Length of efficacy and effect of implant location in adult tom cats treated with a 9.4 mg deslorelin subcutaneous implant.

OBJECTIVES: The objective of this study was to assess duration of efficacy, side effects and return to fertility following use of the 9.4 mg deslorelin implant (Suprelorin 12; Virbac) in cats, and test whether efficacy and duration of action are influenced by implantation site (interscapular vs periumbilical). METHODS: Sixteen healthy adult tom cats were checked with (1) reproductive examination, (2) gonadotropin-releasing hormone stimulation test and (3) semen collection until achievement of sterility, then with (1) and (2) only at 2, 4, 6 and 12 months, and every 6 months thereafter until treatment effect disappeared. RESULTS: Serum testosterone reached basal levels by 7 days post-treatment. Semen quality improved initially then started to worsen by 1 month post-treatment and after 70 days post-treatment all cats were sterile. Early in the third month post-treatment there was a significant decrease in testicular volume and penile spikes. Testicular histology was normal upon neutering performed after resumption of fertility. No injection site lesions or treatment-related side effects were observed. There was no difference between periumbilical and interscapular placement for all criteria, but there was a trend for the decrease in testicular volume to last longer and for the regression of penile spikes to start sooner after interscapular administration. One of 16 cats did not respond to treatment. Six cats were lost at variable times during the study while fully responding to treatment. In the cats that completed the study, normal fertility was regained after 805 days, on average, but with a variable duration of effect from 750-850 days. CONCLUSIONS AND RELEVANCE: Treatment with a 9.4 mg deslorelin implant in male cats was effective for a period of 750-850 days, which is 1.5-2 times longer than the effect of the 4.7 mg deslorelin implant. Fertility (based on serum testosterone production and the presence of penile spikes) was regained at the end of the study. Placing implants in the intrascapular vs periumbilical location did not affect duration of suppression of testosterone production. The interscapular location may be characterised by a better efficacy, although further studies are needed to clarify this issue.

Umbilical temperature correlation with core and skin temperatures at rest, in the heat and during physical activity.

PURPOSE: to determine the correlation of umbilical temperatures (Tumb) with simultaneously recorded chest wall temperature (Tchest) and rectal temperature (Trectal) in adults during rest, heat exposure and exercise. METHODS: A total of 28 healthy men, wearing different types of clothing (athletic garb, a spandex full body heating garment, firefighter bunker gear) had average and peak umbilical, chest wall and rectal temperature measurements taken during sedentary temperature stabilisation stages, heat exposure periods and active exercise phases. RESULTS: Curvilinear relationships were noted between Tchest and Tumb compared with Trectal and their association became noticeably positive and linear at approximately 35.5 °C. Polynomial regression analysis of Trectal with linear and quadratic forms of Tchest and Tumb indicated an overall R2 of 0.657 and 0.767, respectively. Bivariate analysis of a restricted data set (where Tchest and Tumb ≥35.5°), indicated that Tumb was significantly associated with Trectal (raverage = 0.710, p <0.001; rpeak = 0.841, p <0.001) and Tchest was also significantly associated with Trectal, but less so (raverage = 0.570, p <0.001; rpeak = 0.699, p <0.001). CONCLUSIONS: the umbilicus offers a non-invasive, peripheral site for measurement of temperature that more closely correlated with body core temperature than Tchest when core temperature was ≥35.5 °C.

[Origin and development of umbilical therapy in traditional Chinese medicine].

The origin and development of umbilical therapy in traditional Chinese medicine is explored from related literature in the history. As a result, the Shang period is regarded as initial period of umbilical therapy, while periods from Han Dynasty, Jin Dynasty and Southern-Northern Dynasties to Sui Dynasty and Tang Dynasty could be taken as stage of primary development. Time from Song Dynasty, Jin Dynasty and Yuan Dynasty to Ming and Qing Dynasties is believed as mature stage. Also the manipulation, application principle, indications and contraindications of umbilical therapy are explained. A brief overview of modern development of umbilical therapy is also described.

