• Disease
  • Fetal
  • Fetal Surgery
  • N Scott Adzick

    Prominent publications by N Scott Adzick

    KOL Index score: 16527

    BACKGROUND/PURPOSE: Cystic adenomatoid malformation of the lung (CAM) diagnosed in utero has a variable natural history that may result in hydrops in up to 40% or regress in up to 15%. No criteria have been available to determine which lesions would grow and develop hydrops versus those whose growth would stabilize or regress. To better understand the natural history of CAM the authors developed a measure of tumor volume normalized for gestation age, the CAM volume ratio, or CVR. The ...

    Also Ranks for: Cystic Adenomatoid |  volume ratio |  fetuses cvr |  fetal intervention |  development hydrops
    KOL Index score: 15940

    BACKGROUND: Since the results of the Management of Myelomeningocele Study were published, maternal-fetal surgery for the in utero treatment of spina bifida has become accepted as a standard of care alternative. Despite promise with fetal management of myelomeningocele repair, there are significant complications to consider. Chorioamniotic membrane separation and preterm premature rupture of membranes are known complications of invasive fetal procedures. Despite their relative frequency ...

    Also Ranks for: Myelomeningocele Repair |  premature rupture |  membrane separation |  gestational age |  risk preterm
    KOL Index score: 15901

    OBJECT: The Management of Myelomeningocele Study (MOMS) was a multicenter randomized trial comparing the safety and efficacy of prenatal and postnatal closure of myelomeningocele. The trial was stopped early because of the demonstrated efficacy of prenatal surgery, and outcomes on 158 of 183 pregnancies were reported. Here, the authors update the 1-year outcomes for the complete trial, analyze the primary and related outcomes, and evaluate whether specific prerandomization risk factors ...

    Also Ranks for: Prenatal Surgery |  shunt placement |  ventricle size |  cerebrospinal fluid |  hindbrain herniation
    KOL Index score: 14987

    BACKGROUND/PURPOSE: Prenatal tracheal occlusion (TO) has been shown to accelerate lung growth in animal models and models of pulmonary hypoplasia. However, these models may not mimic early events in human congenital diaphragmatic hernia (CDH). The authors previously have developed a model of TO in the rat. The purpose of this study was to apply this technique to characterize TO-induced lung growth in the early onset nitrofen-induced model of CDH, and to address the clinically important ...

    Also Ranks for: Lung Growth |  rat model |  diaphragmatic hernia |  prenatal tracheal occlusion |  cdh induced
    KOL Index score: 14446

    Most fetuses with congenital diaphragmatic hernia (CDH) diagnosed before 24 weeks' gestation die despite optimal postnatal care. In fetuses with liver herniation into the chest, prenatal repair has not been successful. In the course of exploring the pathophysiology of CDH and its repair in fetal lambs, the authors found that obstructing the normal egress of fetal lung fluid enlarges developing fetal lungs, reduces the herniated viscera, and accelerates lung growth, resulting in improved ...

    Also Ranks for: Congenital Diaphragmatic |  tracheal occlusion |  fetal trachea |  hypoplastic lung |  liver herniation
    KOL Index score: 14149

    The objective of this paper is to evaluate the efficacy of various magnetic resonance imaging (MRI) sequences and the general usefulness of prenatal MRI in determining the position of the fetal liver and visualizing lung tissue in fetuses who have congenital diaphragmatic hernia (CDH). This was a retrospective review of prenatal MRI of fetuses with a confirmed diagnosis by surgery or autopsy of CDH. MRI was performed in a 1.5-Tesla magnet using fast gradient echo, half-Fourier ...

    Also Ranks for: Prenatal Mri |  congenital diaphragmatic hernia |  fetal liver |  lung tissue |  retrospective review
    KOL Index score: 13651

    Congenital cystic adenomatoid malformation and bronchopulmonary sequestration are congenital lung tumors that are classically described as having distinct embryology, pathology, and natural history. The authors treated six patients who had prenatally diagnosed lung masses that displayed clinicopathologic features of both lesion types. At prenatal diagnosis (19 to 30 weeks' gestation), all six lesions were classified sonographically as congenital cystic adenomatoid malformation, and none ...

