Getting Back Into Shape After The Pregnancy

Getting Back Into Shape After The Pregnancy

Once your pregnancy is over and done with, your baby is happily in your arms, and youre headed back home from the hospital, youll begin to realize that things have only just begun. Over the next few days, weeks, and months, youre going to increasingly notice that your entire life has changed in more ways than you could ever imagine.

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Analgesics See painkillers

This birth defect is detectable early in pregnancy by measuring alpha-fetoprotein, by ultrasound scanning, and by amniocentesis. If anencephaly is detected, the parents may want to consider termination of the pregnancy since there is no chance the child can survive after birth.

Touching by the hands to knowing

In the first semester after birth, the young baby is capable of quite good performances in the detection of object properties. Thus, Molina and Jouen (1998) showed that newborns modulate pressure on objects differing according to their texture, therefore suggesting that they detect differences between the smooth or rough aspects of surfaces. Moreover, neonates are able to compare objects varying in texture properties between hands (Molina & Jouen 2003).

Formation Elimination and Stabilization of Synapses in the Primate Cerebral Cortex

ABSTRACT The formation of synaptic connections in the primate brain is a protracted and complex process that lasts for decades. We have performed a systematic examination of syn-aptogenesis in the cerebral cortex of the macaque monkey from the fortieth day of the six-month embryonic period through 30 years of age, identifying five distinct phases of syn-aptogenesis. In the five major cytoarchitectonic areas so far examined (visual, somatosensory, motor, limbic, and prefrontal), the first three phases of synaptogenesis proceed concurrently in different areas at a rate resistant to experimental manipulation. In contrast, the fourth phase, in which there is high synaptic density, is more malleable, i.e., subject to activity-dependent stabilization and presumed molecular changes in synaptic strength. This phase begins shortly after birth and continues until puberty. The fifth phase, which begins after sexual maturity and extends into old age, is characterized by a very slow decline in...

Acquisition of Emotion

Response to an event that includes physiological, experiential, and cognitive aspects (Mayer, Salovey, Caruso, and Sitarenios, 2001, p. 235). Acquisition of emotion occurs at or shortly after birth and essentially involves emotions and emotional expressions that are inherent in us as human beings. For example, a baby cries when he is uncomfortable and may display a form of anger when he is confined. Babies also display positive emotions for example, by cooing and, later, smiling. These emotional expressions are not necessarily learned but rather are part of being human. Of course, we expect these behaviors and expressions to be tempered and regulated as a child grows up, but we understand and accept that they are a normal part of infancy. The point here is that we are born with an emotional basis of some kind. Acquisition encompasses the basic expression and perception of emotion.

Overview of Object Relations Theory

The object relations theory of Melanie Klein was built on careful observations of young children. In contrast to Freud, who emphasized the first 4 to 6 years of life, Klein stressed the importance of the first 4 to 6 months after birth. She insisted that the infant's drives (hunger, sex, and so forth) are directed to an object a breast, a penis, a vagina, and so on. According to Klein, the child's relation to the breast is fundamental and serves as a prototype for later relations to whole objects, such as mother and father. The very early tendency of infants to relate to partial objects gives their experiences an unrealistic or fantasy-like quality that affects all later interpersonal relations. Thus, Klein's ideas tend to shift the focus of psychoanalytic theory from organically based stages of development to the role of early fantasy in the formation of interpersonal relationships.

Thyroid Hormone and Brain Development

Among the most dramatic actions of thyroid hormone are those exerted on brain development and function. In the adult human brain, a deficiency or excess of thyroid hormone may lead to various psychiatric manifestations, but it is during development when thyroid hormone exerts its most varied and critical actions on neural tissue. In humans, a deficiency of thyroid hormone taking place during a critical period of development may lead to severe mental retardation and also to neurological defects (1). This critical period may extend from the start of the second trimester of pregnancy to the first few months after birth. During this period, the absence of thyroid hormone, if not corrected by early postnatal treatment, leads to irreversible damage with mental retardation. While in utero, the fetal brain is protected from thyroid deficiency by the maternal hormone. Severe thyroid hormone deficiency in the pregnant woman, especially if combined with fetal deficiency, leads to severe...

Fgf and Fgfr expression in the growth plate

The expression of FGF8 and FGF17, two ligands for FGFR3, has recently been observed in developing bone in the mouse between E14.5 and E16.5 (Xu et al 1999). Both ligands were expressed in dorsal costal cartilage and in costal perichondrium. Fgf8 expression was observed in the osteoblast compartment of calvarial bone, in the mandible, in cortical bone and in the growth plate of long bones. Fgf17 expression was not detected in long bones but was detected in some intramembranous bone such as the maxilla and the scapula. After E16.5, expression of these ligands decreased in the growth plate. It is not yet known whether they are re-expressed in the growth plate of long bones after birth. Besides these ligands, other FGFs can function as ligands for FGFR3 in vitro, yet have not been rigorously examined for expression in the growth plate of developing bones. Because the ligand for FGFR3 appears to be limiting, the regulation of such a ligand, in terms of its expression or bioavailability,...

Concurrent synaptogenesis in the cortical mantle

In the macaque, likewise, early signs of competencies that will later be fully developed are already in evidence. Thus, adult-like properties of neurons in the inferotemporal cortex, such as selective responses to face recognition, are present at only a few weeks after birth (Rodman, Gross, and Scalaidhe, 1993 Rodman, 1994). The critical periods for obtaining social skills and learning simple discriminations also take place as early as two months after birth in macaque infants (Harlow and Harlow, 1962). The cognitive process of working memory, which is subserved by the dor-solateral prefrontal association cortex, likewise emerges in monkeys soon after birth and before the end of phase 3 (Diamond and Goldman-Rakic, 1989), when basic synaptoarchitectonic features are still being laid down (Bourgeois, Goldman-Rakic, and Rakic, 1994 Goldman-Rakic, Bourgeois, and Rakic, 1997 Goldman-Rakic, 1987). Although monkeys obviously do not possess language, they do have...

