Liver biopsies and/or autopsy specimens from 17 children (ages 1 week to 5 years) with nonsyndromatic paucity of the interlobular bile ducts were studied by light and electron microscopy. Initial biopsies were obtained before 90 days of age from all patients, and two or more specimens were available from nine. No specific underlying condition was found in nine infants. The remaining cases were associated with Down's syndrome (n = 2), hypopituitarism (n = 2), cystic fibrosis (n = 1), alpha 1-antitrypsin deficiency (n = 1), cytomegalovirus (n = 1) and Ivemark syndrome (n = 1). Before 90 days of age, portal changes included duct paucity and fibrosis. Lobular changes were nonspecific, consisting of cholestasis, giant cell transformation, extramedullary hematopoiesis and perisinusoidal fibrosis. Duct paucity, portal fibrosis and perisinusoidal fibrosis persisted after 90 days. Cholestasis was mild or no longer apparent. Portal changes before 90 days of age appear to be sufficiently distinctive to microscopically distinguish nonsyndromatic from syndromatic paucity. Electron microscopic findings suggest that paucity in nonsyndromatic patients may result from a primary ductal insult: ultrastructural studies revealed bile duct destruction characterized by undulation and breaks in the basal lamina and infiltration of the epithelium by lymphocytes. Bile canalicular dilatation with blunting of microvilli and electron-dense material in the lumen, predominantly seen before 90 days, also reinforces the hypothesis of a primary ductal defect.

Age Factors↗

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Recurrent thrombosis in a child.

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Blood Coagulation Disorders↗

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Quantification of intracellular calcitonin gene transcripts in human medullary thyroid carcinoma (MTC) by in situ hybridization.

The human calcitonin gene generates 2 distinct mature mRNAs by alternative RNA processing, encoding calcitonin (CT) in thyroid C-cells or a neuropeptide (CGRP) in the brain. We evaluated quantitatively by in situ hybridization the expression of the CT gene in tissue section of 5 MTCs (2 sporadic and 3 familial forms). The primary tumor of one MTC was compared to a brain metastasis. In situ hybridization was carried out with tritiated cDNA probes coding for CT and CGRP mRNA. After autoradiography the number of silver grains was counted in 400 cells by computerized analysis of digitized images and expressed as the labelling level (L.L. = grain area/cell area per day of autoradiographic exposure). This was used to calculate the relative abundance per cell of the specific messengers studied, which depends on the autoradiographic efficiency and the specific activity of the probe used. The CT mRNA content was 3.25-6.55 10(-10) micrograms equivalents in the 3 familial forms of MTC and 4.95-9.25 10(-10) micrograms equivalents for the 2 sporadic forms. The levels of CT mRNA in the brain metastasis and in the primary tumor were identical (4.10 10(-10) micrograms equivalents). CGRP mRNA expression was weaker in the sporadic and in the familial thyroid tumors (0.60-1.65 10(-10) micrograms equivalents). The content of mRNA CGRP in the brain metastasis (0.60 10(-10) micrograms equivalents) was lower than that in the primary tumor (1.05 10(-10) micrograms equivalents).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

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Neurofibromatosis with cardiac involvement.

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Child↗

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Origin of cardiac mucosa: ontogenic consideration.

The origin and histology of the cardiac mucosa remains controversial. The classical concept that the cardiac mucosa is of gastric origin has been challenged by those who advocate that the cardiac mucosa results from a metaplastic esophageal process. Some regard cardiac mucosa as consisting solely of pure mucous glands, whereas others accept the presence of isolated parietal cells within the mucous gland (mixed glands). In this study, we have clarified the presence and site of origin of the cardiac mucosa and its histological composition. To do so we studied the microscopic characteristics of the gastric side of the squamous-columnar junction (SCJ) of 77 autopsied fetuses of different gestational ages (prenatal group) and of infants, young children, and adolescents (postnatal group). We evaluated the presence or absence of a transitional zone, defined as the area between the squamous esophageal and oxyntic mucosa, the glandular composition of the transitional zone (i.e., pure mucous and mixed glands), and the presence or absence of inflammation. Our study revealed that a transitional zone with the microscopic characteristics of cardiac mucosa was universally present at the SCJ. The microscopic characteristics of this zone varied with age. Both pure mucous and mixed glands were observed. We conclude that the cardiac mucosa is partially if not entirely the result of normal embryonic gastric development. Both mucous and mixed glands constitute normal components of the cardiac mucosa.

Adolescent↗

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Multiple ischemic infarcts in a child with AIDS, varicella zoster infection, and cerebral vasculitis.

A 4 1/2-year-old girl with acquired immunodeficiency syndrome and prolonged varicella zoster virus skin infection developed multiple ischemic strokes and radiologic and histopathologic evidence of central nervous system vasculitis. Typical features of acquired immunodeficiency syndrome encephalitis were not present and there was no evidence of vasculitis outside the nervous system. Central nervous system vasculitis probably resulted from varicella zoster virus infection that persisted because of immunodeficiency. This acquired immunodeficiency syndrome complication has only rarely been described in adults and to our knowledge has not been described in children.

Acquired Immunodeficiency Syndrome↗

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Dyspnea and chest pain in a 14-year-old boy.

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Adolescent↗

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Assessment of acute health effects from the Medfly Eradication Project in Santa Clara County, California.

Surveys were performed to assess the acute health effects of aerial application of malathion bait over a large urban area. Three indirect attempts to assess utilization of health care services were made: (1) surveillance of a major hospital emergency department was undertaken, (2) ambulance dispatches were reviewed, and (3) emergency treatments for asthma at a university hospital were reviewed. These assessments were negative but insensitive. Prevalence of self-reported symptoms was assessed with two surveys that were subject to severe time constraints. Personal interviews of the same individuals, before and after the spraying, were conducted: one was conducted by telephone and the other by residential visit. Results indicated no detectable increase in acute morbidity. Also, after the spraying, there was a decrease in anxiety-related symptoms.

Adolescent↗

PubMedDate not supplied

[Recessive type of Freeman-Sheldon syndrome - report of two affected siblings]

OBJECTIVE: To share knowledge and information about the peculiarities of the Freeman-Sheldon syndrome, especially concerning the high risk of recurrence of its recessive type in siblings, and to stress the importance of genetic counseling for families after the birth of an affected child. DESCRIPTION: The authors describe and comment two pediatric cases of the Freeman-Sheldon syndrome in siblings born to healthy parents. These two cases present significant peculiarities that contradict the findings of the medical literature, obtained through bibliographic research about the subject. The cases described here corroborate the existence of a recessive type of the Freeman-Sheldon syndrome. In spite of the fact that some authors suggest a high frequency of severe neurological impairment in this type of syndrome, the two cases we analyzed did not show any apparent manifestation of such sequelae. COMMENTS: The Freeman-Sheldon syndrome is heterogeneous not only in its clinical presentation but also in its genetic transmission. It is very important to be informed about the existence of more than one form of hereditary transmission of this syndrome, since genetic counseling should take into consideration all possibilities. In these cases, the use of empiric risks of recurrence would be justified.

Journal Article↗