    Also Ranks for: Bronchopulmonary Sequestration |  congenital cystic |  adenomatoid malformation |  lung lesions |  blood supply
    KOL Index score: 13642

    PURPOSE: The optimal timing of repair for congenital diaphragmatic hernia (CDH) in patients requiring extracorporeal membrane oxygenation (ECMO) is controversial. Repair during ECMO may improve respiratory function by restoring normal anatomy. However, there is increased risk of complications including surgical bleeding. The purpose of this study was to examine the impact of timing of CDH repair on outcomes in a large cohort of patients treated at a single institution.

    METHODS: We ...

    Also Ranks for: Congenital Diaphragmatic Hernia |  ecmo patients |  extracorporeal membrane |  repair decannulation |  surgical bleeding
    KOL Index score: 13438

    OBJECTIVE: Our purpose was to review our experience with fetal congenital cystic adenomatoid malformation and extralobar pulmonary sequestration emphasizing natural history, management, and outcome.

    STUDY DESIGN: We conducted a retrospective review of 175 fetal lung lesions diagnosed by antenatal ultrasonography at 2 fetal treatment centers.

    RESULTS: There were 134 congenital cystic adenomatoid malformation cases. Fourteen women underwent elective abortion, 101 women were managed ...

    Also Ranks for: Lung Lesions |  thoracoamniotic shunting |  nonimmune hydrops |  postnatal resection |  fetal congenital
    KOL Index score: 13158

    BACKGROUND/PURPOSE: In utero repair of myelomeningocele (MMC) in humans spares distal neurologic function, reverses the hindbrain herniation component of the Arnold-Chiari II malformation (ACM), and reduces the rate of postnatal shunt placement. The authors hypothesized that extravasation of cerebrospinal fluid (CSF) from the lumbar spinal cord results in herniation. This hypothesis was tested by assessing the impact of a spinal cord myelotomy on hindbrain anatomy in fetal ...

    Also Ranks for: Hindbrain Herniation |  mmc repair |  102 gestation |  spinal cord |  fetal sheep
    KOL Index score: 13107

    OBJECTIVE: Fetal skin wounds heal without scarring. To determine the role of TGF-beta 1 in fetal wound healing, mRNA expression of TGF-beta 1 was analyzed in human fetal and adult skin wounds.

    METHODS: Human fetal skin transplanted to a subcutaneous location on an adult athymic mouse that was subsequently wounded heals without scar, whereas human adult skin heals with scar formation in that location. In situ hybridization for TGF-beta 1 mRNA expression and species-specific ...

    Also Ranks for: Scar Formation |  fetal skin |  transforming growth |  beta 1 |  adult wounds
    KOL Index score: 13021

    BACKGROUND: Ultrasound (US) evaluation of some fetal anomalies provides limited information. Anatomic details that affect prognosis and selection for fetal therapy, such as liver herniation and pulmonary hypoplasia in congenital diaphragmatic hernia (CDH) and airway patency in giant neck masses, may be difficult to delineate using conventional sonographic methods. The authors evaluated the utility of prenatal magnetic resonance imaging (MRI) with new ultrafast imaging sequences in the ...

    Also Ranks for: Fetal Diagnosis |  magnetic resonance |  liver herniation |  imaging mri |  lung masses
    KOL Index score: 13018

    BACKGROUND/PURPOSE: The high mortality rate of congenital diaphragmatic hernia (CDH) is ascribed generally to pulmonary hypoplasia and persistent pulmonary hypertension characterized by associated pulmonary arterial structural changes. Prenatal tracheal occlusion (TO) accelerates lung growth, but the effect of TO on pulmonary arterial structure in CDH has not been well defined. The authors hypothesized that TO could reverse the pulmonary arterial structural changes observed in CDH. To ...

