WordNet

(library science) the count of books that are loaned by a library over a specified period
movement through a circuit; especially the movement of blood through the heart and blood vessels
number of copies of a newspaper or magazine that are sold; "by increasing its circulation the newspaper hoped to increase its advertising"
the spread or transmission of something (as news or money) to a wider group or area
free movement or passage (as of cytoplasm within a cell or sap through a plant); "ocean circulation is an important part of global climate"; "a fan aids air circulation"
the dissemination of copies of periodicals (as newspapers or magazines)
never-ceasing; "the relentless beat of the drums" (同)relentless, unrelenting
retained; not shed; "persistent leaves remain attached past maturity"; "the persistent gills of fishes" (同)lasting
of or relating to a fetus; "fetal development" (同)foetal

PrepTutorEJDIC

〈U〉『血液の循環』,血行 / 〈U〉(貨幣の)流通;(情報・うわさなどの)流布伝達;(新聞・雑誌など,印刷物の)配布 / 〈C〉(新聞・雑誌などの)発行部数
(反対・困難にもくじけず)『あくまでもやり抜く』,ねばり強い,執ような / いつまでも続く,持続する(lasting)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/13 18:48:15」(JST)

wiki en

Persistent fetal circulation is a condition caused by a failure in the systemic circulation and pulmonary circulation to convert from the antenatal circulation pattern to the "normal" pattern.

In a fetus, there is high pulmonary vascular resistance and low pulmonary blood flow as the fetus does not use the lungs for oxygen transfer. Once the baby is born, the lungs are needed for oxygen transfer and need high blood flow which is encouraged by low pulmonary vascular resistance.

It can be associated with pulmonary hypertension.^[1] Because of this, the condition is also known as "persistent pulmonary hypertension of the newborn".^[2]

1 Epidemiology
2 Types
- 2.1 Normal vascular anatomy with functional vasoconstriction
- 2.2 Decreased diameter of pulmonary vessels with hypertrophy of vessel walls
- 2.3 Decreased size of pulmonary vascular bed
- 2.4 Functional obstruction of pulmonary blood flow
3 Treatment
4 References
5 External links

Epidemiology

It occurs in 1-2 infants per 1000 live births^[3]

Types

Normal vascular anatomy with functional vasoconstriction

This has a good prognosis, as it is reversible. Causes include hypoxia, meconium aspiration, and respiratory distress syndrome.

Decreased diameter of pulmonary vessels with hypertrophy of vessel walls

This has a poor prognosis, as it is a fixed abnormality. Causes include post-term pregnancy, placental insufficiency, and NSAID use by the mother.

Decreased size of pulmonary vascular bed

This has a poor prognosis, as it is a fixed abnormality. It is caused by space occupying lesions such as pleural effusions and diaphragmatic hernias.

Functional obstruction of pulmonary blood flow

This has a good prognosis if it is reversible. Causes include polycythemia and hyperfibrinogenemia. ^[4]

Treatment

Treatment aims to increase the amount of oxygen in the blood and reverse any causes of hypoxia.

oxygen therapy
mechanical ventilation
NO Inhalation
Prostaglandins (intravenous)

The therapies available to manage PPHN include the high frequency ventilation, surfactant instillation, inhaled nitric oxide, and extracorporeal membrane oxygenation. These expensive and/or invasive modalities are unavailable in the developing countries where the frequency and mortality of PPHN is likely to be much higher due to higher incidence of asphyxia and sepsis. In developing countries, the medical facilities are usually supplied with outdated equipment that was initially donated. "For people in developing countries, basic medical supplies are luxuries that are simply not available or not affordable. Doctors and nurses must constantly make do - washing and reusing "disposable" gloves and syringes, or substituting inappropriate materials such as fishing line or sewing thread for suture- or patients must go without needed care. In many countries patients must bring their own supplies, even acquire their own medicines, before treatment can be given." The limitations made it necessary to search for cheaper therapies, assuring quick effectiveness and stabilization of the patient going through a very high-risk situation. The treatments are chosen on the basis of low cost, low-tech, wide availability, and safety in the hands of non-professionals. Therefore, oral sildenafil citrate, has been the alternative way of therapy. The cost comparison shows that sildenafil is lower in cost than iNO and more readily available. There is improvement in oxygenation when oral sildenifal is administered according to the studies found in the Official Journal of the American Academy of Pediatric. The positive research results for varies studies indicates that oral sildenifal is a feasible source to improve oxygenation and survival in critical ill infants with PPHN secondary to parenchymal lung disease in centers without access to high-frequency ventilation, iNO, or ECMO.