Impact of chlorhexidine cleansing of the umbilical cord on cord separation time and neonatal mortality in comparison to dry cord care - a nursery-based randomized controlled trial.

AIM: To study the impact of chlorhexidine cleansing of the umbilical cord on cord separation time and neonatal mortality in comparison to dry cord care. METHODS: This is the secondary analysis of the data of the study which was conducted in the NICU of a teaching hospital in north India between 2010 and 2011. Newborns (>32 weeks of gestation and weighing >1500 g) were randomized into chlorhexidine application and dry cord care groups. Here, we analyze the data regarding time of cord separation, umbilical sepsis and mortality in both the groups. RESULTS: One hundred and forty (dry care group 70, chlorhexidine group 70) were enrolled and finally analyzed. A significant difference was observed among groups in terms of time to cord separation (8.92 ± 2.77 days versus 10.31 ± 3.23 days; t = 2.20; p = 0.02, significant) and neonatal mortality (χ(2) = 4.11; p = 0.042, significant). CONCLUSION: Use of chlorhexidine for umbilical cord care shortens duration of cord separation and decreases neonatal mortality in NICU. This simple intervention can be used as mode for decreasing neonatal mortality.

Time-dependent properties of human umbilical fascia.

This investigation is devoted to the study of the viscoelastic behavior of human abdominal fascia from the umbilical region. Seventeen samples 10 mm wide and up to 70 mm long were cut along the primary fiber direction (group FL) or perpendicular to it (group FT) and subjected to relaxation tests. The viscoelastic response of the tissue at three different strain levels (4%, 5%, and 6%) was investigated. The relaxation curves were fitted using a two-stage decaying exponential form. The following parameters were determined: initial stress σ(0), relaxation times τ(1) and τ(2), stress reduction Δσ, initial relaxation modulus E and equilibrium relaxation modulus E(eq), as well as the ratio E/E(eq). Fiber orientation and strain levels were varied to determine their influence on the viscoelastic properties of fascia. The results highlight the inherent viscoelastic mechanical properties of umbilical fascia. The values of the viscoelastic parameters determined for the longitudinal and transverse directions varied markedly. Significant differences were found between the two groups FL and FT for the initial stress at 5% and 6% strain (p < 0.038) and for the initial and equilibrium moduli at the 6% strain level (p < 0.046). The stress reduction in samples from the FL group (45-55%) was less than that in samples from the FT group (37-54%), but this difference was not significant (p > 0.388). The influence of strain level on the parameter values was not statistically significant (p > 0.121). The nonlinear response of the tissue was demonstrated over the chosen strain range.

Prospective evaluation of the sensory outcome following abdominoplasty.

The aim of this study is to prospectively evaluate the changes in the sensation of the skin of the abdominal wall and thighs following abdominoplasty. Patients underwent standard full abdominoplasty with reinsertion of the umbilicus. Sensory testing was performed preoperatively and at least 1 year postoperatively. Predetermined targets on the abdominal wall, umbilicus, and on the anterior thighs were tested for light touch, sensory thresholds, using Semmes-Weinstein monofilaments (SW), vibration, and temperature. Fourteen patients completed the study. On average targets demonstrated a decrease in sensory thresholds, average from SW 3.61 to 4.14 (P < 0.001), the targets that had the most significant decrease were the umbilicus SW 3.67 to 6.97 (P = 0.001) and the infra umbilical 3.75 to 6.57 P = 0.001. Similar findings were seen for the other modalities tested, there was a significant disappearance in their perception at the umbilical target and at the lower abdominal regions. We did not identify any significant decrease in the sensation of the thighs. Abdominoplasty causes lasting sensory changes concentrating on the umbilical and infraumbilical regions. This study enables surgeons to inform their patients about the expected sensory outcome following abdominoplasty.

The nature of navel fluff.

