We present the first report of extramedullary hematopoiesis (EMH) in an encephalocele. The patient was a new-born with semilobar holoprosencephaly, a frontoethmoidal encephalocele, and a large subdural hematoma. The encephalocele appeared as a hemorrhagic mass, protruding from the forehead to cover the right eye, without involvement of the sinuses or nasopharynx. Computerized tomography and magnetic resonance imaging studies ruled out other forms of holoprosencephaly and confirmed the continuity of the brain with the extruded mass. Immunohistochemistry confirmed the presence of an atrophic epithelium covering the mass. Histologic examination of the encephalocele revealed EMH both within and adjacent to malformed cerebral cortex, with a tendency for the hematopoietic cells to line up in columns within malformed cerebral cortex. We propose that a single event during the fourth week of gestation could both interrupt closure of the neural tube, giving rise to the encephalocele, and impair migration of the neural crest, leading to holoprosencephaly secondary to failure of neural crest derivatives to induce basomedial telencephalic differentiation. EMH may have been induced from hematopoietic stem cells in the richly vascular meningeal component of the encephalocele, in response to anemia and hypoxia.

Biomarkers↗

PubMedDate not supplied

The role of an early intervention on enhancing the quality of mother-infant interaction.

The study examines an intervention designed to influence mothers' sensitive responsiveness toward their infant by presenting information about the newborn's competence to interact and promoting affectionate handling and interaction with the infant. Thirty-six primiparous mothers and their newborn infants participated in the study. On day 2/3 after delivery, mother-infant dyads were assigned to either: (1) an experimental group that received an intervention program designed to enhance mother-infant interaction; or (2) a control group that was presented with an intervention that emphasized basic caregiving skills. One month later an observation was undertaken in the home to assess mother-infant synchronous and asynchronous co-occurrences during free-play and infant bathing. The enhancement group showed a reliably greater frequency of co-occurrences involving vocal exchanges, looking to the partner, and physical contact. There also were differences in mothers' responsiveness to infant crying and involuntary responses. The findings show that even a modest videotaped early intervention can enhance mothers' sensitive responsiveness to the infant.

Adult↗