Biomedical subjects

Oluyinka O Olutoye

Publications and source records attributed to Oluyinka O Olutoye.

11 recordsLinked to original sources

PubMed2007

Age-dependent recruitment of neutrophils by fetal endothelial cells: implications in scarless wound healing.

PURPOSE: Fetal dermal wounds heal with minimal inflammation and absent fibrosis. Later in gestation, a transition to adult-like healing with marked inflammation and scarring is observed. Interaction with endothelial cells (ECs) is imperative for leukocyte transmigration, a critical step in the inflammatory cascade. This study was embarked upon to determine if gestational age-dependent differences in EC function modulate changes in inflammatory response and correlate with the healing phenotype. METHODS: Fetal porcine ECs were harvested at days 65 (mid gestation), 85 (late gestation), and 100 (near-term) (term = 115 days). Confluent monolayers were activated with IL-1beta at 10 and 100 ng/mL and exposed to adult neutrophils under static (n = 4 per group) and continuous flow (n = 6 per group) conditions. Neutrophil-endothelial interaction was quantified and compared using analysis of variance. RESULTS: Under static conditions, the lower cytokine dose elicited maximal neutrophil recruitment in later-gestation ECs, while midgestation ECs required higher stimulation. Midgestation ECs recruited significantly less neutrophils than later gestation ECs at both cytokine concentrations under flow conditions. CONCLUSION: There is a gestational age-dependent variation in neutrophil recruitment by fetal ECs. With minimal stimulation, later-gestation ECs actively recruit neutrophils, whereas midgestation ECs do not. These findings correlate with the transition period to adult-like healing, supporting the potential role of fetal ECs in scarless healing.

Age Factors↗

PubMed2006

Lytic rib lesion in a 1-year-old child: group A beta streptococcal osteomyelitis mimicking tumor.

Pediatric osteomyelitis commonly occurs in the long bones and has rarely been reported in small bones such as the vertebrae and ribs. Rib osteomyelitis occurs in approximately 1% or less of all cases of hematogenous osteomyelitis, and is usually caused by Staphylococcus aureus. We present a case of acute osteomyelitis in the rib of an otherwise healthy and afebrile 1-year-old infant that appeared as a lytic bone lesion on imaging studies and was mistaken for a tumor. Biopsy was needed to rule out malignancy and establish the diagnosis of osteomyelitis caused by group A Streptococcus. This is one of the few reported cases of pediatric rib osteomyelitis caused by this organism.

Anti-Bacterial Agents↗

PubMed2006

Subclavian venipuncture following ipsilateral extrapleural dissection is hazardous.

Subclavian artery puncture is an infrequent complication of subclavian vein cannulation. In spite of the limited ability to apply direct pressure to the bleeding vessel, significant hematoma or exsanguinating bleeding rarely occurs. This study was a retrospective chart review of a neonate who underwent extrapleural repair of a tracheo-esophageal fistula and sustained significant blood loss following an accidental ipsilateral subclavian artery puncture. This case highlights the importance of an intact apical pleura in controlling bleeding from the subclavian vessels. Thus, ipsilateral percutaneous subclavian venipuncture should be avoided in patients in whom the apical pleura is not intact.

Humans↗

PubMed2006

Prenatal presentation and outcome of children with pleuropulmonary blastoma.

BACKGROUND/PURPOSE: Pleuropulmonary blastoma (PPB) is a rare primary neoplasm of pleuropulmonary mesenchyme. Fewer than 170 children have been reported, and few single institutions have reported more than several cases. Treatment for this condition is primarily surgical resection; however, increasing experience suggests that adjuvant chemotherapy may decrease recurrence and improve outcome. METHODS: We reviewed the charts of all children with PPB treated at our institution since 1960. We reviewed the prenatal features, clinical presentation, operation, pathological findings, adjuvant treatment, and outcome. RESULTS: Ten children (6 boys and 4 girls) were treated for PPB at a mean age of 3.2 +/- 4.3 years. In 2, a cystic lung mass was diagnosed prenatally, and in 8, a cystic or solid and cystic lung mass was diagnosed postnatally (right lung, 3; left lung, 4; and bilateral, 3). In no patient was PPB considered preoperatively. Surgical resection was performed at 1 day to 11 years (median, 23 months) of age. Seven children had complete resection; 1 had microscopic residual disease, and 2 had gross residual disease. Pathology showed type I PPB in 7, type II in 1, and type III in 2. Five patients received adjuvant chemotherapy with vincristine, actinomycin, and cyclophosphamide-based regimens. At follow-up (mean, 7.7 +/- 11.5 years; range, 1-456 months), children with type I PPB have no evidence of disease (n = 6) or are lost to follow-up (n = 1), whereas all those with type II/III PPB have died of the disease. CONCLUSIONS: PPB must be included in the differential diagnosis of a fetus, neonate, or child with a cystic lung mass. This finding supports early resection of these lesions rather than observation or treatment with nonoperative strategies.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2006

Mitomycin C in the management of pediatric caustic esophageal strictures: a case report.