The Developmental Approach

Developmental psychology represents the study of a subset of the full set of developmental processes that yield the mature adult. Developmental psychologists tend to focus on the period after birth and the set of influences that can be studied psychologically. As a general rule, we can say that at each and every stage of development further change is a product of psychological processes operating at the existing level of development along with information that is provided in the environment. Acritical point is that the information input that is available at any stage of development will depend on the level of understanding at that stage. For example, information relevant to understanding the emotion of pride is meaningless to the child who has not yet acquired a concept of the self as an objective entity because pride is premised on the self as the object of one's own and others' admiration. So the child's level of development constrains the kind of information that can be used for...

Generation And Analysis Of Psti Knockout Mice

Mutations in the PSTI gene seem to promote a predisposition to pancreatitis, possibly by lowering the threshold of pancreatitis caused by pancreatotoxic factors. To validate this hypothesis, we have generated a mouse bearing a null allele of the gene encoding PSTI.9 The basic structure of the pancreas, including acinar cells, was once constructed before birth. The rapid and synchronized onset of acinar cell death occurred within a few days after birth and resulted in the disappearance of all acinar cells. There was no apparent degeneration of the ductal epithelium and islet cells. The heterozygously knockout mice (Psti+ -) were healthy, fertile, and indistinguishable from wild type. To produce homozygous knockout mice (Psti7-), male and female heterozygous mice were intercrossed. The ratio of living newborn mice matched the Mendelian rate of 1 2 1, suggesting that PSTI deficiency does not cause embryonic lethality. In Psti - mice, PSTI mRNA and protein were not detected at all. At...

Is Disease Prevention Possible

Against the background of this information, intervention can be considered at three levels before detectable abnormalities are present (primary intervention) after development of immune markers of progression but before the onset of hyperglycaemia (secondary prevention) and after presentation with overt hyperglycaemia (tertiary prevention). Primary prevention should be offered as early in life as possible in practice from soon after birth. For the reasons given above, children born to a family affected by diabetes, especially those who carry high-risk HLA genotypes, are most appropriate for trial interventions. Safety is the major criterion for any form of primary prevention, since this will inevitably have to be offered to many who would not in any case have developed the disease.

The Origins of Social Action in Early Infancy

Having considered the nature of commonsense psychology and of developmental psychology in a general way, I now begin on the task of describing the development of commonsense psychology. In this chapter we examine the earliest phase of development after birth. Our main goal in this chapter is to examine when and how the infant first gains exposure to the social information that will be important in the development of commonsense psychology. We will consider social information in both third- and first-person forms. Third-person information is largely derived from other people, who start to become involved in the infant's life at birth. First-person information is derived from the infant's own activity. As we shall see these two forms of information are available from the beginning of life outside the womb.

Differential Diagnosis

The differential diagnosis in this infant at the time of her second ED visit included an IEM, sepsis, severe dehydration, and liver dysfunction, with IEM at the top of the list. Many IEM cases classically present a few days after birth with increasing lethargy and decreasing food intake or food intolerance. In utero these infants are well because of the normal functioning of the maternal enzymes to perform the reactions that are deficient in the fetus. Depending on the specific IEM in question, pregnancies are often uncomplicated, and weight and health status of the infant at birth are normal. After birth, the infant's own enzymes are required for metabolizing ingested nutrients, and complications ensue where a metabolic block exists. Classically these infants present with a variety of general symptoms that may include lethargy, hypotonia, hypo-glycemia, acidemia, elevated liver enzymes, and hyperammonemia. Although not noted in this case, in some cases the urine may have an odor. For...

The role of visual experience in the development of orientation selectivity

The role of visual experience in the development of cortical orientation selectivity has been extensively studied. Patterned vision in the cat occurs when the eyes open about a week after birth. However, electrophysiological experiments reveal that orientation-selective cells are already present at around that time (Blakemore and Van Sluyters, 1975 Wiesel and Hubel, 1963). The actual number of orientation-tuned cells in visually naive kittens is controversial. Reported values range from 0 (Pettigrew, 1974) to 20 (Blakemore and Van Sluyters, 1975) to 100 (Wiesel and Hubel, 1963). This disparity has been attributed to the low level of responsiveness of the immature cat cortex to visual stimuli. This problem is bypassed in studies using ferrets because the cortex of young ferrets is very responsive to visual stimulation. Orientation selectivity in the ferret is first detected at postnatal day (P) 23, 9-12 days before eye opening (Chapman and Stryker, 1993). Although only 25 of neurons in...

PTHrP regulates endochondral bone formation

Studies of transgenic mice overproducing PTHrP in chondrocytes are consistent with this model (Weir et al 1996). These mice have few hypertrophic chondrocytes at birth and exhibit a delay in chondrocyte differentiation. Similarly, mice expressing a constitutively active PTH PTHrP receptor (Schipani et al 1997) show delay in the movement of chondrocytes from the proliferative to the hypertrophic chondrocyte compartment and show delay in death of hypertrophic chondrocytes. The constitutively active receptor sequence was derived from that of some patients with Jansen chondrodystrophy, a human disorder of short stature and hypercalcaemia (Schipani et al 1995). When the Jansen transgene is introduced into growth plates of PTHrP mice by appropriate matings, the overactive PTH PTHrP receptor rescues the growth plate abnormality and allows the mice to live for several months after birth (Schipani et al 1997). An analogous rescue of the PTHrP mice occurs when the transgene directing...

Human immunodeficiency virus HIV

When a new baby is born to an HIV-infected mother, however, an antibody test is almost guaranteed to be positive, since babies have their HIV-infected mother's antibodies for up to 18 months after birth. Uninfected infants will gradually lose their mother's antibodies during this time, whereas infected infants generally remain antibody positive. Instead, a diagnosis can be made in early infancy by using a viral culture (PCR polymerase chain reaction), or a p24 antigen test.

