Umbilical Extracts Research Articles

The incidence of extraction site incisional hernia after minimally invasive colorectal surgery: a systematic review and meta-analysis.

Minimally invasive colorectal surgery reduces surgical trauma with better preservation of abdominal wall integrity, but the extraction site is still at risk of incisional hernia (IH). The aim of this study was to determine pooled incidence of IH for each type of extraction site and to compare rates of IH after midline, nonmidline and Pfannenstiel extraction. A systematic review and meta-analysis was conducted using the PRISMA guidelines. Single-armed and multiple-armed cohort studies and randomized controlled trials regarding minimally invasive colorectal surgery were searched from five databases. Outcomes were pooled and compared with random-effects, inverse-variance models. Risk of bias within the studies was assessed using the Cochrane ROBINS-I and RoB 2 tool. Thirty six studies were included, with a total 11,788 patients. The pooled extraction site IH rate was 16.0% for midline (n=4081), 9.3% for umbilical (n=2425), 5.2% for transverse (n=3213), 9.4% for paramedian (n=134) and 2.1% for Pfannenstiel (n=1449). Nonmidline extraction (transverse and paramedian) showed significantly lower odds ratios (ORs) for IH when compared with midline extraction (including umbilical). Pfannenstiel extraction resulted in a significantly lower OR for IH compared with midline [OR 0.12 (0.50-0.30)], transverse [OR 0.25 (0.13-0.50)] and umbilical (OR 0.072 [0.033-0.16]) extraction sites. The risks of surgical site infection, seroma/haematoma or wound dehiscence were not significantly different in any of the analyses. Pfannenstiel extraction is the preferred method in minimally invasive colorectal surgery. In cases where Pfannenstiel extraction is not possible, surgeons should avoid specimen extraction in the midline.

OC-055 THE INCIDENCE OF EXTRACTION SITE INCISIONAL HERNIA AFTER MINIMALLY INVASIVE COLORECTAL SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Aim Minimally invasive colorectal surgery reduces surgical trauma with better preservation of abdominal wall integrity, but the extraction site is still at risk of incisional hernia (IH). This study aimed to determine pooled incidence of IH for each type of extraction site, and to compare IH rates after midline, non-midline and Pfannenstiel extraction. Methods A systematic review and meta-analysis was conducted using PRISMA guidelines. Single-armed and multiple-armed cohort studies, and randomized controlled trials regarding minimally invasive colorectal surgery were queried from five databases. Outcomes were pooled and compared with random-effects, inverse-variance models. Risk of bias was assessed using the Cochrane ROBINS-I and RoB 2 tools. Results Thirty-six studies were included, totalling 11,788 patients. Pooled extraction site incisional hernia (ESIH) rate was 16.0% for midline (n=4081), 9.3% for umbilical (n=2425), 5.2% for transverse (n=3213), 9.4% for paramedian (n=134) and 2.1% for Pfannenstiel (n=1449). ESIH occurred significantly more with midline extraction in comparison to Pfannenstiel (Odds Ratio (OR) 8.4 [3.5;20.0]). Non-midline extraction (transverse and paramedian) showed a significantly lower OR for IH compared to midline extraction (midline and umbilical). Pfannenstiel extraction resulted in significantly lower OR for ESIH compared to midline (OR 0.12 [0.050;0.30]), transverse (OR 0.25 [0.13;0.50]) and umbilical (OR 0.072 [0.033;0.16]) extraction sites. The risks of surgical site infection and surgical site occurrence were not significantly different in any analyses. Conclusions Specimen extraction through a Pfannenstiel incision is the preferred method in minimally invasive colorectal surgery. In cases where Pfannenstiel extraction is not possible, surgeons should avoid midline specimen extraction.

TH7.10 Extraction site hernias following Laparoscopic Right Hemicolectomy: Does location matter?