Although the incidence of caustic ingestion is declining, the management of caustic esophageal strictures remains a challenge. Mitomycin C (MMC) inhibits fibroblast proliferation and is effective in reducing scar in animal experiments. We report the case of a child with a distal esophageal stricture from lye ingestion managed with MMC. Despite repeated dilatations, at 1 year post injury, the stricture was 20% of esophageal diameter. Mitomycin C (4 microg/mL) was applied topically and circumferentially by endoscopy and repeated 4 months later. At 20 months follow-up, the child eats normally, and esophagram showed decreased stenosis (stricture was 50% of esophageal diameter). No complications were observed. Although controlled trials are required to confirm its efficacy, MMC should be considered as an adjunct in the management of caustic esophageal strictures in children.

Burns, Chemical↗

PubMed2006

Foregut abnormalities.

Explore the source record for details and available documents.

Diagnostic Techniques, Digestive System↗

PubMed2005

Neutrophil recruitment by fetal porcine endothelial cells: implications in scarless fetal wound healing.

Fetal dermal wounds heal scarlessly and with a minimal inflammatory response. When a robust inflammatory response is induced at the site of fetal dermal wounds by the application of cytokines, healing results in fibrosis. To test the hypothesis that the reduced inflammatory response in fetal wounds is due to impaired fetal leukocyte-endothelial interactions, the contributions of fetal endothelial cells to the inflammatory response in the fetus were investigated. Endothelial cells isolated from blood vessels of adult and mid-gestational fetal pigs were cultured in media until confluent monolayers were established. Adult porcine neutrophils were isolated and resuspended at a concentration of 1 million cells/mL. Interactions between neutrophils and endothelial cells were observed under static and flow conditions. Endothelial monolayers were exposed to neutrophils with and without prior stimulation of the endothelial cells with tumor necrosis factor alpha (TNF-alpha) for 4 h. The neutrophil-endothelial interactions were observed and analyzed for neutrophil adhesion, rolling velocity, and transmigration. Endothelial P-selectin mRNA expression was determined by real-time polymerase chain reaction (PCR). A novel in vitro model of fetal inflammation is described. Both adult and fetal endothelial cells demonstrated a dose-dependent increase in neutrophil adhesion and transmigration with increasing doses of TNF-alpha. The fetal response was significantly lower than the adult. As expected, rolling velocity was lower at higher cytokine concentrations and had an inverse correlation with P-selectin mRNA expression. Fetal endothelial cells are less permissive to adhesion and transmigration of neutrophils than adult endothelial cells. This may contribute to the paucity of inflammation seen in the fetal response to dermal injury.

Animals↗

PubMed2004

Outcomes for children with gallbladder abnormalities and sickle cell disease.

OBJECTIVE: To determine whether elective cholecystectomy is justifiable in children with sickle cell disease (SCD), gallbladder abnormalities, and minimal clinical symptoms. STUDY DESIGN: A retrospective review comparing clinical presentations and abdominal ultrasound results with outcomes in 146 children with SCD. RESULTS: Ultrasound examination showed sludge or stones in 83 of 146 children (57%). This was found during a diagnostic ultrasound in 59 patients (71%) and during a screening ultrasound in 24 asymptomatic patients (29%). Fifty-four (65%) children with a positive ultrasound underwent cholecystectomy; 13 of these were initially asymptomatic patients who had subsequent development of clinical symptoms. Of the patients with cholecystectomy, 93% had histopathologic evidence of cholecystitis. Perioperative complications were rare, and there were no episodes of postoperative acute chest syndrome. Children who underwent elective surgery had an average 12-days-shorter overall hospital stay than those who underwent emergent surgery (4 vs 16 days, P <.001). CONCLUSIONS: Elective laparoscopic cholecystectomy may be safely performed in children with SCD. Surgery should be strongly considered at the time of gallstone diagnosis before symptoms or complications develop. Histopathologic chronic cholecystitis does not correlate with clinical symptoms.

Adolescent↗

PubMed2004

Renal tumors in infants less than 6 months of age.

