1/39. The decline and early fall of neonatal pulmonary hemorrhage.Seven years' experience (1965-1972) with neonatal pulmonary hemorrhage at the University of colorado was reviewed. Pulmonary hemorrhage still occurs frequently as a preterminal event in hyaline membrane disease. As an isolated "pure" entity, however, pulmonary hemorrhage has shown a marked decline. This phenomenon is probably related to advances in neonatal intensive care. The radiographic pattern of "pure" pulmonary hemorrhage in the newborn is most commonly a diffuse alveolar infiltrate. Since pure hemorrhage is now an uncommon entity, the radiologist can reasonably suggest this diagnosis on rare occasions only, in the clinical setting of profound hypoxia.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/39. Fetal scalp abscess secondary to intrauterine monitoring.Thirty-one cases of fetal scalp abscess secondary to internal fetal monitoring over a 32 month period were reviewed. The over-all incidence was 1:230 monitored labors, or 0.4 per cent. Twenty-nine infants were cultured, with no growth in 10, staphylococcus epidermidis in 11, and pathogenic organisms in the remainder. Gram stains of the exudates generally supported the culture results. All cases responded to drainage, local care, and systemic antibiotics, with no deaths. One case of osteomyelitis of the skull was confirmed roentgenographically. A strong correlation between prolonged rupture of the membranes and scalp abscess was observed, but no definite infectious origin was confirmed. The etiology of scalp abscess secondary to monitoring remains obscure.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
3/39. Neonatal lupus erythematosus. Report of four cases with review of the literature.We report four newborn infants with a distinctive evanescent cutaneous eruption that clinically and histologically resembled lupus erythematosus; two of the mothers had undifferentiated connective tissue disease. The tendency for lesions to occur in a periorbital location and the association of prominent telangiectasias were characteristic clinical signs in our patients. Immunoglobulin deposition at the basement membrane was demonstrated in one patient. Cytogenetic studies, done to exclude bloom syndrome, revealed only nonspecific chromosomal abnormalities. A brief review of the literature, with speculations on the possible relationship of these changes to the occurrence of connective tissue disease in the mothers, is included in the discussion.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
4/39. Alveolar capillary dysplasia: a logical approach to a fatal disease.PURPOSE: The aim of the study was to review the authors' experience with alveolar capillary dysplasia (ACD), a cause of persistent pulmonary hypertension of the neonate (PPHN) caused by decreased alveolar units, dilated anomalous pulmonary veins, thick-walled arterioles, and thickened interalveolar septa. methods: The records of all neonates with ACD were reviewed from Children's Hospital, Columbus, ohio, and Sophia's Children's Hospital, Rotterdam, The netherlands. The clinical characteristics and pathological findings are discussed. RESULTS: Eight neonates were diagnosed with ACD from 1994 to 2002. Twenty-five percent (2/8) experienced respiratory distress immediately after birth, whereas 75% (6/8) had normal Apgar scores but deteriorated 1.5 hours to 30 days after birth. All infants required conventional ventilation initially; 50% (4/8) were placed on high-frequency oscillating ventilation and 87% (7/8) on extracorporeal membrane oxygenation. A premorbid diagnosis was established in 3 patients by open lung biopsy. The diagnosis of ACD was confirmed at autopsy in all patients. CONCLUSIONS: ACD is a fatal disease that should be suspected in all neonates with respiratory failure and PPHN who fail conventional therapy. Prompt diagnosis helps to avoid prolongation of costly treatment modalities in a uniformly fatal disease. An algorithm is proposed in which neonates with PPHN who fail treatment with extracorporeal membrane oxygenation are managed by open lung biopsy.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
5/39. Transient bullous dermolysis of the newborn. Case report and review of pathogenesis.A case of transient bullous dermolysis of the newborn is reported. A healthy Hispanic newborn developed bullae during the first two days of life. From age two to four weeks, the lesions healed with milia formation. There was no residual scarring or hypopigmentation. An induced blister showed dermal-epidermal separation with the PAS-positive basement membrane in the epidermal roof. PAS-positive inclusions were present in the cytoplasm of a few basal cells. Examination by electron microscopy showed degeneration of the collagen and anchoring fibrils. There were numerous stellate inclusions in the endoplasmic reticulum of the cytoplasm of the lesional basal keratinocytes.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