Abstract Introduction Laparoscopic colorectal surgery is the gold standard treatment for patients requiring colorectal resection, however the need to exteriorise the specimen and perform extracorporeal anastomosis leads to a risk of incisional hernia. Robotic surgery may facilitate intracorporeal anastomosis which could potentially negate the need for an umbilical extraction site. This study compares current practice of transverse versus midline extraction sites for laparoscopic right hemicolectomy and the incidence of incisional hernia. Methods A retrospective collection of all patients undergoing laparoscopic right hemicolectomy between 2018 and 2020 was performed using OPCS theatre codes. Only those undergoing laparoscopic right hemicolectomy, who had cross-sectional imaging post-operatively were included. Operation notes were scrutinised to identify extraction site and closure method. Post-operative CT scans were reviewed by a radiologist to identify presence of incisional hernia. Results Of 103 patients, 50 met the inclusion criteria. 25 were male. The mean age was 67 (Range = 21–85). 31 patients had midline extraction sites, with 19 having transverse. The average time from operation to CT was 662 days (314–1094) and 34% (n=17) had incisional hernia identified on a CT scan post-operatively. Midline extraction sites were associated with a significantly higher rate of incisional hernia when compared to transverse sites (n=16/31, 1/19; p<0.01). Conclusion Transverse extraction sites are associated with a lower risk of incisional hernia after laparoscopic right hemicolectomy and should be preferred to midline incisions where possible. As intracorporeal anastomosis becomes a more established technique, further work is needed to determine optimum extraction site to further reduce the risk of incisional hernias.

Robotic-assisted laparoscopy living donor nephrectomy: Technique and results of a monocentric retrospective series

Robot-assisted nephrectomy for living kidney donation (LKD) has been described in the literature as a safe and reproducible technique in high volume centers with extensive robotic surgery experience. Any surgical procedure in a healthy individual ought to be safe in regards to complications. The objective of this study was to evaluate the Robotic-assisted Living Donor Nephrectomy (RLDN) experience in a robotic surgery expert center. This is a retrospective study from 11/2011 and 12/2019. In total, 118 consecutive Living Donor (LD) kidney transplants were performed at our institution. All the procedures were performed by robotic-assisted laparoscopic approach. Extraction was performed by iliac (IE), vaginal (VE) or umbilical extraction (UE). The left kidney was preferred even if the vascular anatomy was not modal. For donors: the median operative time was 120min with 50mL of blood loss. The median warm ischemia time was 4min, with a non-significant shorter duration with the UE (4min) in comparison with IE or VE (5min). Nine patients had postoperative complications including 1 grade II (blood transfusion) and 1 grade IIIb (vaginal bleeding after VE). None of our procedures were converted to open surgeries and no deaths were reported. For the recipients: 1.7% presented delayed graft function; their median GFR at 1 year was 61mL/min/1.73m2. RLDN in an expert center appears to be a safe technique. The advantages of the robot device in terms of ergonomy don't hamper the surgical outcomes. Donor, recipient and graft survivals seem comparable to the reported laparoscopic outcomes in the literature.

Laparoscopic Management of a Second Trimester Tubal Ectopic Pregnancy

Study Objective To demonstrate the safe laparoscopic management of a tubal ectopic pregnancy presenting at an advanced gestational age. Design Narrated video tutorial for safe laparoscopic management of this rare presentation. Setting Ectopic pregnancy most often occurs within the fallopian tube commonly presenting as vaginal bleeding and abdominal or pelvic pain during the first trimester. Second-trimester tubal ectopic pregnancies are extremely rare and carry a significantly higher level of maternal morbidity and mortality compared to first-trimester presentation. Second-trimester tubal ectopic pregnancies are challenging to diagnose by ultrasound alone and may appear as peritoneal or ovarian ectopics. A high degree of suspicion must be maintained to ensure the best maternal outcomes. Patients or Participants We present a case of a bleeding tubal ectopic pregnancy diagnosed at 13 weeks and 4 days at an academic tertiary care hospital. Interventions A laparoscopic approach to manage a tubal ectopic pregnancy at 13 weeks and 4 days gestational age. Measurements and Main Results Laparoscopic approach was utilized with several key steps: 1. Confirmation of the tubal location of the ectopic pregnancy 2. Sequential cuts through the mesosalpinx minimizing injury to the adjacent ovary while limiting intraoperative blood loss 3. Specimen containment and umbilical extraction Conclusion Advanced gestational age tubal ectopic pregnancy represents an extremely rare clinical situation that requires the surgeons appreciation for the potential for massive maternal bleeding. Ultrasound diagnosis alone can be very challenging and thus high clinical suspicion should be maintained and appropriate preoperative planning is crucial.

