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Byline: Amanda R. Crowley (1), Sheilendra S. Mehta (1), Mark J. Hembree (1), Barry L. Preuett (1), Krishna L. Prasadan (1), Susan W. Sharp (1), Hooi Yew (1), Christopher R. McFall (1), Christina L. Benjes (1), Sidhartha S. Tulachan (1), George K. Gittes (1), Charles L. Snyder (1) Keywords: Esophageal atresia; Tracheoesophageal fistula; Bone morphogenetic protein; Branching; Morphogenesis Abstract: The organogenesis of esophageal atresia with tracheoesophageal fistula (EA/TEF) remains unknown. The fistula tract appears to develop from a non-branching trifurcation of the embryonic lung bud. The non-branching growth of the fistula differs from the other lung buds and suggests a deficiency in bone morphogenetic protein (BMP) signaling, since BMPs are critical to proper lung development and branching. With IRB approval, portions of newborn human proximal esophageal pouch and distal fistula samples were recovered at the time of surgical repair of EA/TEF. The tissues were processed for immunohistochemistry. Commercially available fetal tissues were used as controls. In control tissues, BMP ligands (BMP 2, 4, and 7) were all present in the esophagus but absent in the trachea. BMPRIA was absent in both tissues. BMPRIB was detected in trachea but not in esophagus and BMPRII was detected in esophagus but not in trachea. In the EA/TEF specimens, all BMP ligands were present in the proximal esophageal pouch but absent in the fistula tract. BMPRIA and BMPRIB were not detected in either tissue. However, BMPRII was found in both fistula tract and proximal pouch. The submucosa of the fistula appears to maintain a mixed (identical neither to lung, esophagus, or trachea) BMP signaling pattern, providing one mechanism which could potentially explain the esophageal dismotility and lack of lung branching seen in the fistula/distal esophagus. Author Affiliation: (1) Laboratory for Surgical Organogenesis, Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA Article History: Registration Date: 09/11/2005 Accepted Date: 21/10/2005 Online Date: 29/11/2005

Byline: J. F. Felix (1), R. Keijzer (1,3), M. F. Dooren (1,3), R. J. Rottier (3), D. Tibboel (1,2) Keywords: Foregut; Oesophageal atresia; Tracheo-oesophageal fistula; Genes; Embryology Abstract: Oesophageal atresia and tracheo-oesophageal fistula are relatively frequently occurring foregut malformations of which the aetiology and pathogenesis are poorly understood. Recent results of molecular genetic studies, in particular the use of single and compound mutant mice, have yielded a tremendous increase in the understanding of the molecular mechanisms involved in normal and abnormal foregut morphogenesis. In the introduction of this paper, we review the very early stages of normal and abnormal embryology of the foregut derivatives and the separation of the foregut into a ventral respiratory part and a dorsal digestive part. After that, we describe the genes that have been demonstrated to play an important role in these processes. Author Affiliation: (1) Department of Paediatric Surgery, Erasmus MC--Sophia Children's Hospital, Rotterdam, The Netherlands (2) Paediatric Surgical Intensive Care Unit, Erasmus MC--Sophia Children's Hospital, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands (3) Department of Cell Biology and Genetics, Erasmus MC, Rotterdam, The Netherlands Article History: Registration Date: 21/09/2004 Accepted Date: 16/01/2004 Online Date: 28/10/2004

Byline: Mustafa Adegmamoglu (1), Ali Cay (1), Polat KoAucu (2), Ali Ahmetoglu (2), Haluk Sarihan (1) Keywords: Button-battery ingestion; Acquired tracheo-esophageal fistula; Multislice CT; Children Abstract: Esophageal impacting of button batteries must be distinguished from impacting of other foreign bodies because of their severe complications. We present a 2.5-year-old girl who had an acquired tracheo-esophageal fistula (TEF) caused by a calculator battery lodged in her esophagus. We also review the literature and assess the applicability of multislice CT and its possible advantages in children with acquired TEF. Author Affiliation: (1) Department of Pediatric Surgery, Karadeniz Technical University, Faculty of Medicine, 61080 , Trabzon, Turkey (2) Department of Radiology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey Article History: Registration Date: 28/11/2003 Online Date: 18/05/2004