6/39. extracorporeal membrane oxygenation in a European center--clinical experience.extracorporeal membrane oxygenation (ECMO) has rapidly become the treatment of choice for critically ill newborn infants with reversible pulmonary disease refractory to conventional treatment. Since 1987 ECMO has been available at our hospital and up to December 1989 11 patients have been treated. Eight patients could be weaned from ECMO. The aim of this study was to describe the procedure and its implications in the neonatal and pediatric age groups and to present our experience. It is concluded that even though ECMO in the short term is a costly and personnel-consuming procedure it is well documented, safe and life-saving.- - - - - - - - - - ranking = 5keywords = membrane (Clic here for more details about this article) |
7/39. Maternal genomic neutrophil FcRIII deficiency leading to neonatal isoimmune neutropenia.The healthy mother of a child with transient immune neutropenia was found to be "NA-null." The mother's neutrophils did not react with anti-NA1 and anti-NA2 antibodies (polyclonal human alloantibodies and mouse monoclonal antibodies). A healthy donor was discovered during routine neutrophil antigen typing whose neutrophils were also "NA-null." This NA-phenotype was due to the absence of FcRIII (CD16 antigen) on neutrophils as demonstrated with anti-FcRIII monoclonal antibodies. The neutrophils of these two individuals were not able to bind dimeric immunoglobulin g. However, their cells had a normal expression of other phosphatidylinositol (PI)-linked membrane glycoprotein (CD24, CD67, and CLB gran/5 antigens), ruling out the existence of a PI-linkage defect, such as paroxysmal nocturnal hemoglobinuria. The mother (propsitus) had isoantibodies in her blood against neutrophil-FcRIII without allospecificity, apparently produced during pregnancy and responsible for the neutropenia of her child. The expression of FcRIII on natural killer lymphocytes of both individuals was normal. FcRIII is encoded by two separate genes, one (FcRIII-1) for the neutrophil-PI-linked receptor, another (FcRIII-2) for the natural killer cell and macrophage-transmembrane receptor. By messenger rna and dna analysis (with an FcRIII-cDNA probe and restriction endonucleases) the neutrophil-FcRIII deficiency appeared to be due to deletion of the FcRIII-1 gene in both individuals, while the FcRIII-2 gene was normally present. The parents of the propositus were found to be heterozygous for this defect. Thus, FcRIII-1 gene deficiency of the mother may be a cause of (iso)immune neutropenia of the newborn. Whether this deficiency may have other clinical consequences has to be studied.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
8/39. Infantile osteopetrosis complicating neuronal ceroid lipofuscinosis.An autopsy case of infantile osteopetrosis complicating neuronal ceroid-lipofuscinosis is reported. autopsy revealed generalized sclerosis and thickening of cortical and spongy bones, formation of mineralized cartilagenous tissues, and narrowing of the marrow cavities associated with decreased hematopoietic cell components. Around the thickened bone trabecles, osteoclasts lacked a ruffled border and clear zone along the cell membrane facing the bone matrix surface. The brain was markedly atrophic with neuronal cell loss and focal gliosis, and the remaining neuronal cells accumulated brown granular pigments, which were confirmed histochemically and electron-microscopically to be ceroid and lipofuscin. In the cerebral medulla, the development of myelin sheaths was extremely poor. Also, the occurrence of Lex type glycolipids and GM3 and the apparent absence of cerebroside and cerebroside sulfate were proved by biochemical analysis, suggesting that the brain was still in a stage of embryonic development or still in the process of differentiation. Except for one suggestive case, this is the first case of complicating neuronal ceroid-lipofuscinosis in infantile osteopetrosis.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
9/39. Isolation of chlamydia trachomatis from amniotic fluid.A 26-year-old white woman had premature rupture of membranes at 35 weeks' gestation. Cervical specimens initially demonstrated group B streptococci and chlamydia trachomatis. amniocentesis was performed and the amniotic fluid was positive for chlamydia by direct fluorescent antibody stain. The Gram stain was negative. The patient had an elevated white blood cell count. Labor was induced because of suspected chorioamnionitis. A 2120-g female infant was delivered with an apgar score of 9 at 1 and 5 minutes. The infant's eye and nasopharyngeal specimens were positive for chlamydia by direct fluorescent antibody stain. After delivery, both ureaplasma urealyticum and C trachomatis were isolated from the amniotic fluid and fetal membranes. This is the first reported case of chlamydial isolation in amniotic fluid.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
10/39. Diffuse neonatal hemangiomatosis. A case with heart failure and thrombocytopenia.An examination of the skin in a nine day old infant revealed multiple cherry-red superficial hemangiomas, which progressively increased in size and number. At the age of three weeks these skin lesions involved the scalp, trunk, extremities, palms, soles, and buccal mucous membranes. In addition, similar lesions of the liver and gastrointestinal tract were found. steroids and irradiation were tried with limited success. Finally, hepatic artery ligation was successful in eliminating the heart failure.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
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