Umbilical cord extracts improve osteoporotic abnormalities of bone marrow-derived mesenchymal stem cells and promote their therapeutic effects on ovariectomised rats

Bone marrow-derived mesenchymal stem cells (BM-MSCs) are the most valuable source of autologous cells for transplantation and tissue regeneration to treat osteoporosis. Although BM-MSCs are the primary cells responsible for maintaining bone metabolism and homeostasis, their regenerative ability may be attenuated in postmenopausal osteoporosis patients. Therefore, we first examined potential abnormalities of BM-MSCs in an oestrogen-deficient rat model constructed by ovariectomy (OVX-MSCs). Cell proliferation, mobilisation, and regulation of osteoclasts were downregulated in OVX-MSCs. Moreover, therapeutic effects of OVX-MSCs were decreased in OVX rats. Accordingly, we developed a new activator for BM-MSCs using human umbilical cord extracts, Wharton’s jelly extract supernatant (WJS), which improved cell proliferation, mobilisation and suppressive effects on activated osteoclasts in OVX-MSCs. Bone volume, RANK and TRACP expression of osteoclasts, as well as proinflammatory cytokine expression in bone tissues, were ameliorated by OVX-MSCs activated with WJS (OVX-MSCs-WJ) in OVX rats. Fusion and bone resorption activity of osteoclasts were suppressed in macrophage-induced and primary mouse bone marrow cell-induced osteoclasts via suppression of osteoclast-specific genes, such as Nfatc1, Clcn7, Atp6i and Dc-stamp, by co-culture with OVX-MSCs-WJ in vitro. In this study, we developed a new activator, WJS, which improved the functional abnormalities and therapeutic effects of BM-MSCs on postmenopausal osteoporosis.

In vitro evaluation of the effects of human umbilical cord extracts on human fibroblasts, keratinocytes, and melanocytes

Skin aging is the result of internal and external factors. So-called photoaging has been identified as the major factor in skin aging. Effects of photoaging include inhibition of fibroblast and keratinocyte proliferation as well as collagen and fibronectin expression, while activating expression of collagenases such as matrix metalloproteinase-1. Previous studies have shown that extracts or products from human placenta significantly improve skin aging and chronic wound healing. However, there are few studies of umbilical cord extracts. Therefore, this study aimed to evaluate the effects of umbilical cord extract-derived formulae on three kinds of skin cells including fibroblasts, keratinocytes, and melanocytes. We prepared 20 formulae from intracellular umbilical cord extracts, extracellular umbilical cord extracts, and umbilical cord-derived stem cell extracts, as well as five control formulae. We evaluated the effects of the 25 formulae on fibroblast and keratinocyte proliferation, and expression of collagen I, fibronectin, and matrix metalloproteinase-1 in fibroblasts and tyrosinase in melanocytes. The results showed that 7.5% formula 35 was the most effective formula for promotion of fibroblast and keratinocyte proliferation. At this concentration, formula 35 also induced collagen expression and inhibited matrix metalloproteinase-1 expression at the transcriptional level. However, this formula had no effect on tyrosinase expression in melanocytes. These results demonstrate that umbilical cord extracts can serve as an attractive source of proteins for skincare and chronic wound healing products.

