Kenneth S Azarow1, Robert Cusick2, Julia Wynn3, Wendy Chung3, George B Mychaliska4, Timothy M Crombleholme5, Dai H Chung6, Foong Yen Lim7, Douglas Potoka8, Brad W Warner9, Gundrun Aspelund10, Marc S Arkovitz11. 1. Division of Pediatric Surgery, Department of Surgery, Oregon Health & Sciences University, Portland, OR. Electronic address: azarow@ohsu.edu. 2. Division of Pediatric Surgery, Department of Surgery, University of Nebraska College of Medicine/Children's Hospital and Medical Center, Omaha, NE. 3. Department of Pediatrics and Medicine, Columbia University Medical College, New York, NY. 4. Division of Pediatric Surgery, Department of Surgery, University of Michigan School of Medicine, Ann Arbor, MI. 5. Colorado Fetal Care Center, Division of Pediatric General, Thoracic and Fetal Surgery, Children's Hospital Colorado and the University of Colorado School of Medicine, Denver, CO. 6. Division of Pediatric Surgery, Department of Surgery, Vanderbilt Children's Hospital, Nashville, TN. 7. Division of Pediatric General, Thoracic, and Fetal Surgery, Center for Molecular Fetal Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 8. Division of Pediatric Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA. 9. Division of Pediatric Surgery, Department of Surgery, Washington University School of Medicine, St Louis Children's Hospital, St Louis, MO. 10. Division of Pediatric Surgery, Department of Surgery, Columbia University Medical College, New York, NY. 11. Division of Pediatric Surgery, Department of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Abstract
BACKGROUND: Undescended testes (UDT) is a common abnormality treated by pediatric surgeons. Embryological development of the genitourinary ridge is in close proximity with the pleuroperitoneal fold. The purpose of this paper is to describe the association between congenital diaphragmatic hernia (CDH) and UDT. MATERIALS/ METHODS: As part of the DHREAMS (Diaphragmatic Hernia Research and Exploration: Advancing Molecular Science) study (www.cdhgenetics.com), all living children had tissue banked and analyzed for common genetic mutations and had a health assessment performed by telephone consultation with the parents at two years of age. The incidence of UDT was then compared to clinical and genetic findings previously identified. RESULTS: Sixty-five males had complete information from their 2year health assessment. Of these, twelve (18%) had a UDT repaired by the time of the 2year assessment. Of the twelve who had a repair, no child had a unilateral UDT which was contralateral to the side of the CDH. There were no differences in rate or number of mutations of any of the genes we checked as part of our study. CONCLUSION: It appears that a deficiency of diaphragm tissue may affect the first or transabdominal phase of the testicular descent, leading to an increased incidence of UDT.
BACKGROUND: Undescended testes (UDT) is a common abnormality treated by pediatric surgeons. Embryological development of the genitourinary ridge is in close proximity with the pleuroperitoneal fold. The purpose of this paper is to describe the association between congenital diaphragmatic hernia (CDH) and UDT. MATERIALS/ METHODS: As part of the DHREAMS (Diaphragmatic Hernia Research and Exploration: Advancing Molecular Science) study (www.cdhgenetics.com), all living children had tissue banked and analyzed for common genetic mutations and had a health assessment performed by telephone consultation with the parents at two years of age. The incidence of UDT was then compared to clinical and genetic findings previously identified. RESULTS: Sixty-five males had complete information from their 2year health assessment. Of these, twelve (18%) had a UDT repaired by the time of the 2year assessment. Of the twelve who had a repair, no child had a unilateral UDT which was contralateral to the side of the CDH. There were no differences in rate or number of mutations of any of the genes we checked as part of our study. CONCLUSION: It appears that a deficiency of diaphragm tissue may affect the first or transabdominal phase of the testicular descent, leading to an increased incidence of UDT.
Authors: Julia Wynn; Usha Krishnan; Gudrun Aspelund; Yuan Zhang; Jimmy Duong; Charles J H Stolar; Eunice Hahn; John Pietsch; Dai Chung; Donald Moore; Eric Austin; George Mychaliska; Robert Gajarski; Yen-Lim Foong; Erik Michelfelder; Douglas Potolka; Brian Bucher; Brad Warner; Mark Grady; Ken Azarow; Scott E Fletcher; Shelby Kutty; Jeff Delaney; Timothy Crombleholme; Erika Rosenzweig; Wendy Chung; Marc S Arkovitz Journal: J Pediatr Date: 2013-01-30 Impact factor: 4.406