Origin Of Pancreatic Hepatocytes

Hepatocyte development in the pancreas of adult rats although it appears peculiar is not illogical considering the embryological lineage of these two organs. Both pancreas and liver arise from the specified areas of foregut endoderm (pancreas from ventral and dorsal buds and liver from ventral bud adjacent to the ventral pancreatic bud).99,100 Epithelial-mesenchymal interactions, extracellular signaling molecules, and transcription factors influence specific differentiation patterns of foregut endoderm into liver or pancreas. Sonic hedgehog signaling molecules, PDX1 transcription factor, and signals from notochord mesenchyme specify the commitment to pancreatic and liver fate.41,101 Now there is clear evidence to suggest that all pancreatic cell lineages arise from PDX1 positive stem cells.42,102 Once the endodermal stem cells are committed to pancreatic lineage, the subsequent events of pancreatic morphogenesis and differentiation depend on the mesenchyme that surrounds dorsal and...

Box 222 Partial Aneuploidy Through Translocation Of A Chromosomal Segment

Prediction on the evidence that some of the most profound problems arising from the extra copy of chromosome 21 arise during development before birth, in structures such as the lungs and heart. Once that damage is done, we may simply have to rely on traditional medical and surgical processes for help. However, some of the Down syndrome problems, such as leukemia and Alzheimer diseases, develop after birth, so there may be a chance for prevention or to improve medical intervention if enough is understood about the roles of the particular genes and gene products in these later developments of the disorder. On the other hand, if the most conspicuous component of this disorder, mental retardation, is truly due to the triplication of a single gene, we have to wonder whether it may be possible someday, with early enough prenatal diagnosis, to correct or at least ameliorate that problem through interventions before the baby is even born. It remains to be seen whether the study of triplicate...

Molecular Regulation Of Osteoblast Differentiation By

To further study the role of Runx-2 in bone formation after birth, Ducy et al. (27) generated trans-genic mice that overexpressed a dominant-negative mutant of Runx-2 (DN-Runx-2) under the control of the osteocalcin promoter in differentiated osteoblasts. Mice expressing the DN-Cbfa1 presented a normal skeleton at birth but develop an osteopenic phenotype thereafter. Dynamic histomorphometric studies found that the osteopenia was caused by a major decrease in the bone formation rate, whereas the number of osteoblasts was normal. Molecular analyses revealed that the expression of the genes encoding bone extracellular matrix proteins was nearly abolished in these mice (27). These results indicate that Runx-2 also transcriptionally controls the function of mature osteoblasts. Conversely, Liu et al. (28) generated transgenic mice that overexpressed wild-type Runx-2 under the control of the type I collagen promoter in osteoblasts. Paradoxically, they found that Runx-2 transgenic mice also...

Intermodal transfer tasks

That this question gave rise to three centuries ago has been revived in recent years, as difficulties in the methodology of studying perception in babies were overcome. Regarding infants, the answer to Molyneux's question makes sense only if it is given in the first semester after birth. Indeed, from the age of six months, during a bimodal object exploration, the baby can easily confront visual and tactile information and develop strategies favoring their integration. Studies carried out after the age of six months have tried to establish the conditions and limits within which intermodal transfer between touch and vision can be obtained. Examples of such research include modulating the length of familiarization, creating perceptual conflicts or evaluating the impact of certain pathologies or of premature birth (cf. Kellman & Arterberry 1998).

Origins of conceptual distinctions and the modern view

Der genetic control, that unfold well after birth rather than those existing at birth (innate behavior). Learning encompassed processes that depend on explicit experience and produce long-lasting changes. Neuroscientists currently debate how experience alters the brain and whether experience induces selection, where options are chosen from a set of innate possibilities, or instruction, where experience sculpts a wide open brain (see Doupe and Kuhl's 1999 discussion of birdsong and speech).

Sharing The Spotlight Nurse Midwives

Due to rising insurance premiums and the overall threat of liability, fewer family physicians are including obstetrical care in their private practices. Many medical students wonder about the role of family practitioners and midwives, however, as providers of pregnancy-related care. A midwife (meaning with a woman) provides prenatal care, attends childbirth, manages her clinic patients during labor and delivery, and supervises the general care of women and children directly after birth. As advanced degree registered nurses, nurse midwives have completed an accredited midwifery program and passed the certification examination. Family practitioners are medical doctors who are trained in obstetrics. Although they

Box 242 Tonguerolling Twins

Now stretch your brain around this concept in some cases, your phenotype might not be caused by genetics, but it might be caused by someone else's genotype rather than your own. In the case of Rh incompatability, when the baby has an Rh+ blood type and the mother has an Rh- blood type, the baby can develop anemia after birth as a result of exposure to maternal antibodies directed against the Rh+ proteins in the baby's blood. However, this can only happen after the mother has borne a previous baby with the Rh+ blood type. How many other factors that affect a baby's development before birth are also affected by the maternal genotype We can imagine that a variety of things, including hormone levels that affect whether the baby is delivered prematurely, and other factors affecting things such as nutrition and oxygenation could all affect the traits that will be observed in the new baby that do not depend on the new baby's genotype at all. So in this case the problem has underlying genetic...

Types Of Gut Microorganisms

The gastrointestinal tracts of all animals are inhabited by a mixed population of microorganisms that generally include bacteria, protozoa, fungi, and bacterio-phages. The establishment of a microbial population commences soon after birth. The digestive tracts of fetuses of all animals are sterile. But within hours after birth, the gut gets colonized by bacteria derived from the immediate vicinity, including the birth canal of the mother. Subsequent development of the micro-bial population is the result of interactions of diet, environment, and host physiology. The processes involved are complex, involving a succession of microorganisms and eventually resulting in a dense, more or less stable population.