Laparoendoscopic Single-site Donor Nephrectomy: A Single-center Experience

To present our experience with 13 patients undergoing laparoendoscopic single-site live donor nephrectomy. The Quadport/Triport (Advanced Surgical Concepts, Ireland) was inserted through an incision in the umbilicus. Apart from standard laparoscopic instruments, we used extra-long harmonic scalpel, suction, and bent instruments, particularly for upper pole dissection. After securing the hilum, the graft was brought near the umbilical extraction site with a grasper inserted through an extra 3- or 5-mm port and easily retrieved with the help of 2 fingers. The parameters analyzed were warm ischemia time, operative time, blood loss, postoperative visual analogue score, grafts retrieval time, and artery, vein, and ureteral length. Mean body mass index was 22.18 +/- 3.42 kg/m(2) (range 17.9-29.78). The mean operative time, blood loss, warm ischemia time, and hospital stay were 176.9 +/- 42.47 minutes, 158 +/- 78 mL, 6.79 +/- 1.7 minutes, and 3 +/- 0.45 days (range 2-5), respectively. Graft artery, vein, and ureteral length was 3.8 +/- 0.4, 4 +/- 0.12, and 14.5 cm (range 13-16), respectively. The urine output was prompt in all cases. Visual analogue score in the donor at 2 weeks was 0/10 in all cases. Eleven patients required extra 3- or 5-mm port. Cosmesis was excellent, with the mean incision length of 5.23 +/- 0.96 cm. The laparoendoscopic single-site donor nephrectomy in our initial experience is efficacious and a feasible, minimally invasive option for donors in renal transplantation. Further prospective studies with conventional laparoscopic donor nephrectomy are required to establish its current status.

Final report on the safety assessment of human placental protein, hydrolyzed human placental protein, human placental enzymes, human placental lipids, human umbilical extract, placental protein, hydrolyzed placental protein, placental enzymes, placental lipids, and umbilical extract.

Various proteins, lipids, or other extracts from human or other animal placentas are described as cosmetic ingredients. Human Placental Protein comprises protein derived from human placentas. Placental Protein is derived from animal placentas. Similarly, Human Placental Lipids and Placental Lipids are the lipid fractions from the same source materials. Hydrolyzed Human Placental Protein and Hydrolyzed Placental Protein are produced from the respective protein extracts by acid, enzyme, or other hydrolysis methods. Human Placental Enzymes and Placental Enzymes are enzymes obtained by aqueous extraction of human or other animal placental material. Human Umbilical Extract and Umbilical Extract are unspecified extracts of material from human or other animal umbilical cords. Different materials called Human Placental Extracts and Placental Extracts, assumed to contain estrogenic hormones or other biologically active substances, are not recognized as cosmetic ingredients, even though the use of these ingredients in cosmetics have been reported to the Food and Drug Administration (FDA). Human-derived ingredients are prohibited from use under the provisions of the European Union cosmetics directive based on concerns about transmission of human spongiform encephalopathies and viral diseases, for example, human immunodeficiency virus (HIV). Umbilical Extract has precedent for unrestricted use in Japan, except for certain products. Most of these ingredients are described as hair-conditioning agents and miscellaneous skin-conditioning agents, although the umbilical extracts function as biological additives in cosmetics. Of the human-derived ingredients, only Human Placental Protein is currently reported to be used. Animal-derived placental proteins, hydrolyzed proteins, lipids, and enzymes were all currently reported to be used. No current uses of the umbilical extracts were reported. Most of the available data relates to placental derivatives that appear to have estrogenic or other biological activity. The one clinical study that appears to utilize proteinaceous material only reported no irritant reaction. Clearly, the available data are insufficient to support safety of these ingredients in cosmetics. The additional data needed include (1) skin sensitization at concentration of use; (2) gross pathology and histopathology in skin and other major organ systems associated with repeated exposures, and dermal reproductive and developmental toxicity data; (3) photosensitization; (4) one genotoxicity assay in a mammalian system; if positive, then a 2-year dermal carcinogenicity study using National Toxicology Program (NTP) methods may be needed; (5) ocular toxicity, if available. Any studies should be done on all ingredients unless chemical analysis data show similarity among ingredients. Because there is confusion and concern about the use of substances with estrogenic or other biological activity in cosmetic formulations, it was concluded that none of these ingredients used in cosmetics should deliver any metabolic/endocrine activity. In addition, any current use of these ingredients should be free of detectable pathogenic viruses or infectious agents.

