Multi Organ Dysfunction in Term Neonates with Perinatal Asphyxia

Introduction: Multiorgan dysfunction (MOD) is one of the four consensus based criteria for the diagnosis of intrapartum asphyxia. The theoretical concept behind MOD is the diving reflex -conservation of blood flow to vital organs at the cost of non-vital organs. The objective of this study was to assess the patterns of involvement of each major organ/system in term asphyxiated neonates.Material and Methods: This was a hospital based prospective study. Sixty term neonates who had suffered perinatal asphyxia were assessed for central nervous system, kidney, cardiovascular system, gastrointestinal system and liver dysfunction. Results: Out of 60 eligible neonates, 57 (95%) had evidence of at least one organ dysfunction. Cardiovascular system involvement (95%) was most common, followed by renal system (37%), hepatic system (22%), central nervous system and hematological system (20% each) and finally, gastrointestinal tract (8%).Conclusion: MOD is frequently associated with perinatal asphyxia with cardiovascular system being the most commonly affected.J Nepal Paediatr Soc 2015;35(3):307-311.

Multiple Congenital Anomalies after Assisted Reproductive Technology in Japan (between 2004 and 2009)

Multiple congenital anomalies (MCAs) are defined as two or more unrelated major structural malformations that cannot be explained by an underlying syndrome or sequence. The percentage and combination patterns of MCAs were analyzed using the European surveillance of congenital anomalies computer algorithms for nationwide data on congenital anomalies after assisted reproductive technology between 2004 and 2009 in Japan. There were a total of 177,548 pregnancies and 124,846 live births. About 7% (96/1,324) were MCAs. Although most maternal/neonatal outcomes between the isolated cases group and the MCAs group were similar, higher early neonatal death rate was observed in the MCAs group than in the isolated cases group (9.8% versus 3.7%, resp.). Regarding the major organ system subcategory in ICD-10, the rate of MCAs was around 30% in “congenital malformations of eye, ear, face, and neck,” “congenital malformations of the respiratory system,” and “congenital malformations of genital organs.” On the other hand, the rate of MCAs was less than 10% in “congenital malformations of the circulatory system.” The combination patterns of diseases were widely varied. Of them, two or three diseases of the circulatory system, the digestive system, and the musculoskeletal system tended to co-occur in the same individuals.

Pheochromocytoma is an Eventful Tumor: A Case Description

ABSTRACT Pheochromocytoma is a tumor arising from adrenal medulla in > 90% of cases. It is a great mimic, featuring in differential diagnosis of disorders of multiple organ systems. Here we present a prototypical case of right adrenal pheochromocytoma, highlighting this unique feature of the tumor. It presented with repeated hypertensive crises with predominant involvement of one major organ system in each episode. All of them were reversible with timely intervention and successful removal of the tumor, highlighting the functional basis rather than organic pathology.

Biological significance of nitric oxide-mediated protein modifications

Nitric oxide (NO), despite an apparently simple diatomic structure, has a wide variety of functions in both physiology and pathology and within every major organ system. It has become an increasingly important scientific challenge to decipher how this wide range of activity is achieved. To this end a number of investigators have begun to explore how NO-mediated posttranslational modifications of proteins may represent mechanisms of cellular signaling. These modifications include: 1) binding to metal centers; 2) nitrosylation of thiol and amine groups; 3) nitration of tyrosine, tryptophan, amine, carboxylic acid, and phenylalanine groups; and 4) oxidation of thiols (both cysteine and methionine residues) and tyrosine. However, two particular modifications have recently received much attention, nitrosylation of thiols to produce S-nitrosothiol and nitration of tyrosine residues to produce nitrotyrosine. It is the purpose of this review to examine the possibility that these modifications may play a role in NO-mediated signaling.

Metabolic adaptations for desert survival in the Bedouin goat

Energy conservation is a key adaptation for desert survival in the Bedouin goat. When food is scarce, metabolism is reduced and body weight can be maintained indefinitely on less than one-half of normal intake. We hypothesized that metabolism would be turned down during both rest and exercise, but it was not. It was low when animals rested and returned to normal during exercise. We expected catecholamines and thyroid hormones would modulate metabolism, but they did not. The reduction in metabolism preceded any change in thyroid hormone concentrations, and infusions of epinephrine did not restore reduced metabolism to normal levels. Finally, we expected the gut would be the major organ system involved in the metabolic reduction because less food is eaten, processed, and absorbed. Contrary to our expectations, we found that muscle is the primary organ system responsible for the reduction. It appears that the adaptations of the Bedouin goat for surviving on limited food supplies involve different organ systems and different modulators to reduce metabolism from those known for other mammals.