Clinical studies of human Xlinked genes and infertility

There is also speculation that the ZFX gene in humans, a zinc finger protein located on the X chromosome that appears to be a transcriptional activator, may function in sex differentiation or spermatogenesis (Mardon and Page, 1989). To study this hypothesis, Luoh et al. used a reverse genetic strategy, mutagenized the mouse homolog ZFX and noted organismal effects that might suggest a role of this gene in reproductive development or function (Luoh et al., 1997). The ZFX mutant had an impressive decrease in primordial germ cell number during the embryonic period before testicular differentiation. After birth, the mutant mice were smaller,

Subcortical visual structures

The organization of the optokinetic system, whose visual inputs come through the NOT and the dorsal terminal nucleus of the accessory optic system, is qualitatively adultlike between 5 and 12 weeks after birth (Distler et al., 1999), but there is little quantitative information available on neuronal sensitivity or receptive field organization in these structures. The functional organization and receptive field properties of neurons in newborn monkey SC are remarkably mature (Wallace et al., 1997). Topographic organization is adult-like in the neonate, as are many receptive field properties. However, receptive field sizes particularly for neurons with receptive fields near the fovea are larger in the newborn than in the adult. Visual responses are also more sluggish throughout the SC, and visual latencies are significantly longer than in adults. Wallace et al. (1997) have argued that the retinotectal input is the primary determinant of SC response properties in infants, with little...

Interacting Moleculesthe Sox10ErbB3 Connection

In the Jackson Laboratories in 1984, a spontaneous mouse mutation arose named Dom. Mice heterozygous for the Dom allele are characterized by a white belly spot, and the absence of enteric ganglia within the distal colon, leading to a variable megacolon (Dom dominant megacolon). In the homozygous state the Dom mutation was found to be embryonic lethal, and a portion of heterozygous Dom mutant mice die within the first weeks after birth (Lane and Liu 1984).

Genetic studies of skeletal maintenance and disease

For example, we have recently been using positional cloning techniques to identify a novel gene disrupted by a classical mouse mutation called progressive ankylosis (Ank) (Ho et al 2000). AnkjAnk mutant mice are born with normal appearing skeletons, but develop a severe, progressive form ofarthritis and mineral deposition that begins several weeks after birth (Sweet & Green 1981). Studies of genes like Ank may help identify novel pathways that control maintenance of joints long after they have formed in embryos (Ho et al 2000). We believe that genetic approaches in mice have great potential for future studies of many different areas of bone and joint maintenance, in addition to their important role in studying the fundamental mechanisms that govern the condensation, and segmentation of mesenchyme cells during embryonic development.

Positional plagiocephaly flattened head A

Newborn's head is often slightly misshapen during the few days or weeks after birth, because the passage through the birth canal often temporarily elongates a baby's soft skull bones. However, a persistent flat spot either in the back or on one side of his head can result from being put to sleep on his back or by problems with the baby's neck muscles. Fortunately, this condition will correct itself by the time the child is one year old. Premature babies are more prone to positional plagiocephaly because their skulls are softer than those of full-term babies, and they spend a great deal of time on their backs without being moved because of their extreme fragility after birth. A baby may even start to develop positional plagio-cephaly before birth, if the baby's skull is pressured by the mother's pelvis or by a twin.

Box 344 Sample Indications That Might Lead Someone To Seek Advice From Professional Geneticists

Since most children are, in fact, born healthy and without major genetic anomalies such as extra copies of chromosomes, perhaps the primary value of such testing for many people turns out to be simply to provide peace of mind to couples who fall into one or another so-called risk groups, such as older mothers or parents who have already had one or more children with a genetic anomaly. In such cases, the test can often reassure the parents that the fetus developing inside the mother is healthy, at least as far as we can assay it. However, since couples who elect such testing often fall into known risk groups, there obviously will be cases in which the answer will not be a happy one (i.e., the fetus does have an extra copy of a chromosome or bears some other significant hereditary defect). In such cases, this information is crucial in giving parents the choice to either prepare for a child who may have very special needs or perhaps to terminate the pregnancy. Neither of these options...

The Detection of Fetal Anomalies on Routine Ultrasound Examination

Fetal malformations are usually identified serendipitously during a routine ultrasound. Clinicians challenged with making a precise fetal diagnosis are limited by a snapshot glimpse of the fetus, instead of the luxury of the full-system review that can be done after birth. Certainly a family history can assist with attempts at diagnosing a fetal condition yet the pedigree may not influence immediate management decisions. The sonographic finding of any malformation necessitates an immediate discussion about further testing to determine the fetal chromosome pattern.(i.e., by obtaining amniotic fluid or umbilical cord blood). This is true regardless of the parental family history or any potential maternal exposures to fetal teratogens. When a fetal anomaly is detected, it is reasonable to obtain an abbreviated family history from the parents, as is outlined in Table 4.6. A more thorough family history can be initiated once the chromosome results are available. Reviews by Eydoux and...

Arterial and Venous Cell Fate Specification

Shh induces the expression in the adjacent somites of VEGF which, in turn, drives arterial differentiation of angioblasts. In the chick, the early extra-embryonic blood islands contain a mixture of subpopulations of cells expressing Nrp-1 and Nrp-2, which subsequently become lineage markers of arteries and veins, respectively (Herzog et al. 2005). This suggests that even early angioblasts may already be committed to either the arterial or venous lineage. Further evidence that VEGF has a role stems from findings that, when released from Schwann cells, it induces arterial specification of vessels, tracking alongside these nerves (Mukouyama et al. 2002) and that Nrp-1, a receptor selective for the VEGF165 isoform, is expressed in arterial beds (Moyon et al. 2001 Stalmans et al. 2002). VEGF also determines arterial EC specification after birth in the heart and retina, where the matrix-binding VEGF188 isoform is critical for arterial development (Stalmans et al. 2002 Visconti et al....

Principles of Substance Abuse Treatment

As stated earlier in the chapter, Hispanic women may underreport their alcohol use because of the austere cultural proscriptions they face when drinking. Clinicians must stress to all Hispanic female drinkers of childbearing age, whether known to be pregnant or not, that there is no known safe level of alcohol consumption during pregnancy and that they should abstain completely if possible. Some are tragically unaware that although they may deliver apparently healthy babies without physical signs of fetal alcohol syndrome, myriad neuropsychiatric problems are attributable to gestational alcohol intake, such as speech and language delays, learning disabilities, and emotional instability, which sometimes do not become evident until well after birth. It is helpful for clinicians to present balanced points of view to their Hispanic patients when the media sensationalize a particular drug issue. For example, the past media reports of low to moderate alcohol ingestion reducing cholesterol...