Biography of Tor Norseth

Various proteins, lipids, or other extracts from human or other animal placentas are described as cosmetic ingredients. Human Placental Protein comprises protein derived from human placentas. Placental Protein is derived from animal placentas. Similarly, Human Placental Lipids and Placental Lipids are the lipid fractions from the same source materials. Hydrolyzed Human Placental Protein and Hydrolyzed Placental Protein are produced from the respective protein extracts by acid, enzyme, or other hydrolysis methods. Human Placental Enzymes and Placental Enzymes are enzymes obtained by aqueous extraction of human or other animal placental material. Human Umbilical Extract and Umbilical Extract are unspecified extracts of material from human or other animal umbilical cords. Different materials called Human Placental Extracts and Placental Extracts, assumed to contain estrogenic hormones or other biologically active substances, are not recognized as cosmetic ingredients, even though the use of these ingredients in cosmetics have been reported to the Food and Drug Administration (FDA). Human-derived ingredients are prohibited from use under the provisions of the European Union cosmetics directive based on concerns about transmission of human spongiform encephalopathies and viral diseases, for example, human immunodeficiency virus (HIV). Umbilical Extract has precedent for unrestricted use in Japan, except for certain products. Most of these ingredients are described as hair-conditioning agents and miscellaneous skin-conditioning agents, although the umbilical extracts function as biological additives in cosmetics. Of the human-derived ingredients, only Human Placental Protein is currently reported to be used. Animal-derived placental proteins, hydrolyzed proteins, lipids, and enzymes were all currently reported to be used. No current uses of the umbilical extracts were reported. Most of the available data relates to placental derivatives that appear to have estrogenic or other biological activity. The one clinical study that appears to utilize proteinaceous material only reported no irritant reaction. Clearly, the available data are insufficient to support safety of these ingredients in cosmetics. The additional data needed include (1) skin sensitization at concentration of use; (2) gross pathology and histopathology in skin and other major organ systems associated with repeated exposures, and dermal reproductive and developmental toxicity data; (3) photosensitization; (4) one genotoxicity assay in a mammalian system; if positive, then a 2-year dermal carcinogenicity study using National Toxicology Program (NTP) methods may be needed; (5) ocular toxicity, if available. Any studies should be done on all ingredients unless chemical analysis data show similarity among ingredients. Because there is confusion and concern about the use of substances with estrogenic or other biological activity in cosmetic formulations, it was concluded that none of these ingredients used in cosmetics should deliver any metabolic/endocrine activity. In addition, any current use of these ingredients should be free of detectable pathogenic viruses or infectious agents.

Transport of calcium by the placenta of the rat.

Transport of 45Ca and of radioactively labelled inert saccharides across the intact or perfused placenta was measured in the rat on day 21 of pregnancy, the day after mating being day 1. The values of permeability--surface area product (PS) of the intact placenta to radioactive mannitol, sucrose, raffinose, and methoxyinulin were approximately proportional to their diffusion coefficients in water. This suggests that diffusion of inert hydrophilic molecules across the rat placenta takes place through wide aqueous channels. Net flux of Ca from mother to fetus, estimated from the increase of the fetal Ca content between day 20 and day 21 is 100 +/- 4 nmol min-1 (the limits here and below are S.E. of means). The unidirectional maternal-fetal flux of Ca (Jmf) in non-anaesthetized animals, estimated from the flux of 45Ca, is 100 +/- 7 nmol min-1. The similarity of the two values suggests that the fetal-maternal flux (Jfm) is small The umbilical vascular bed of the rat placenta was perfused in situ with Krebs-dextran fluid. Jmf estimated from the transfer of 45Ca from maternal plasma to perfusate was 81 +/- 4 nmol min-1. PS of the perfused placenta to radioactive sucrose was 2.6 +/- 0.3 microliter min-1. Jmf decreased reversibly when the placenta was perfused with 0.5 mM-dinitrophenol or 1 mM-CN-, which is consistent with the presumed active nature of the maternal-fetal transport of Ca. Jmf did not decrease when the placenta was perfused with Na-free fluids (substitution with Tris, Li or sucrose), indicating that Na-Ca exchange across the fetal border of the placental trophoblast is not involved in maternal-fetal transport of Ca. Transport of 45Ca to the perfusate was reduced to about 60% when maternal plasma concentration of Ca was doubled. This suggests that the affinity of the maternal-fetal transport system to Ca is high. Jmf did not change when the umbilical concentration of Ca was varied between 0.1 and 3 mM. There thus seems to be no rapid feed-back between umbilical concentration of Ca and transport of Ca from mother to fetus. Fetal-maternal transfer of Ca, estimated from the steady-state extraction of 45Ca from the umbilical perfusate, is only about 20% of the maternal-fetal transfer. Umbilical extraction of 45Ca changed only little when umbilical concentration of Ca was varied between 0.1 and 3 mM. This suggests that either most of the fetal-maternal transport of Ca is diffusional or the fetal-maternal transport system has a very low affinity to Ca.(ABSTRACT TRUNCATED AT 400 WORDS)

Umbilical glucose and lactate extractions during maternal hyperglycemia in sheep.