Hard facts on a soft matter! In their popular scientific book (Leyner M, Goldberg B. Why do men have nipples - hundreds of questions you'd only ask a doctor after your third martini. New York: Three Rivers Press; 2005), Leyner and Goldberg raised the question why "some belly buttons collect so much lint". They were, however, not able to come up with a satisfactory answer. The hypothesis presented herein says that abdominal hair is mainly responsible for the accumulation of navel lint, which, therefore, this is a typically male phenomenon. The abdominal hair collects fibers from cotton shirts and directs them into the navel where they are compacted to a felt-like matter. The most abundant individual mass of a piece of lint was found to be between 1.20 and 1.29 mg (n=503). However, due to several much larger pieces, the average mass was 1.82 mg in this three year study. When the abdominal hair is shaved, no more lint is collected. Old T-shirts or dress shirts produce less navel fuzz than brand new T-shirts. Using elemental analysis, it could be shown that cotton lint contains a certain amount of foreign material, supposedly cutaneous scales, fat or proteins. Incidentally, lint might thus fulfill a cleaning function for the navel.

Umbilicus as a fitness signal in humans.

Typically, mammalian umbilical cord forms a tiny, stable, and asymmetrical scar. In contrast, humans have a clearly visible umbilicus that changes with age and nutrients gathered. Based on this, I propose that umbilicus, together with the surrounding skin area, is an honest signal of individual vigour. More precisely, I suggest that the symmetry, shape, and position of umbilicus can be used to estimate the reproductive potential of fertile females, including risks of certain genetically and maternally inherited fetal anomalies. The idea is supported by a comparative study where symmetrical t-shaped and oval-shaped umbilici of fertile females were considered the most attractive. Further support comes from observations that abnormal velocity of umbilical cord has been associated with fetal brain development, diabetes, and other fitness-related properties with a strong genetically or maternally inherited component. In addition, umbilicus and the umbilical skin area may reveal nutrimental competitive ability, and need for social care in small children and pregnant females. The novel hypothesis explains why umbilicus has aesthetic value, and why umbilicus has had a distinctive role in different cultures. If further research confirms the signalling hypothesis, female umbilici may be routinely measured to detect risk pregnancies of several fetal abnormalities.

Umbilical complications of malignancy.

INTRODUCTION: Cancer patients may manifest a variety of intraabdominal complications occurring during various phases of their illness; however, little in the literature exists regarding umbilical abnormalities in this population. DISCUSSION: Umbilical metastases (Sister Mary Joseph's sign) are the most common malignant complication involving the umbilicus and may be the presenting manifestation of visceral malignancy. Cancer patients may occasionally experience periumbilical ecchymosis (Cullen's sign), infection, hernia, or varices, each of which may require therapy. This review succinctly presents several umbilical complications that the clinician may encounter in patients with malignant disease.

Prediction of visceral fat area at the umbilicus level using fat mass of the trunk: The validity of bioelectrical impedance analysis.

The aims of this study were to determine the validity of fat mass of the trunk as a predictor for visceral fat area at the umbilicus level and to develop equations to predict visceral fat mass at the umbilicus level using fat mass of the trunk measured by dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). The participants were 121 normal Japanese adults (69 males, 52 females). Another 60 volunteer adults (34 males, 26 females) were recruited for examination of cross-validity. Altogether, 41 adults (15 males, 26 females) in the original group and 19 adults (7 males, 12 females) in the cross-validity group received BIA measurement. We measured fat mass by DXA and the BIA system, which was a single-frequency BIA with 8-point contact electrodes, and visceral fat area by computed tomography. We observed significant correlations for visceral fat area in waist circumference (0.56) and fat mass of the trunk measured by DXA (0.64). There was no significant difference in fat mass of the trunk between the DXA and BIA systems, but the BIA system tended to provide an underestimate compared with DXA. With combined fat mass of the trunk measured by DXA and waist circumference as predictors, visceral fat area was estimated by equation (1) (R = 0.87, R(2) = 0.76, standard error of the estimate = 20.9 cm(2)). When substituting fat mass of the trunk measured by BIA into equation (1), there was no significant difference in visceral fat area between the reference and predicted values. An equation using fat mass of the trunk measured by BIA (equation 2) was obtained (R = 0.89, R(2) = 0.78, standard error of the estimate = 20.7 cm(2)), but a systematic error was found for the males. There was cross-validity in both equations. In conclusion, fat mass of the trunk is an effective predictor for the visceral fat area at the umbilicus level. Fat mass of the trunk measured by BIA might be a valid method to predict visceral fat, although further studies with larger samples taking into account the extent and type of obesity are required.