Partial Autosomal Aneuploidies

Pallister Killian Syndrome

Many patients die shortly after birth, but survival to adulthood is possible. Clinically, a distinct pattern of anomalies is observed in these patients. Growth parameters at birth are usually normal. Profound hypotonia is present in the newborn period, whereas contractures develop later in life. Sparse scalp hair, especially bitemporally, is observed in infancy, with coarsening of facial features over time. Craniofacial dysmorphism includes prominent forehead, large malformed ears, hyper-telorism, epicanthal folds, broad flat nasal bridge, short nose, upturned nares, long philtrum, thin upper lip, and high arched palate. Most patients have a generalized pigmentary dysplasia with areas of hyperpigmentation and hypopigmentation. Other abnormalities include short neck, macroglossia, micrognathia progressing to prognathia, accessory nipples, umbilical and inguinal hernias, and urogenital abnormalities. Severe mental retardation and seizure are seen in those who survive.

Type Of Pancreatitis Initial Damage In The Pancreas And Fibrosis Pattern

A special situation of duct obstruction is encountered in cystic fibrosis of the pancreas and in pancreatic lobular fibrosis, which is frequently observed in elderly persons. Whereas the first condition causes duct obstruction due to clogging with viscous mucin, the second condition leads to narrowing of the duct lumen by papillary hyperplasia of the duct epithelium. In cystic fibrosis, complete or almost complete (inter-and intralobular) fibrosis develops slowly after birth,34 after many years, fibrosis is replaced by fatty tissue (Figure 16.8),35 a process that is not understood so far, but is of great interest for the resolution of fibrosis. In elderly persons the fibrosis that develops is mainly of the intralobular type and affects those lobes that are drained by ducts showing hyper-plastic epithelial changes (Figure 16.9). The lobular fibrosis of the pancreas therefore shows a patchy pattern. Its degree varies from person to person the most severe form and the highest incidence...

Clinical Aspects Of Iliocaval Obstruction

Ivc Obstruction Collaterals

FIGURE 61.2 Twenty-two-year-old male with long-standing iliocaval obstruction, suspected to have occurred shortly after birth. Within two years of his initial episode left femoral-popliteal thrombosis, at age 20, he had a recurrent DVT and developed a stasis ulcer on the medial anterior calf. Evidence of varicosities in his teenage years was an additional sign suspicious for central venous obstruction. FIGURE 61.2 Twenty-two-year-old male with long-standing iliocaval obstruction, suspected to have occurred shortly after birth. Within two years of his initial episode left femoral-popliteal thrombosis, at age 20, he had a recurrent DVT and developed a stasis ulcer on the medial anterior calf. Evidence of varicosities in his teenage years was an additional sign suspicious for central venous obstruction.

Acquired Amnesia In Children

The first of Vargha-Khadem et al.'s (1997) three cases was a 14-year-old girl, Beth. After birth Beth remained without a heartbeat for 7-8 min before resuscitation. Memory difficulties were noticed on entrance into mainstream school. The second case, Jon, was a 19-year-old boy. He had been delivered prematurely at 26 weeks, had breathing difficulties and was in an incubator, on a ventilator, for 2 months. At the age of 4, he had two protracted seizures. Memory difficulties were noted by his parents at age 5.5 years. The third case was a 22-year-old, Kate, who for 3 days at the age of 9 had received a toxic dose of theophylline, a drug being given for her asthma. This led to respiratory arrest and loss of consciousness. Upon physical recovery, she displayed amnesia. Both Beth and Jon (Vargha-Khadem et al., 1997) had hypoxic-ischaemic episodes at or shortly after birth without showing any subsequent hard neurological signs. A further three similar cases are also presented by Gadian et...

Genital Hygiene Of Infants Vulvar Anatomy and Vaginal Discharge

The vulva of the newborn exhibits the effects of residual maternal estrogen. Immediately after birth, the labia appear swollen, and a white mucoid discharge is present for the first few weeks of infancy. The discharge is normal and can be cleansed by wiping gently from front to back with a damp washcloth, moistened cotton wool, or wipe. As the influence of the residual maternal hormones declines, slight blood spotting may occur because of endometrial bleeding

Demyelinating disorders

Dysmyelination disease is best exemplified by metachromatic leukodystrophy, which results in impaired development of myelin in the brain along with a toughening of the brain. The disorder often appears in the fiber tracts, which should myelinate after birth. The diseased tissues contain granular material that occurs from a defect in the metabolism of fatty substances appearing in the nerves, pituitary gland, liver, testes, and kidneys and that are excreted in the urine. symptoms, which appear in infancy, childhood, or early adult life, include convulsive seizures, optic atrophy, paralyses, and dementia, or emotional abnormalities. The disease ends in death within a few years of onset. There is no satisfactory treatment.

Etiology And Pathogenesis Of Varicose Veins

Hippocrates was the first to deal with the pathogenesis and epidemiology of varicose disease when he affirmed that varicose veins were more frequent in Scythians due to the prolonged time spent on the horseback with the legs hanging down. In 1514, Marianus Sanctus noted that varicose veins were more frequent after pregnancy and in longtime standing peoples (. . . standing too much before kings . . .). In 1545, Ambroise Par related varicose veins to pregnancy and long travelling and affirmed that they are more frequent in melancholic subjects. Ten years later, Jean Fernel (1554), Professor of Medicine at Paris, stated that varicose veins can develop after an effort or a trauma . . . the varix comes also from a blow ( ), from a contusion, from an effort . . . Virchow (1846) was the first to point out the hereditary tendency to varicose veins. Finally, the rare syndrome due to congenital absence of venous valves was first reported by Josephus Luke in 1941.