Umbilical glucose and lactate extractions were determined in previously instrumented pregnant ewes into some of which D-glucose was infused to produce graded levels of maternal hyperglycemia as great as 20 mM. While fetal arterial glucose concentration continued to increase linearly as a function of maternal arterial glucose concentration during maternal hyperglycemia, the umbilical venoarterial difference in blood glucose concentration did not, and umbilical glucose extraction approached a plateau at approximately 0.063 mmol X min-1 X kg fetus-1 at maternal glucose concentrations greater than approximately 8 mM. The observed plateau in glucose extraction is consistent with saturation at high maternal glucose concentrations of the carrier mechanism for transport of glucose from the maternal to the fetal aspects of the trophoblast. The observed value of the plateau in umbilical extraction of glucose is slightly less than the maximum extraction predicted from previously published equations for this species, but the maternal blood glucose concentration at which the observed maximum occurred agrees closely with the value predicted by those equations. Umbilical lactate extraction, 0.031 +/- 0.021 mmol X min-1 X kg fetus-1, was independent of maternal arterial blood glucose and lactate concentrations and was independent of umbilical glucose extraction.

Effect of maternal serum insulin on umbilical extraction of glucose and lactate in fed and fasted sheep

In 18 chronically instrumented pregnant ewes in late gestation, umbilical extractions of glucose and lactate were determined before and during the continuous infusion of ovine insulin, 0.25 mU/kg . min, into one uterine artery. Studies were conducted in both well-nourished and fasting ewes. Exogenous insulin increased the umbilical extraction of glucose without altering the umbilical extraction of lactate over the range of concentrations of maternal blood glucose encountered in the fed and fasted states. Moreover, the efflux of lactate into the uterine venous circulation in two additional ewes was not altered by the administration of insulin. These studies support the hypothesis that maternal circulating insulin binds to insulin receptors on the microvillous brush border of the placenta to effect an increase in the carrier-mediated transfer of glucose rather than cause an intraplacental decrease in the catabolism of glucose to lactate. The results suggest that, as maternal levels of blood glucose and serum insulin spontaneously rise in concert over the physiologic range, both factors may contribute to the increasing umbilical extraction of glucose. Furthermore, these observations raise the possibility that decreased binding of insulin by placental insulin receptors, which is reported to occur in placentas from diabetic women, may be accompanied by a relatively decreased umbilical uptake of glucose for a given maternal concentration of glucose, but not of lactate.

Growth of glucose and oxygen uptakes by fetuses of fed and starved ewes.

