Epigenetic insights to pediatric uropathology: Celebrating the fundamental biology vision of Tony Khoury.

Introduction: Many pediatric urology conditions affect putatively normal tissues or appear too commonly to be based solely on specific DNA mutations. Understanding epigenetic mechanisms in pediatric urology, therefore, has many implications that can impact cell and tissue responses to settings, such as environmental and hormonal influences on urethral development, uropathogenic infections, obstructive stimuli, all of which originate externally or extracellularly. Indeed, the cell's response to external stimuli is often mediated epigenetically.

Self-reported respiratory and gastrointestinal outcomes in children with isolated congenital diaphragmatic hernia: A prospective multicentre study.

Objective: To evaluate medium-term self-reported respiratory and gastrointestinal (GI) outcomes in children with congenital diaphragmatic hernia (CDH).

Design: Self-reported respiratory and GI outcomes correlated with prenatal severity indicators.

Setting: Prospective study at three fetal medicine units.

EZH2 and matrix co-regulate phenotype and KCNB2 expression in bladder smooth muscle cells.

Background: Partial bladder outlet obstruction (PBO) is a widespread cause of urinary dysfunction and patient discomfort, resulting in immense health care costs. Previously, we found that obstruction is associated with altered regulation of epigenetic machinery and altered function. Here we examined if PBO and chronic bladder obstructive disease (COBD) affect epigenetic marks in a proof of principle gene and explored mechanisms of its epigenetic regulation using models.

Inhibition of DNA methylation during chronic obstructive bladder disease (COBD) improves function, pathology and expression.

Partial bladder outlet obstruction due to prostate hyperplasia or posterior urethral valves, is a widespread cause of urinary dysfunction, patient discomfort and also responsible for immense health care costs. Even after removal or relief of obstruction, the functional and pathologic aspects of obstruction remain as a chronic obstructive bladder disease (COBD). Epigenetic changes, such as DNA methylation, contribute to the persistent character of many chronic diseases, and may be altered in COBD.

Favorable Outcome of Electively Delayed Elongation Procedure in Long-Gap Esophageal Atresia.

The ideal approach to long gap esophageal atresia is still controversial. On one hand, preserving a patient's native esophagus may require several steps and can be fraught with complications. On the other hand, most replacement procedures are irreversible and disrupt gastrointestinal physiology.

Insufflation in minimally invasive surgery: Is there any advantage in staying low?

Aim: Minimally invasive repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) and congenital diaphragmatic hernia (CDH) is feasible and confers benefits compared to thoracotomy or laparotomy. However, carbon dioxide (CO) insufflation can lead to hypercapnia and acidosis. We sought to determine the effect of lower insufflation pressures on patients' surrogate markers for CO absorption - arterial partial pressure of CO (PaCO), end tidal CO (EtCO) and pH.

Thoracic versus abdominal approach to correct diaphragmatic eventration in children.

Background: Plication of diaphragm (DP) for eventration (DE) can be done using thoracic or abdominal approaches. The purpose of our study was to compare outcomes between these approaches based on our experience and on systematic literature review.

Methods: Retrospective records of children <16 years who underwent DP (single-center, 2004-2018) were recorded and analyzed.

Potential Benefits of Laparoscopic Repair of Duodenal Atresia: Insights from a Retrospective Comparative Study.

Introduction:  Congenital duodenal obstruction (CDO) repair can be performed open or laparoscopically. We aimed to determine the potential benefit of laparoscopic repair regarding tolerance of enteral feeding, postoperative pain, hospital stay, and complication rate.

Materials And Methods:  In a single-center retrospective cohort study, we compared neonates with isolated CDO operated open versus laparoscopically from 2010 to 2019.

Augmented latissimus dorsi transfer: initial results in patients with massive irreparable posterosuperior rotator cuff tears.

Background: The surgical treatment of irreparable massive rotator cuff tears is challenging. The purpose of the present study was to report the initial outcomes after a modified latissimus dorsi transfer (LDT) augmented by acellular dermal allograft (ADA).