Lessons from Transgenic Zebrafish Expressing the Green Fluorescent Protein GFP in the Myeloid Lineage

The PU.1 protein belongs to the ets family of transcription factors and plays an early role in myelopoiesis that is essential for the development of both myeloid (granulocytes and monocytes macrophages) and lymphoid cells (Akashi et al., 2000 Hromas et al., 1993 Klemsz et al., 1990). In transgenic mouse studies, embryos in one PU.l-deficient mouse line died in late gestation and exhibited an array of functional deficiencies in macrophages, granulocytes, and progenitors of B and T lymphocytes (Scott et al., 1994). Another PU.l-deficient mouse line produced live pups that had impaired myeloid development, lacked B-lympho-cytes, and died soon after birth from septicemia (McKercher et al., 1996). Analysis of the promoter and enhancer sequences of genes expressed by hematopoietic cells have defined PU.l-dependent regulatory elements, including components of the B-cell receptor and an array of adhesion molecules, growth factor receptors, and lysozymal enzymes expressed by myeloid cells...

Box 144 Manipulating Gene Expression To Treat Sickle Cell Anemia

Red cells do not become rigid and sickle-shaped in a fetus with sickle cell anemia. The gene that makes fetal hemoglobin (HbF) is a different gene from the one that makes HbS, and normally the job of fetal hemoglobin gets taken over by HbA in an adult. How far off the HbF expression gets turned after birth apparently varies from one person to the next. And how far off the HbF gene gets turned also apparently affects how severe a case of sickle cell anemia will be. So one of the most interesting treatments recently developed involves manipulating gene expression to get expression of the fetal hemoglobin gene HbF to partially compensate for the defective hemoglobin in the red cells (see Box 14.4).

Cot death and antimony

Other researchers were directed to look more closely at the stibine theory, and at London University's Birkbeck College, a microbiologist, Dr Jane Nicklin, and a chemist, Dr Mike Thompson, carried out a series of experiments. Nicklin cut up SIDS mattresses and placed samples in conditions that would allow Scopulariopsis brevicaulis to flourish and Thompson analysed the gases given off to see if stibine was evolved it wasn't. Meanwhile the Scottish Cot Death Trust commissioned an investigation by researchers at the Royal Hospital for Sick Children in Glasgow and they found that the livers of SIDS babies had lower levels of antimony than those of infants who had died of other causes. At Liverpool University, Professor Dick Van Velsen analysed hair samples from cot death babies and found that the hair that had grown on babies while they were still in the womb had more antimony than that which grew after birth, which again seemed to disprove the theory that the antimony was coming from...

Series Of Nested Targeted Deletions In The Hoxd Cluster

The gene is present, but no functional HOXD13 protein is produced because of a targeted insertion of lacZ sequence into the homeodomain. Digit defects are present in essentially the same structures but to a less severe degree as compared with the simultaneous loss of Hoxd13, Hoxd12, and Hoxdll (see next panels). C and F show the corresponding parts of the skeleton of a homozygous mutant of the Hoxd13-, Hoxd12-, and Hoxdll-deficient chromosome. In homozygous individuals, all digits are shorter (ectrodactyly), lack well-formed articulations between the phalanges (p2, p3, etc., in panel C), and a diagnostic pattern of synpolydactyly is observed in the hindlimb, which involves the fourth digit (IV in panel F). In addition to these patterning defects, skeletons of mice 1 wk after birth show ossification deficiency. Ossification centers of the different skeletal elements were visualized by alizarin red staining, and here appear in dark grey in panels G and H. When comparing G and...

Epidemiology And Prognosis Of

In search for the aetiology of TGA several studies have investigated the prevalence of risk factors for atherosclerosis. In different samples of TGA patients the frequency of arterial hypertension varies widely. It was reported to be only 13 (Hinge et al., 1986), 25-35 (Mumenthaler & Treig, 1984 Matias-Guiu et al., 1986 Miller et al., 1987 Frederiks, 1990 Hodges & Warlow, 1990a), and about 50 (Crowell et al., 1984 Kushner & Hauser, 1985 Colombo & Scarpa, 1988 Guidotti et al., 1989 Zorzon et al., 1995). A history of coronary heart disease was found with frequencies between some 5 (Mumenthaler & Treig, 1984 Hinge et al., 1986 Hodges & Warlow, 1990a) and some 25 (Hinge et al., 1986 Miller et al., 1987 Guidotti et al., 1989 Frederiks, 1990). The frequency of previous cerebrovascular events was reported to be as high as 67 in one study (Kushner & Hauser, 1985), but only 10 or lower in the remainder (Matias-Guiu et al., 1986 Miller et al., 1987 Colombo & Scarpa, 1988...

Audition in Children Development of

Auditory sensitivity is within about 10-15 dB of adult values by 6 months after birth, but behavioral and elec-trophysiological methods show different trends during early infancy. Behavioral thresholds at 1 month are approximately 40 dB above adult values, with substantial improvement through 6 months and gradual improvement through the early school years (Schneider et al., 1986 Olsho et al., 1988). By 6 months the audibility curve (threshold plotted against frequency) is adultlike in Like absolute sensitivity, frequency resolution approaches adult values by 6 months after birth. The segregation of auditory processing by frequency is demonstrated by the enhanced effectiveness of masking sounds that are closer in frequency to the signal. Infants' cochlear frequency resolution has been studied via suppression tuning curves from otoacoustic emissions. Such frequency resolution is adultlike at full-term birth (Bar-gones and Burns, 1988 Abdala, 1998). Beyond the cochlea, resolution for...

Hormonal and Nonhormonal Basis of Maternal Behavior in Primates

Concerning adoption in human societies, although such behavior suggests that maternal motivation may be relatively high even in nulliparous women, this does not rule out a role for hormonal factors and processes akin to sensitization in human maternal responsiveness. Interestingly, Hrdy (1999) describes some historical evidence that is relevant to these issues. In Europe in the 1800s, the level of abandonment of infants by their natural mothers was high in destitute populations. In a particular hospital in Paris, a subset of such indigent women were asked to remain with their infants for 8 days after birth prior to making a decision on whether they would give up their young. This requirement substantially reduced the incidence of abandonment. Since these females gave birth naturally and also breastfed their infants, it is conceivable that infant stimulation coupled with hormonal events played a role in reversing the initial intent of these mothers to abandon their young.