References

^ "Medcyclopaedia - Persistent fetal circulation". Archived from the original on 2012-02-05.
^ Mayock, Dennis E. (April 10, 2000). "Persistent Pulmonary Hypertension Of The Newborn". Archived from the original on October 12, 2010.
^ Chambers CD, Hernandez-Diaz S, Van Marter LJ, et al. (February 2006). "Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn". The New England Journal of Medicine 354 (6): 579–87. doi:10.1056/NEJMoa052744. PMID 16467545.
^ Graves ED, Redmond CR, Arensman RM (March 1988). "Persistent pulmonary hypertension in the neonate". Chest 93 (3): 638–41. doi:10.1378/chest.93.3.638. PMID 3277808.

External links

http://www.kumc.edu/instruction/medicine/pedcard/cardiology/pedcardio/pfcdiagram.gif
Dunn PM (March 1994). "Professor Charles D Meigs (1792-1869) of Philadelphia and persistent fetal circulation". Archives of Disease in Childhood. Fetal and Neonatal Edition 70 (2): F155–6. doi:10.1136/fn.70.2.f155. PMC 1061019. PMID 8154909.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 子宮内から子宮外の生活への生理的変化 physiologic transition from intrauterine to extrauterine life
2. 胎便吸引症候群の臨床的特徴および診断 clinical features and diagnosis of meconium aspiration syndrome
3. 胎児評価のための静脈ドップラー venous doppler for fetal assessment
4. 新生児における脳卒中 stroke in the newborn
5. 新生児脳症の臨床的特徴、診断、および治療 clinical features diagnosis and treatment of neonatal encephalopathy

English Journal

Wide clinical variability in conditions with coarse facial features and hypertrichosis caused by mutations in ABCC9.

Czeschik JC, Voigt C, Goecke TO, Lüdecke HJ, Wagner N, Kuechler A, Wieczorek D.SourceInstitut für Humangenetik, Universitätsklinikum Essen, Essen, Germany. christina.czeschik@uni-due.de
American journal of medical genetics. Part A.Am J Med Genet A.2013 Feb;161A(2):295-300. doi: 10.1002/ajmg.a.35735. Epub 2013 Jan 10.
We present two previously unreported and unrelated female patients, one with the tentative diagnosis of acromegaloid facial appearance (AFA), the other with the tentative diagnosis of hypertrichosis with acromegaloid facial appearance (HAFF) with or without gingival hyperplasia. Main clinical featur
PMID 23307537

Cerebral inflammation and mobilization of the peripheral immune system following global hypoxic-ischemia in preterm sheep.

Jellema RK, Passos VL, Zwanenburg A, Ophelders DR, De Munter S, Vanderlocht J, Germeraad WT, Kuypers E, Collins JJ, Cleutjens JP, Jennekens W, Gavilanes AW, Seehase M, Vles HJ, Steinbusch H, Andriessen P, Wolfs TG, Kramer BW.AbstractABSTRACT: BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is one of the most important causes of brain injury in preterm infants. Preterm HIE is predominantly caused by global hypoxic-ischemia (HI). In contrast, focal ischemia is most common in the adult brain and known to result in cerebral inflammation and activation of the peripheral immune system. These inflammatory responses are considered to play an important role in the adverse outcomes following brain ischemia. In this study, we hypothesize that cerebral and peripheral immune activation is also involved in preterm brain injury after global HI.
Journal of neuroinflammation.J Neuroinflammation.2013 Jan 24;10(1):13. [Epub ahead of print]
ABSTRACT: BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is one of the most important causes of brain injury in preterm infants. Preterm HIE is predominantly caused by global hypoxic-ischemia (HI). In contrast, focal ischemia is most common in the adult brain and known to result in cerebral infla
PMID 23347579