ARTICLESGrowth of glucose and oxygen uptakes by fetuses of fed and starved ewesRD Boyd, Morriss FH Jr, G Meschia, EL Makowski, and FC BattagliaRD BoydSearch for more papers by this author, Morriss FH JrSearch for more papers by this author, G MeschiaSearch for more papers by this author, EL MakowskiSearch for more papers by this author, and FC BattagliaSearch for more papers by this authorPublished Online:01 Oct 1973https://doi.org/10.1152/ajplegacy.1973.225.4.897MoreSectionsPDF (1 MB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Next Download PDF FiguresReferencesRelatedInformation Cited ByMaternal-Fetal Transfer of Lipid MetabolitesMetabolism of Glucose and Methods of Investigation in the Fetus and NewbornMaternal-Fetal Transfer of Lipid MetabolitesMetabolism of Glucose and Methods of Investigation in the Fetus and NewbornFetal PhysiologyTwin-pregnancy increases susceptibility of ewes to hypoglycaemic stress and pregnancy toxaemiaResearch in Veterinary Science, Vol. 84, No. 2Chapter 15 Hepatic gluconeogenesis in developing ruminantsMaternal-Fetal Transfer of Lipid MetabolitesMetabolism of Glucose and Methods of Investigation in the Fetus and NewbornHypoglycemic injury to the immature brainClinics in Perinatology, Vol. 29, No. 4PlacentationEffects of maternal undernutrition and exercise on glucose kinetics in fetal sheep9 March 2007 | British Journal of Nutrition, Vol. 64, No. 2Lipid Metabolic Interactions in the Mother during Pregnancy and their Fetal RepercussionsIntegration of perinatal events, pathophysiological changes and consequences for the newborn lambBritish Veterinary Journal, Vol. 144, No. 6Acute versus chronic conditions for studies of fetal nutrient requirements: Applicability to the humanPlacenta, Vol. 7, No. 2Physiology of the PlacentaCarbohydrate, Fat and Amino Acid Metabolism in the Pregnant Woman and FetusEffects of exogenous insulin on placental transfer of maternal glucose to the rat fetusDiabetologia, Vol. 28, No. 10Effects of undernutrition and exercise during late pregnancy on uterine, fetal and uteroplacental metabolism in the ewe24 July 2007 | British Journal of Nutrition, Vol. 53, No. 3Fetal Fat and Glucose MetabolismEnergy and Substrate Requirements for Fetal and Placental Growth and MetabolismNutritional and Placental Determinants of Foetal Growth Rate in Sheep and Consequences for the Newborn LambBritish Veterinary Journal, Vol. 139, No. 4Carbohydrate MetabolismNutritional Physiology in Pregnancy and LactationAdvances in Pediatrics, Vol. 30, No. 1Effect of maternal serum insulin on umbilical extraction of glucose and lactate in fed and fasted sheepAmerican Journal of Obstetrics and Gynecology, Vol. 142, No. 2Within-day variations in the composition of maternal and fetal plasma from catheterised ewes fed once daily or at hourly intervals during late pregnancyResearch in Veterinary Science, Vol. 31, No. 2Fetal metabolic response to experimental placental vascular damageAmerican Journal of Obstetrics and Gynecology, Vol. 140, No. 4The use of chemical analyses of umbilical cord blood for the computation of instantaneous fetal growthJournal of Theoretical Biology, Vol. 89, No. 3Effects of placental weight and maternal nutrition on the growth rates of individual fetuses in single and twin bearing ewes during late pregnancyResearch in Veterinary Science, Vol. 30, No. 2Effect of maternal canine starvation on fetal and neonatal liver metabolismE. L. Miettinen1 February 1981 | American Journal of Physiology-Endocrinology and Metabolism, Vol. 240, No. 2Glucose and lactate metabolism in vivo in ovine fetusR. L. Prior1 September 1980 | American Journal of Physiology-Endocrinology and Metabolism, Vol. 239, No. 3Effect of insulin-induced maternal hypoglycemia on glucose turnover in maternal and fetal sheepR. S. Anand, S. Ganguli, and M. A. Sperling1 June 1980 | American Journal of Physiology-Endocrinology and Metabolism, Vol. 238, No. 6Placental amino acid uptakeAmerican Journal of Obstetrics and Gynecology, Vol. 137, No. 4Metabolism in the whole animal28 February 2007 | Proceedings of the Nutrition Society, Vol. 38, No. 3Physiology of the PlacentaCarbohydrate, Fat, and Amino Acid Metabolism in the Pregnant Woman and FetusMaternal-Foetal Glucose Kinetics in Conscious, Catheterised Sheep26 July 2012 | Proceedings of the Nutrition Society, Vol. 36, No. 1Fetal carbohydrate metabolism: Its clinical importanceAmerican Journal of Obstetrics and Gynecology, Vol. 127, No. 1Development of gluconeogenic enzymes in fetal sheep liver and kidneyDevelopmental Biology, Vol. 52, No. 2Placental production and foetal utilisation of lactate and pyruvateNature, Vol. 254, No. 5502Carbohydrate and Lipid Metabolism More from this issue > Volume 225Issue 4October 1973Pages 897-902 Copyright & PermissionsCopyright © 1973 by American Physiological Societyhttps://doi.org/10.1152/ajplegacy.1973.225.4.897PubMed4743381History Published online 1 October 1973 Published in print 1 October 1973 Metrics