    Also Ranks for: Tracheal Occlusion |  rat model |  diaphragmatic hernia |  cdh cdhto |  pulmonary arteries
    KOL Index score: 12817

    OBJECTIVE: The purpose of this study was to determine the ability of liver position and lung-to-head ratio to predict outcome in isolated left congenital diaphragmatic hernia.

    STUDY DESIGN: We reviewed prenatal studies and postnatal outcomes of congenital diaphragmatic hernia between January 1996 and January 2006.

    RESULTS: Eighty-nine patients received prenatal and postnatal care at 1 institution. In fetuses with liver up, extracorporeal membrane oxygenation was required in 39 of 49 ...

    Also Ranks for: Liver Position |  membrane oxygenation |  head ratio |  congenital diaphragmatic |  outcome survival


    N Scott Adzick: Influence Statistics

    Sample of concepts for which N Scott Adzick is among the top experts in the world.
    Concept World rank
    mass size mortality #1
    pancreas 18fpet #1
    large uterine incision #1
    cases linehi #1
    healing scarless repair #1
    fetal urinary extravasation #1
    concomitant lung lesions #1
    myelomeningocele repair complications #1
    fetal neck #1
    liver herniation head #1
    ultrasound bilateral disease #1
    fetuses adcmvlacz #1
    cystic masses retroperitoneum #1
    separate genetic events #1
    tgfbeta1 fetal skin #1
    fetal neuroblastoma sonography #1
    lesions congenital #1
    closure fetal period #1
    prenatal mri evaluation #1
    sensory function technique #1
    fetal wound repair #1
    severe hypoglycemia neonates #1
    gddtc patients #1
    selective ucc ucc #1
    cases frozen evaluation #1
    prenatal postnatal #1
    cesarean fetal airway #1
    il6 authors #1
    fetal kidney levels #1
    pneumonectomy pregnancy #1
    fetal lobectomy #1
    adult wounds mrna #1
    postnatal chest #1
    expander authors #1
    progress fetal diagnosis #1
    early fetal intervention #1
    humans meningomyelocele #1
    insulinoma focal neonates #1
    fetal surgery mmc #1
    rhamm incisional wounds #1
    score ≤ #1
    newborn meningomyelocele muscle #1
    fiftythree patients focal #1
    congenital cystic #1
    fetal surgery #1
    fetal spinal cords #1
    spinal defects oeis #1
    congenital evaluation studies #1
    treatment focal lesion #1
    patients fetal management #1

    Key People For Fetal Surgery

    Top KOLs in the world
    N Scott Adzick
    fetal surgery congenital diaphragmatic hernia prenatal diagnosis
    Michael R Harrison
    fetal surgery congenital diaphragmatic hernia hyaluronic acid
    Mark Paul Johnson
    prenatal diagnosis fetal surgery gestational age
    Alan W Flake
    fetal surgery stem cell gene transfer
    Lori J Howell
    fetal surgery prenatal repair congenital diaphragmatic hernia
    Timothy M Crombleholme
    wound healing fetal surgery gene transfer

    N Scott Adzick:Expert Impact

    Concepts for whichN Scott Adzickhas direct influence:Fetal surgery,  Congenital diaphragmatic hernia,  Diaphragmatic hernia,  Prenatal diagnosis,  Diaphragmatic hernias,  Congenital hyperinsulinism,  Scar formation,  Congenital diaphragmatic.

    N Scott Adzick:KOL impact

    Concepts related to the work of other authors for whichfor which N Scott Adzick has influence:Congenital diaphragmatic hernia,  Wound healing,  Spina bifida,  Prenatal diagnosis,  Fetal surgery,  Gestational age,  Pulmonary hypoplasia.



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    Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, PA. | Department of Surgery, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA | Department of S