Ecografía doppler en la gestación normal: circulación umbilical / Doppler ultrasound scan during normal gestation: umbilical circulation

Objetivos: Determinar mediante ecografía Doppler los patrones de normalidad en la circulación umbilical en una población gestante sana, sin factores de riesgo y con resultado perinatal normal y valorar las modificaciones que se producen en función de la edad gestacional obteniendo registros en diferentes semanas del embarazo. Material y métodos: Se han estudiado 116 gestantes con feto único, sin factores de riesgo conocidos y con controles clínicos, analíticos y ecográficos normales. Se realizaron un total de 193 ecografías Doppler, entre la 15-41 semanas de gestación, con análisis del flujo en las arterias y vena del cordón umbilical. Los datos obtenidos se correlacionaron con los parámetros que evalúan el bienestar fetal (monitorización fetal y/o prueba de oxitocina) y el resultado perinatal (tipo de parto, peso al nacimiento, puntuación Apgar). El análisis estadístico se realizó con los programas SPSS 6.0.1. para Windows y EPIINFO 6.0.4.Resultados: Mediante Doppler pulsado, la arteria umbilical presentó en todos los casos morfología bifásica, con componente sistólico y diastólico, sin flujo invertido. Al aumentar las semanas de gestación, se observó un descenso progresivo de la resistencia con aumento de la velocidad diastólica. Conclusiones: La ecografía Doppler es un método no invasivo que permite el estudio hemodinámico de la circulación umbilical. El conocimiento de la morfología normal de las ondas de flujo y de los valores normales de los índices Doppler relacionados con la edad gestacional nos permitirá la aplicación del método en embarazos de alto riesgo. (AU)

Eficacia de una aplicación frente a tres de merbromina en el tiempo de caída del cordón / Efficacy of one versus three applications of merbromin in achieving umbilical cord detachment

Objetivo: comparar la eficacia de dos pautas de aplicación de la merbromina (una aplicación diaria frente a tres) en el tiempo de caída del cordón umbilical. Método: un total de 285 neonatos fueron asignados aleatoriamente a uno de los dos grupos de estudio. Se obtuvo información completa de 280 neonatos (145 en el grupo de tres aplicaciones y 135 en el grupo de una aplicación). Se recogieron las siguientes variables: tipo de parto, peso y apgar del recién nacido, días hasta la caída del cordón, efectos adversos, grado de dificultad de la cura del ombligo y preocupación de los padres. Resultados: en el grupo de tres aplicaciones de membromina diarias la caída del cordón se produjo a los 10,8 +/- 6,1 días, mientras que en el grupo de una aplicación fue a los 8,8 +/- 3,9 días (9<0,001). No se detectó ningún cado de onfalitis ni alergias. No se observaron diferencias significativas en la aparición de granulomas (4,1 por ciento en el grupo de tres aplicaciones y 3,7 por ciento en el de una aplicación ). Conclusiones: una única aplicación diaria de merbromina en el cuidado umbilical presenta un buen efecto curativo, menor tiempo de caída del cordón, menor coste y mayor seguridad para los padres (AU)

Assessment of the umbilical cord outside of the delivery room. Part 2.

