Lateral nasal proboscis: antenatal diagnosis and counseling

BACKGROUND

Lateral nasal proboscis is a rare anomaly resulting in incomplete formation of one side of the nose and other variable abnormalities in the adjoining regions of the face, without associated brain malformations. We report a case diagnosed antenatally and confirmed after birth of the infant.

CASE

A 32-year-old white gravida 2 para 1 was referred for a comprehensive fetal ultrasound at 30.5 weeks to evaluate a facial anomaly seen on an ultrasound done to evaluate decreased fetal movements. A fingerlike projection was seen in the left inner eye area with visualization of one nostril and a small nose. After a spontaneous delivery at term, a 3845-g healthy female infant with lateral nasal proboscis and other locally associated anomalies was born and is doing well at 9 months. Reconstructive surgery was done at 3 and 6 months.

CONCLUSION

Accurate antenatal diagnosis of lateral nasal proboscis is possible with ultrasound, which is important because its prognosis and management are different from other types of proboscides.

Renal cell carcinoma with X;1 translocation in a child with Klinefelter syndrome

Klinefelter syndrome (KS) is a sex chromosome abnormality occurring in 1 in 1,000 males. An association with leukemia, germ cell tumor, and male breast cancer has been suggested in KS. Such information is important for professionals caring for KS patients as the condition is frequently not clinically recognizable until after puberty. We report on a renal cell carcinoma (RCC) in a 10-year-old boy with KS. He developed intermittent hematuria at age 10 years and was diagnosed with a right kidney mass, which on pathology was identified as RCC. In addition, he was known to have learning disabilities and language delays. Analysis of peripheral blood chromosomes showed a 47,XXY karyotype while analysis of tumor cells demonstrated clonal abnormalities including a translocation between chromosomes X and 1, designated 47,XXYc,t(X;1)(p11.2;q21)[6]/47,XXYc,t(X;1),r(Xp)[2]/46,X XYc,-X,t(X;1)[7]. Renal cell carcinoma is rare in childhood and is not previously reported in KS. The oncogenetic significance of the chromosomal regions involved in this translocation is discussed in relation to the congenital abnormality of the patient.

Jaccoud's arthritis

A 16 year old girl with multivalvular heart disease and recurrent episodes of polyarthritis with correctable deformities of hands and feet fitting into that of Jaccoud's arthritis is reported. The condition is rare and often difficult to differentiate from rheumatoid arthritis.

Aluminium phosphide poisoning. Two cases with rare presentation

We report two cases of aluminium phosphide poisoning who presented with rare manifestations, one with bleeding diathesis, hepatitis and acute tubular necrosis and the other with acute respiratory failure.

Plasma renin activity in shock due to aluminium phosphide poisoning

Plasma renin activity (PRA) was estimated in 30 patients with aluminium phosphide (AIP) poisoning (study group) admitted in shock. Ten patients in shock other than due to AIP poisoning (Group II A) and 20 normal healthy subjects (Group II B) served as controls. The PRA was significantly higher in the study group and group II A as compared to normal healthy subjects (p less than 0.001). Significantly higher PRA was found in the study group as compared to Group II A (p less than 0.001). The initial higher PRA continued to rise further in the study group but it started decreasing in Group II A as the duration of shock advanced. Continuation of shock in AIP poisoning was probably due to slow release of toxic PH3 gas, which was detected by positive silver nitrate paper test. The rise in PRA was directly proportional to the dose of pesticide consumed. There was direct relationship of mortality with increased PRA. Angiotensin converting enzyme inhibitors may have a role in combating shock in AIp poisoning.

Implantation of fetal thymus and sympathetic ganglion within the anterior eye chamber in mice, to study neuro-immune interaction in thymic development

In this study 13- to 14-day fetal thymic lobes were implanted within the anterior eye chambers in mice either with or without a syngeneic newborn sympathetic ganglion. It was observed after 6 weeks of implantation that the thymic lobes that grew with the ganglia had fewer lymphoid cells than their counterparts which were grown without the ganglia. The cells that developed within the thymic lobes were Thy-1- and peanut agglutinin-positive. The thymic lobes that grew with sympathetic ganglia also showed the presence of adrenergic nerves, perhaps due to reinnervation of the thymic grafts from the ganglia.

Unknown syndrome: congenital heart disease, ptosis, hypodontia, and craniosynostosis

We report a child with total anomalous pulmonary venous drainage, ptosis, hypoplastic teeth, sagittal craniosynostosis, and developmental delay, together with several unusual features.

Recurrence risks for common complications of pregnancy--a review

A review of the literature concerning the more common complications of pregnancy indicates that recurrence risks are available for most and can be summarized as follows: hydatidiform mole--1.3 to 2.9 per cent; recurrent miscarriage--20 to 30 per cent; ectopic pregnancy--20 to 30 per cent; severe preeclampsia--7.5 per cent; mild preeclampsia--29 per cent; preterm labor--15 per cent after one and 30 per cent after two. While recognizing that each individual case merits full investigation and careful assessment, it is proposed that these risk figures provide a useful basis for use in pre- and postpregnancy counseling.

Behaviour disorder in monosomy 10qter

Images

Changing demography of trisomy 18

The incidence of trisomy 18 in Leicestershire during the years 1980-85 inclusive was one in 3086 births. Eleven of the 21 babies born with trisomy 18 in this period were delivered by caesarean section. Median and mean periods of survival were 2.5 and 22 days, respectively.

Parasympathetic innervation of the thymus: a histochemical and immunocytochemical study

The presence of parasympathetic nerve supply to the thymus has been demonstrated by histochemical and immunocytochemical methods using antibodies against cholineacetyl transferase. Fine nerve fibres have been observed both in the thymic parenchyma and around the blood vessels. The role of the parasympathetic nerve supply to the thymus is briefly discussed.

Trisomy 18 in a 13 year old girl

A 13 year old girl with trisomy 18 is described. She showed profound mental and growth retardation, severe kyphoscoliosis, and unusual ocular features including discontinuous eyebrows, distichiasis, and blue sclerae.