BACKGROUND/PURPOSE: Renal tumors are rare in infants less than 6 months of age and may have associated paraneoplastic symptoms. To better define the characteristics of these tumors the authors reviewed their 10-year institutional experience. METHODS: The authors searched the pathology database to identify all renal tumors resected at their institution since 1992 (after IRB approval and guidelines). The clinical presentation, operative details, pathology, and outcome for all children < or = 6 months of age were reviewed. RESULTS: Of 101 children who had renal tumors resected during this period, 11 (11 %) were 6 months of age or less. Histopathologic examination showed congenital mesoblastic nephroma (CMN) in 7 patients (4 with cellular features), Wilms' tumor in 3 patients, and ossifying renal tumor of infancy in 1. Renal masses were detected antenatally in 2 patients and during newborn examination in 1 patient; however, the mean age at diagnosis was 72 +/- 18 days. Ten children had a palpable abdominal mass, 3 had gross hematuria, and 6 had hypertension (4 CMN; 2 Wilms'). Only 1 child had hypercalcemia (cellular CMN). Ten infants had nephroureterectomy, and 1 had a partial nephrectomy. All patients had either stage I or II disease. At follow-up (mean 4.2 +/- 1.2 years) 10 patients are alive with no evidence of disease. One newborn with hydrops and a very large congenital Wilms' tumor had abdominal compartment syndrome and died during surgery. CONCLUSIONS: About 10% of renal masses may occur in infants less than 6 months of age. Although mesoblastic nephroma is the most common renal tumor in this age group, Wilms' tumor also may be seen. Paraneoplastic syndromes, such as hypertension and hypercalcemia, are common in these infants and are not specific for tumor type. These tumors generally present at an early stage and have an excellent prognosis overall.

Disease-Free Survival↗

PubMedDate not supplied

Abnormal umbilical cord Dopplers may predict impending demise in fetuses with sacrococcygeal teratoma. A report of 2 cases.

OBJECTIVE: To identify factors predictive of fetal demise in fetuses with sacrococcygeal teratoma (SCT). METHOD: The recent management of monochorionic twins discordant for a large SCT and a singleton with a large SCT were reviewed. RESULTS: Serial fetal echocardiography and ultrasonography with Doppler flow measurements documented rapid growth of the SCT in both cases with a relatively modest increase in combined cardiac output. No placentomegaly or hydrops was observed at any time. In both fetuses with SCT, evolution of abnormal umbilical artery waveforms was observed with the ultimate development of reversed end-diastolic umbilical arterial flow that was followed by sudden fetal demise. CONCLUSION: Death in these 2 fetuses with large SCTs in the absence of placentomegaly/hydrops or hemodynamic changes suggestive of evolving high-output failure suggests a previously unrecognized mechanism of death in fetuses with large rapidly growing SCTs. In these cases, fetal demise may only be heralded by abnormal umbilical artery waveforms that progress to the premorbid observation of reversed diastolic umbilical artery blood flow. Umbilical artery waveform analysis should be closely monitored with other hemodynamic parameters in fetuses with large SCTs. In such fetuses, depending on the gestational age, abnormalities in umbilical artery waveform should be considered indications for early delivery or in utero intervention to prevent fetal demise.

Adult↗

PubMedDate not supplied

Abnormal umbilical cord Doppler sonograms may predict impending demise in fetuses with sacrococcygeal teratoma. A report of two cases.

OBJECTIVE: To identify factors predictive of fetal demise in fetuses with sacrococcygeal teratoma (SCT). METHOD: The recent management of monochorionic twins discordant for a large SCT and a singleton with a large SCT was reviewed. RESULTS: Serial fetal echocardiography and ultrasonography with Doppler flow measurements documented rapid growth of the SCT in both cases with a relatively modest increase in combined cardiac output. No placentomegaly or hydrops was observed at any time. In both fetuses with SCT, evolution of abnormal umbilical artery waveforms was observed with the ultimate development of reversed end-diastolic umbilical arterial flow that was followed by sudden fetal demise. CONCLUSION: Death in these 2 fetuses with large SCTs in the absence of placentomegaly/hydrops or hemodynamic changes suggestive of evolving high-output failure suggests a previously unrecognized mechanism of death in fetuses with large rapidly growing SCTs. In these cases, fetal demise may only be heralded by abnormal umbilical artery waveforms that progress to the premorbid observation of reversed diastolic umbilical artery blood flow. Umbilical artery waveform analysis should be closely monitored with other hemodynamic parameters in fetuses with large SCTs. In such fetuses, depending on the gestational age, abnormalities in umbilical artery waveform should be considered indications for early delivery or in utero intervention to prevent fetal demise.

Adult↗