaluar del índice Doppler tiempo de aceleración/tiempo de eyección sistólico de la arteria pulmonar, como indicador de desarrollo pulmonar en fetos pretérmino. Diseño: Estudio prospectivo y descriptivo. Institución: Hospital III Honorio Delgado, Arequipa, Perú. Participantes: Gestantes pretérmino. Intervenciones: Desde julio de 2011 hasta agosto de 2012, a fetos de gestantes entre 25 y 36 semanas de gestación, que acudieron al hospital para evaluación ecográfica de rutina sin evidencia de patología, se realizó Doppler del tronco de la arteria pulmonar y se correlacionó el índice tiempo de aceleración/tiempo de eyección sistólico (índice TA/TE) con la edad gestacional. Principales medidas de resultados: Valor promedio del índice por grupos de edad gestacional y comparación de los mismos. Resultados: Se evaluó 93 gestantes pretérmino con edad materna promedio de 22,4 años y se encontró una correlación lineal rho de 0,67 en la medición del índice TA/TE de la arteria pulmonar, en relación con la edad gestacional. Los valores promedio del índice TA/TE fueron 0,228 y 0,258 para las gestaciones de 29-30 y 31-32 semanas, respectivamente, habiendo diferencia significativa (p<0,05). Los valores medio del índice TA/TE para las gestaciones de 33-34 y 35-36 semanas fueron 0,272 y 0,292, respectivamente, siendo estadísticamente diferentes (p<0,05). Conclusiones: El índice Doppler tiempo de aceleración/tiempo de eyección sistólico de la arteria pulmonar mostró correlación lineal con la edad gestacional y sufrió un cambio significativo coincidente e indicador del desarrollo alveolar pulmonar.

Objectives: To determine fetal pulmonary artery acceleration time/systolic ejection time Doppler index as marker of pulmonary development in preterm fetuses. Design: Prospective, descriptive study. Setting: Hospital III Honorio Delgado, Arequipa, Peru. Participants: Preterm pregnant women with no evidence of pathology. Interventions: Between July 2011 and August 2012, correlation of acceleration time/systolic ejection time pulmonary artery Doppler index (AT/ET index) with gestational age was performed in pregnant women 25 through 36 weeks of gestation attended in routine hospital ultrasound evaluation. Main outcome measures: Mean index value by age groups and comparison. Results: In 93 preterm pregnant women 22.4 year-old average there was rho linear correlation in pulmonary artery AT/ET index estimation in relation to gestational age. AT/ET index average values were 0.228 and 0.258 for respectively 29-30 and 31-32 weeks with significant difference (p<0.05). AT/ET index values for 33-34 and 35-36 weeks gestations were respectively 0.272 and 0.292, statistically different (p<0.05). Conclusions: Acceleration time/systolic ejection time Doppler index of the fetal pulmonary artery showed linear correlation with gestational age and had a significant change coincident and marker of pulmonary alveolar development.

Prenatal assessment of normal fetal pulmonary grey-scale and lung volume by three-dimensional ultrasonography / 西安交通大学学报·英文版

Objective: To quantitatively analyze the fetal lung echo and right lung volume in the third trimester by real-time three-dimensional ultrasound (3-D US) and evaluate the feasibility of fetal lung maturity. Methods: A total of 732 women with normal singleton pregnancies between 28 and 42 weeks of gestation underwent ultrasound examination. The 3-D US equipment with a 3.5-5 MHz transabdominal transducer was used for the fetal biometric measurement. The echogenicity ratio between fetal lung and liver was compared. The fetal lung volume was calculated by the rotational multiplanar technique for volume measurement (VOCAL). Results: The right fetal lung volume increased with the increase of gestational age with a linear positive correlation (r = 0.884, P<0.01). After 34 weeks, the echogenicity ratio of fetal lung to liver was more than 1.1. Conclusion: The echogenicity of lung/liver and fetal lung volume could be used as normal fetal predictable indicators for fetal lung maturity.

Prenatal assessment of normal fetal pulmonary grey-scale and lung volume by three-dimensional ultrasonography / 药物分析学报

Objective To quantitatively analyze the fetal lung echo and right lung volume in the third trimester by real-time three-dimensional ultrasound (3-D US) and evaluate the feasibility of fetal lung maturity. Methods A total of 732 women with normal singleton pregnancies between 28 and 42 weeks of gestation underwent ultrasound examination. The 3-D US equipment with a 3.5-5MHz transabdominal transducer was used for the fetal biometric measurement. The echogenicity ratio between fetal lung and liver was compared. The fetal lung volume was calculated by the rotational multiplanar technique for volume measurement (VOCAL). Results The right fetal lung volume increased with the increase of gestational age with a linear positive correlation (r=0.884, P<0.01). After 34 weeks, the echogenicity ratio of fetal lung to liver was more than 1.1. Conclusion The echogenicity of lung/liver and fetal lung volume could be used as normal fetal predictable indicators for fetal lung maturity.