The umbilical cord is crucial to the growth and development of the fetus. Careful inspection in the delivery room and throughout the newborn period is essential. Part 1 of this 2-part series, entitled "Look Before You Clamp: Delivery Room Examination of the Umbilical Cord" (Advances in Neonatal Care, Vol. 2, No. 1, pp 19-26), reviewed umbilical problems that present in the delivery room. A number of subtle but significant umbilical cord abnormalities present outside the delivery room. These abnormalities will be the focus of Part 2 of this series. A review of the embryologic development of the umbilical cord enhances the clinician's understanding of umbilical abnormalities that present in the newborn period. The process of umbilical cord separation is outlined. Conditions associated with delayed cord separation are discussed. A systematic approach to the physical examination of the umbilicus is offered, with an emphasis on early detection of abnormalities. Common and uncommon physical findings, such as omphalitis, periumbilical necrotizing fascitis, vitelline duct remnants, and urachal anomalies are presented along with select photographs. A brief discussion of the clinical implications for newborn care is provided for the practicing clinician.

The Pitx2 protein in mouse development.

The Rieger syndrome, an autosomal dominant disorder involving ocular, dental, and umbilical defects is caused by mutations in PITX2, a Bicoid-type homeobox protein. Mouse Pitx2 mRNA is expressed in eye, tooth and umbilicus consistent with the human Riegers phenotype. Moreover, Pitx2 is involved in the Nodal/Sonic hedgehog pathway that determines left/right polarity. In this report we demonstrate a 32-kDa polypeptide on Western blots of nuclear extracts from a rat pituitary cell line, using a Pitx2 specific antibody (designated P2R10). We describe also for the first time expression of the Pitx2 protein in mouse. Pitx2 protein immunostaining was detectable during the development of the eye, tooth, umbilicus, and also in the pituitary, heart, gut, and limb. We demonstrate for the first time directly that Pitx2 is asymmetrically expressed in early heart, gut, and lung development.

Uterine blood flow, oxygen and glucose uptakes at mid-gestation in the sheep.

In early ovine fetal development, the placenta grows more rapidly than the fetus so that at mid-gestation the aggregate weight of placental cotyledons exceeds fetal weight. The purpose of this study was to compare two separate methods of measuring uterine blood flow and glucose and oxygen uptakes in seven mid-gestation ewes, each carrying a single fetus. Uterine blood flow to both uterine horns was measured by microsphere and by tritiated water steady-state diffusion methodology. Calculations of tritiated water blood flows and oxygen and glucose uptakes were based on measurements of arteriovenous concentration differences across each uterine horn. The distribution of blood flow and oxygen uptake between the two uterine horns was strongly correlated with placental mass distribution. The two methods gave comparable results for uterine blood flow (457 +/- 35 vs 476 +/- 35 ml/min), oxygen uptake (457 +/- 35 vs 476 +/- 35 mumol/min), and glucose uptake (63 +/- 8 vs 64 +/- 6 mumol/min). Uterine blood flow was approximately 38% of the late gestation value and 56.1 +/- 1 times higher than umbilical blood flow. Uteroplacental oxygen consumption was about 58% of late gestation measurements and 3.9 +/- 0.5 times higher than fetal oxygen uptake. We confirm that the large placental mass of mid-gestation is associated with high levels of maternal placental blood flow and placental oxidative metabolism.

Hernia umbilical / Umbilical hernia

Se presenta un estudio prospectivo para ver la influencia de hernias umbilicales en ninos menores de un ano de edad; encontramos ua incidencia del 63,6% con una prevalencia similar en ambos sexos, todas las hernias umbilicales fueron asintomaticas. No necesitaron tratamiento ni medico ni quirurgico. Se recomienda el esperar siquiera hasta los 5 o 6 anos de edad antes de considerar un tratamiento correctivo quirurgico. Se hace hincapie en la parte emocional de los padres quienes deben ser instruidos sobre el curso natural de las hernias umbilicales. El uso de esparadrapos o cintas de comprension no tiene ninguna utilidad.