Methods: This retrospective study includes 24 patients managed with LDT using ADA augmentation as a bursal-sided onlay between March 2009 and December 2015.

The fulcrum axis: an accurate measure of glenoid version on radiographs and computed tomography.

Background: Proper glenoid position in total shoulder arthroplasty (TSA) is important. However, traditional glenoid version (GV) measurements overestimate retroversion on radiographs (XR) and computed tomography (CT).The fulcrum axis (FA) uses palpable surface landmarks and may be useful as an intra-operative guide.

DNA Methylation Reduces the Yes-Associated Protein 1/WW Domain Containing Transcription Regulator 1 Pathway and Prevents Pathologic Remodeling during Bladder Obstruction by Limiting Expression of BDNF.

Chronic bladder obstruction and bladder smooth muscle cell (SMC) stretch provide fibrotic and mechanical environments that can lead to epigenetic change. Therefore, we examined the role of DNA methylation in bladder pathology and transcriptional control. Sprague-Dawley female rats underwent partial bladder obstruction by ligation of a silk suture around the proximal urethra next to a 0.

Non-invasive voiding assessment in conscious mice.

Objective: To review available options of assessing murine bladder function and to evaluate a non-invasive technique suitable for long-term recording.

Methods: We reviewed previously described methods to record rodent bladder function. We used modified metabolic cages to capture novel recording tracings of mouse micturition.

Intraoperative blood transfusion in pediatric patients undergoing renal transplant-Effect of renal graft size.

In pediatric RT, donor allograft size often exceeds the expected recipient norms, especially in younger recipients. An "oversize" graft might not only present a technical- and space-related challenge, but may possibly lead to increased demands in perioperative volume requirements due to the disparity between donor and recipient in renal blood flow. We evaluated transfusion practices at a single tertiary institution with special consideration of kidney graft size, hypothesizing that oversize graft kidneys might lead to a quantifiable increased need of blood transfusion in smaller recipients.

Nerve-sparing Mid-urethral Obstruction (NeMO) in Female Small Rodents.

Partial bladder outlet obstruction (pBOO) has a high prevalence, causes significant patient burden, and immense health care costs. The most common animal model to investigate bladder remodeling in pBOO are female rodents undergoing partial obstruction at the proximal urethra. Variability in the degree of obstruction and animal mortality are major concerns with proximal obstruction.

Finding NeMO-Nerve-sparing Mid-urethral Obstruction: A Pathophysiologically Accurate Model of Rodent Partial Bladder Outlet Obstruction.

Objective: To develop and evaluate a novel technique modeling partial bladder outlet obstruction (pBOO) using a nerve-sparing mid-urethral obstruction (NeMO) approach.

Materials And Methods: Female unoperated rats were compared to rats after NeMO, NeMO sham, proximal urethral (PU) obstruction, or PU sham. Residual volume, bladder capacity, voiding volume, and bladder mass were recorded; the contractile characteristics of isolated bladder strips were also analyzed.

Uropathogenic E. coli (UPEC) Infection Induces Proliferation through Enhancer of Zeste Homologue 2 (EZH2).

Unlabelled: Host-pathogen interactions can induce epigenetic changes in the host directly, as well as indirectly through secreted factors. Previously, uropathogenic Escherichia coli (UPEC) was shown to increase DNA methyltransferase activity and expression, which was associated with methylation-dependent alterations in the urothelial expression of CDKN2A. Here, we showed that paracrine factors from infected cells alter expression of another epigenetic writer, EZH2, coordinate with proliferation.

Use of multislice computed tomography in disaster victim identification--advantages and limitations.

After a mass fatality incident (MFI), all victims have to be rapidly and accurately identified for juridical reasons as well as for the relatives' sake. Since MFIs are often international in scope, Interpol has proposed standard disaster victim identification (DVI) procedures, which have been widely adopted by authorities and forensic experts. This study investigates how postmortem multislice computed tomography (MSCT) can contribute to the DVI process as proposed by Interpol.