Production Of Germfree Animals

After birth, the newborn had to be fed a specifically adjusted formula, using a nipple attached to a suitable syringe-type container. Germfree guinea pigs had to be fed for only a few days because of their advanced development at birth. Other species, however, had to be fed in this way for several weeks. This turned out to present no special problems, except for the feeding of newborn GF mice. After many trials, a pair of baby C3H mice were obtained that grew to maturity, bred, All GF rodents and leporidae have significantly enlarged ceca. In GF rats, the distension starts about two weeks after birth. Depending on diet, the GF cecum could be from 4 to 8 of body weight, versus around 1 in the CV rat, and more in GF rabbit and guinea pigs. The enlarged cecum is caused by the absence of a microflora that normally will digest the intestinal mucus which would otherwise accumulate in the cecum. This accumulation of acidic mucus changes the local mineral balance, leaving insufficient sodium...


These CNS cells are the equivalents of Schwann cells of the PNS (Figs. 2.1 and 2.10). They are the cells that make and maintain CNS myelin. There are two types of oligoden-droglia perineuronal satellite cells, which are closely associated with cell bodies and den-drites in the gray matter, and (2) interfascicular cells, which are involved in myelination of axons in white matter. The numerous processes of Individual oligodendrocytes form the myeli-nated internodes for as many as 70 axons. As noted earlier for peripheral nerve axons, the myelin sheath is a continuous layering of spiral lamellae of the oligodendroglial plasma membrane (Fig. 2.10). Myelination of many axons commences prenatally. Most pathways in the human brain are not fully myelinated until 2 years after birth. Oligodendrocytes can participate in the remyelination that can occur following acute or chronic demyelination. This so-called spontaneous remyelination takes place in such diseases as multiple sclerosis and could...

Cell differentiation

CBFA1, one of the mammalian homologues of the Runt Drosophila transcription factors is the earliest and most specific marker of osteoblast differentiation known. Three different lines of evidence reinforcing each other demonstrate that Cbfal plays a role apparently not redundant with the function of any other gene during osteoblast differentiation. CBFA1 was identified as the factor binding to one OSE2, an osteoblast-specific cis-acting element present in the promoter most genes expressed in osteoblasts. Its expression during development and after birth is highly osteoblast-specific, is regulated by the bone morphogenetic proteins and other growth factors, and forced expression of Cbfal in non-osteoblastic cells leads to the expression of osteoblast-specific genes such as Osteocalcin in these cells (Ducy et al 1997).

Pasko Rakic

Of development, including the selective elimination of neurons, axons, and synapses, as well as the shaping of the final circuits within topographical maps, are influenced by activity-dependent mechanisms which-after birth involve individual experience (figure 1.1C, D). As indicated on the right side of the diagram, analysis of these events can be carried out at the genetic, molecular, and cellular levels. This article focuses exclusively on those aspects of the early events that are represented at the bottom of figure 1.1A and B. macaque monkey are produced during midgestation (Rakic, 1974, 1988a). In contrast, neurogenesis has been shown to continue after birth both in the cerebellum and the hippocampus (Rakic, 1973 Rakic and Nowakowski,


NTDs are major malformations in which there is a failure of the developing neural tube to close properly during the fourth week of embryonic life. Incomplete closure of the spinal cord results in spina bifida while incomplete closure of the cranium results in anencephaly (McNulty, 1997). The latter condition means the babies will either die in utero or shortly after birth.

Postnatal Growth

Adult, the brain constitutes only approximately 2 of the total body weight. The postnatal growth of the brain is rapid, especially during the first 2 years after birth. The brain weighs about 350 g in the full-term infant and about 1000 g at the end of the first year. The rate of growth slows down after this, and by puberty, the brain weighs about 1250 g in girls and 1375 g in boys. It appears that the brain of a girl grows more rapidly than that of a boy up to the third year, but the brains of boys grow more rapidly after that. This brain size is reflected in the growth of the cranial skeleton. In contrast to the adult, the young child has a large cranium in relation to the face. Head circumference is a measure of the growth of the brain. The head circumference is 34 cm at birth, 46 cm at the end of the first year, 48 cm at the end of the second year, 52 cm at 10 years, and only slightly larger at puberty and in the adult.

Down syndrome

Down syndrome is usually suspected after birth as a result of the baby's appearance. Among the most common traits are low muscle tone, a flat facial profile, an upward slant to the eyes, an abnormal ear shape, a single deep crease across the center of the palm, and an excessive ability to extend the joints. Other common symptoms include a fifth finger with one furrow instead of two, small skin folds on the inner corner of the eyes, too much space between large and second toe, and an enlarged tongue compared to the size of the mouth Early intervention should begin shortly after birth. These programs offer parents special instruction in teaching their child language, cognitive, self-help, and social skills, and specific exercises for gross and fine motor development. Stimulation during early developmental stages improves the child's chances of developing to his or her fullest potential. Continuing education, positive public attitudes, and a stimulating home environment also promote the...


Malnutrition and undernutrition during fetal life, infancy, and childhood have an effect on the developing nervous system. Certain nutritional deficiencies, especially those occurring at the critical early rapid period of maturation, can result in permanent damage. In humans, the critical period extends from the second trimester of pregnancy through most of the first year after birth. During this interval, many neurons and macroglia are being replicated and much of the brain growth is taking place. Evidence indicates that under severe protein malnutrition, the rates of proliferation of new neurons and glial cells are reduced. This reduction occurs during fetal life because even the fetus is not protected from maternal malnutrition. The developing brain is vulnerable during

Peroxyl radical

The first reduction step, oxygen to superoxide, is fairly easy and many systems with a reduction potential of -0.16V or less can achieve it. Thus some O2 is produced free in mitochondria by escape of electrons onto O2 from electron carriers (2). This superoxide is largely or entirely removed by mito-chondrial superoxide dismutase enzymes, especially manganese-containing SOD, MnSOD. This enzyme is essential to survival, as revealed by the observation that transgenic mice lacking MnSOD usually die soon after birth with a series of defects including neurodegeneration (3,4). Several biomolecules autox-idize to make O2*-, including dopamine, adrenalin, tetrahydropteridines and thiols (1). Reaction starts slowly because direct reaction of non-radicals, such as these molecules, with O2 is disfavored. Traces of transition metals (iron, copper, manganese etc) can catalyze one-electron transfers to promote autoxidation reactions (1).