Japanese Journal

Antenatal management of recurrent fetal goitrous hyperthyroidism associated with fetal cardiac failure in a pregnant woman with persistent high levels of thyroid-stimulating hormone receptor antibody after ablative therapy

Matsumoto Tadashi,Miyakoshi Kei,Saisho Yoshifumi,Ishii Tomohiro,Ikenoue Satoru,Kasuga Yoshifumi,Kadohira Ikuko,Sato Seiji,Momotani Naoko,Minegishi Kazuhiro,Yoshimura Yasunori
Endocrine Journal 60(12), 1281-1287, 2013
… High titer of maternal thyroid-stimulating hormone receptor antibody (TRAb) in patients with Graves' disease could cause fetal hyperthyroidism during pregnancy. … Clinical features of fetal hyperthyroidism include tachycardia, goiter, growth restriction, advanced bone maturation, cardiomegaly, and fetal death. … The recognition and treatment of fetal hyperthyroidism are believed to be important to optimize growth and intellectual development in affected fetuses. …
NAID 130004770403

Factors Affecting Short-Term Mortality in Very Low Birth Weight Infants in Japan

OSHIKI RIEKO,NAKAMURA KAZUTOSHI,YAMAZAKI AKIRA,SAKANO CHUJI,NAGAYAMA YOSHIHISA,OOISHI MASANORI,YAMAMOTO MASAHARU
THE TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 205(2), 141-150, 2005-02-01
… Logistic regression analysis showed that independent risk factors for death of VLBWIs were male gender (relative risk [RR]: 2.0), low birth weight (RR: 0.56), necrotizing enterocolitis (RR: 58.0), pulmonary hypoplasia (RR: 37.8), chromosomal abnormalities (RR: 36.3), congenital heart diseases (RR: 9.8), persistent fetal circulation (RR: 9.6), neonatal asphyxia (RR: 6.3) and sepsis (RR: 4.4). …
NAID 10014318400

Factors Affecting Short-Term Mortality in Very Low Birth Weight Infants in Japan

Oshiki Rieko,Nakamura Kazutoshi,Yamazaki Akira,Sakano Chuji,Nagayama Yoshihisa,Ooishi Masanori,Yamamoto Masaharu
The Tohoku Journal of Experimental Medicine 205(2), 141-150, 2005
… Logistic regression analysis showed that independent risk factors for death of VLBWIs were male gender (relative risk [RR]: 2.0), low birth weight (RR: 0.56), necrotizing enterocolitis (RR: 58.0), pulmonary hypoplasia (RR: 37.8), chromosomal abnormalities (RR: 36.3), congenital heart diseases (RR: 9.8), persistent fetal circulation (RR: 9.6), neonatal asphyxia (RR: 6.3) and sepsis (RR: 4.4). …
NAID 130004459375

Related Pictures

★リンクテーブル★

リンク元	「胸腹裂孔ヘルニア」「新生児遷延性肺高血圧症」
拡張検索	「persistent fetal circulation syndrome」
関連記事	「persistent」「fetal」「circulation」

「胸腹裂孔ヘルニア」

Persistent foetal circulation
Classification and external resources
Specialty	pediatrics
ICD-10	P29.3
ICD-9-CM	747.83
DiseasesDB	29889
eMedicine	ped/2530
MeSH	D010547
	[edit on Wikidata]

　　[★]

英: pleuroperitoneal diaphragmatic hernia
同: 胸腹膜裂孔ヘルニア、ボホダレック孔ヘルニア Bochdalek孔ヘルニア Bochdalek hernia、ボホダレクヘルニア、Bochdalekヘルニア
関: 先天性横隔膜ヘルニア、横隔膜ヘルニア、横隔膜; 腰肋三角、ヘルニア