Comparison of Effects of Antenatal Ambroxol and Dexamethasone on Rats′ Fetal Lung Morphogenesis / 实用儿科临床杂志

Objective To compare the effects of antenatal ambroxol and 3-day dexamethasone and 1-day dexamethasone on rats′ fetal lung morphogenesis.Methods Twelve pregnant rats were divided into 4 groups randomly:3-day ambroxol group,3-day dexamethasone group,1-day dexamethasone group and control group,every group had 3 rats.On gestational day 19,cesareans were carried out and the histologic structures of 6 fetal rats lungs of each pregnant rats were observed with light microscope,electronic microscope and image analysis.Results 1.Under the light microscope,compared with control group,fetal rats lung in three treatment groups had more alveolar numbers,larger alveolar space,and thinner alveolar septum(Pa

Thalidomide inhibits TGF-?1-induced transdifferentiation of human fetal lung fibroblast cell line to myofibroblast / 基础医学与临床

Objective To investigate the effects of Thalidomide(THD)on transdifferentiation of human fetal lung fibroblast(HFL-F) to myofibroblast(MF) induced by Transforming Growth Factor-?1(TGF-?1) and the effects on trans differentiated MF.Methods HFL-F to MF trans-differentiation was induced with 5 ?g/L TGF-?1.The effect of 50 ?g/L THD on HFL-F to MF transdifferentiation was evaluated by measuring hydroxyproline(HYP) content with alkaline hydrolysis colorimetry,?-smooth muscle actin(?-SMA) protein with Western Blot,?-SMA and collagen Ⅲ(COL Ⅲ) mRNA with semiquantitative RT-PCR.Results THD inhibited TGF-?1 induced up-regulation of HYP and COLⅢ mRNA expressions(all P0.05).For HFL-F treated with 5 ?g/L TGF-?1 for 96 h,THD inhibited COLⅢ mRNA expression(P

Bcl-2 Expression in Korean Fetal Lungs / 대한해부학회지

Apoptosis plays an important role in the morphogenesis and the function establishment of organs during embryonic development. Many reports have suggested apoptosis-related genes were ongenes, tumor suppressor genes, growthregulating factors. Although expression of apoptosis-related genes been mostly studied in the development of the nervous system and the limb formation and the immunological organs, the information of regulating mechanism is not comprehensive. Although apoptosis is important in the development, there was few report about apoptosis-related genes including bcl-2 in the human development. We intended to obtain the basic data in order to understand the role of the apoptosis-suppressing gene, bcl-2, in the apoptosis in the lung development. Immunohistochemistry for bcl-2 was performed using a tissue-array technique, on Korean fetal lung tissues in the 14~40 weeks of the human development. Our results showed that the most of mesenchymal cells surrounding the epithelium of the developing bronchi were stained. Bcl-2 expression was high in early stages of human development in the lung. As differentiation grew, the mesenchymal cells expressing bcl-2 decreased and expression of bcl-2 had the tendency of localizing in a few interstitial mesenchymal cells. We suggested that in the early stage when differentiation didn't occur cell death was suppressed, in the late stage when differentiation was achieving cell death increased to remove the innecessary portions of the organs to protect the specific cells of the organs having functions. For the efficiency of the experiment, a high-throughput technique, a tissue-array method was applied which contributed to save time, money and labor without performance errors. Tissue-array technique will be useful to fasten the developmental studies.

Changes of Surfactant Protein A and D in Bronchoalveolar Lavage Fluid in Human Fetal Lungs during Various Gestational Ages / 实用儿科临床杂志

Objective To investigate the metabolic rules of surfactant protein A and D(SP- A,SP- D )in bronchoalveolar lavage fluid(BALF)in human fetal lungs during gestational ages. Methods BALF with 30 mL saline was performed on clinically collected human fetus with induction of labor by water- bag Their BALF was respectively retrieved [total retrieval rate(85. 6% ? 13 1)% ]for analysis of protein content. The BALF SP - A and SP - D from fetus of various gestational ages or newboms were detected by RPHA and ELISA. Results The total protein in BALF gradually increased since 10th week to newborn peak during lung development. And SP - A and SP D were respectively updated from(0.34 ?0.07 ) ,(0.05?0.01) ng/L to newborn climax[ (6 42 ? 0 36),(1.22 ? 0 13)ng/L] .Conclusions The protein in BALF gradually increases with fetal growth and lung development. SP-A and SP- D may reach prenatal climax and become the main indicator of newborn lung maturity.