概念

胸腹裂孔の閉鎖障害により、ヘルニア門を通じて、腸管、脾臓、肝臓が胸腔に脱出する。左に多く(右2:左8)、ヘルニア嚢を欠く。
患側肺、時に両側肺の低形成を伴う。
治療成績は悪い
成人に至ってから発症するものもある（遅発型胸膜裂孔ヘルニア）

疫学

1/2000 (L.197)

病因

病変形成＆病理

症状

主訴：呼吸困難、チアノーゼ

呼吸循環障害

新生児遷延性肺高血圧(PPHN)、遷延性胎児循環(PFC)
圧排による肺低形成

合併奇形

腸回転異常が多い

診断

検査

治療

早期手術、ECMO(extracorporeal membrane oxygenation)
手術によりPFCを悪化させなくなる数日間待つ

予後

出生後24時間以内に緊急手術が必要な症例では予後不良
生後24時間以降にまで手術を待機できるような症例は予後良好。

遷延性胎児循環(persistent fetal circulation, PFC)が存在する場合は予後不良？

予防

「新生児遷延性肺高血圧症」

　　[★]

英: persistent pulmonary hypertension of newborn, persistent pulmonary hypertension of the newborn persistent pulmonary hypertension in the neonate PPHN
同: 胎児循環残存症候群胎児循環遺残症 persistent fetal circulation syndrome PFCS、胎児循環残存 persistent fetal circulation PFC; 新生児遷延性肺高血圧、新生児持続性肺高血圧症

[show details]

新生児遷延性肺高血圧 : 約 43,600 件
新生児遷延性肺高血圧症 : 約 41,300 件

概念

出生後、肺動脈拡張不全に基づく肺高血圧、および動脈管と卵円孔を介する右左シャントによりチアノーゼを呈する疾患。(SPE.107)
肺動脈拡張不全の原因として低酸素血症やアシドーシスがある。
以前は胎児循環遺残症と呼ばれていたが使われなくなった。(SPE.107)

病因

低酸素やアシドーシスによる肺血管抵抗の上昇

横隔膜ヘルニア、新生児仮死、胎便吸引症候群、呼吸窮迫症候群、肺低形成

「persistent fetal circulation syndrome」

　　[★] 胎児循環残存症候群

「persistent」

　　[★]

adj.

持続性の、持続的な、遷延性の、遺残の、残留性の

関: continuous、continuously、insurmountable、long-lasting、permanent、permanently、persistence、persistently、persisting、prolonged、repository、sustained、tonic、tonically

「fetal」

　　[★]

adj.

胎生期の、胎性の、(人間)胎児の、胎児性の、(動物)胎仔の、胎仔型の

関: embryo、embryonal、embryonic、embryonic day、embryonic form、embryonic stage、fetal stage、feto、fetus、foetal、foetus

「circulation」

　　[★]

n.

循環、血行、血行路、(図書などの)流通

関: blood circulation、circulate、circulatory、hematogenic

[urlMedcyclopaedia_-_Persistent_fetal_circulation-1] "Medcyclopaedia - Persistent fetal circulation". Archived from the original on 2012-02-05.

[urlPERSISTENT_PULMONARY_HYPERTENSION_OF_THE_NEWBORN-2] Mayock, Dennis E. (April 10, 2000). "Persistent Pulmonary Hypertension Of The Newborn". Archived from the original on October 12, 2010.

[3] Chambers CD, Hernandez-Diaz S, Van Marter LJ, et al. (February 2006). "Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn". The New England Journal of Medicine 354 (6): 579–87. doi:10.1056/NEJMoa052744. PMID 16467545.

[4] Graves ED, Redmond CR, Arensman RM (March 1988). "Persistent pulmonary hypertension in the neonate". Chest 93 (3): 638–41. doi:10.1378/chest.93.3.638. PMID 3277808.

匿名

検索

案内

persistent fetal circulation