Social Interest

We can compare Adlerian social interest with empathy, defined as concern for the experience of another person. Empathie individuals respond emotionally, sharing the joys and sorrows of others. They are also cognitively concerned, tiying to imagine situations from the perspective of others. According to Carolyn Zahn-Waxler and Marian Radke -Yarrow (1990), empathy is found in children as young as 2 years old. They respond to others' emotions even earlier, from the first few days after birth (Zahn-Waxler, Radke -Yarrow, Wagner, & Chapman, 1992). These observations are consistent with Adler's view of social interest as an inborn potential. Research also confirms Adler's warning that social interest must be nurtured. Empathy declines under adverse conditions, including parents who are depressed or in conflict with one another or who mistreat the child (Zahn-Waxler & Radke-Yarrow, 1990). It provides the basis for moral development, according to a theory proposed by Martin Hoffman...


The brain of a human fetus grows rapidly from the 10th to 18th week of development, so it is important for the pregnant woman to eat nutritious foods during this time. The brain also grows rapidly just before and for about two years after birth. Malnutrition during these periods of rapid brain growth may have devastating effects on the nervous system and can affect not only neurons, but also glial cell development and growth, which can affect myelin development. Babies born to mothers who had poor diets may have some form of mental retardation or behavioral problems, and children who do not eat well in their first few years of life may develop problems later. Often the effects of malnutrition and environmental problems, such as emotional and physical abuse, can combine to create behavioral problems. Therefore, the exact causes of behavioral disorders are difficult to determine.

Cloned Animals

Cloning is an inefficient process and is used to produce gene-altered models in animals where no ES cells are currently available. These techniques are labor-intensive and time-consuming and, to date, offer a low percentage of success. Some progeny are born with large-animal syndrome (33) and some cloned animals die shortly after birth for no apparent reason. Jaenisch and colleagues have argued that the transferred somatic nuclei must reset itself to an embryonic nuclei (reviewed in ref. 34). This might be an inefficient process and frequently leaves nuclear methylation and imprinting patterns in disarray. Despite these drawbacks, some laboratories are achieving higher yields of cloned animals that survive. The question remains whether large-animal models with tumor suppressor onco-gene knockouts or other gene alterations derived by cloning are more suitable than mouse models to study the physiology of cancer progression and metastasis (35).

High Risk Groups

The developing fetus is particularly sensitive to neurotoxins because its nervous system is in the process of growing, dividing, and making important connections and because the blood-brain barrier is not yet fully formed. In later stages of fetal development and after birth, exposure to alcohol or lead, for example, can lead to lowered intelligence levels, motor or sensory problems, learning disabilities, and behavior problems. During childhood, the nervous system is still in a state of rapid development, and young children are still vulnerable to neurotoxin damage.


Although rarely seen in nulliparous teenagers and young women, when one may assume the cause is identical to male varicocele, this condition largely follows pregnancy. Vulval varicose veins are said to occur in 2 to 7 of pregnancies.3,4 These become larger in subsequent pregnancies, although they often disappear in the postpartum period. Usually after three pregnancies some varicose veins remain in the vulva, upper medial thigh, perianal, or gluteal regions. Probably the majority of cases are related to massive enlargement of the ovarian veins draining the pregnant uterus, perhaps associated with internal iliac vein compression. Perhaps after pregnancy some ovarian veins do not return to normal size, and the limited one or two valves at the upper end of the ovarian veins may become incompetent. Maybe segmental reflux occurs in tributaries of the internal iliac veins such as the uterine veins, and the round ligament veins, and can be responsible for persisting pelvic varicosities, even...

Attention Disorders

Experts do not know exactly what causes learning disabilities, but they are assumed to be disorders of the central nervous system triggered by many different factors. These may include heredity, problems during pregnancy or birth, and incidents after birth. After birth, learning disabilities may be caused by head injuries, nutritional deprivation, poisonous substances, or child abuse. New brain cells and neural networks continue to be produced for a year or so after the child is born, and these cells also are vulnerable to certain disruptions.

Gold In The Mine

Cord blood is the blood remaining in the umbilical cord and placenta after birth. Much like bone marrow, cord blood is one of the richest sources of stem cells that can ever be collected. It is removed from the umbilical cord and the placenta right after the cord has been cut.1

New Developments

The second important advance is the development of multichannel cochlear implant technology. Electrodes implanted into the cochlear now bypass the hair cells and stimulate the auditory nerve directly. An external receiver and processor analyzes the incoming speech according to a predetermined strategy and transforms the complex pattern of sound frequencies and amplitudes into a corresponding pattern of electrical stimulation across a number of electrodes in the cochlear. Over the past 15 years, major developments in the complexity of the analysis that can be carried out in the externally worn speech processor (increasingly miniaturized by developing computer technology) first led to remarkable improvements in speech perception in postlingually deafened adults with implants. Now younger and younger profoundly deaf children who lost their hearing at or soon after birth and who would not benefit much from conventional hearing aids are receiving cochlear implants, some as young as 18...


Newborns with PWS have poor muscle tone, and cannot suck well enough to get sufficient nutrients. Often they must be fed through a tube for several months after birth until their muscle control improves. By preschool age, children with PWS develop an increased interest in food and quickly gain excessive weight if calories are not restricted.

Pericyte Recruitment

During capillary formation, pericytes, which express PDGF Receptor- (PDGFR-P), are recruited by platelet-derived growth factor-BB (PDGF-BB) produced by the migrating tip cell of the sprouting capillary 11 . When the PDGF-b or PDGFR-P genes are knocked-out, vessels are severely depleted of pericytes, are unstable, form microaneurysms and bleed, leading to death soon after birth. However, pericyte differentiation proceeds normally during development, and it is their recruitment to nascent vasculature to be severely impaired, resulting in the vascular abnormalities and mortality 19, 20 . The role of PDGF-BB produced by the growing vessels was investigated in mice in which the pdgf-b gene was deleted specifically in endothelial cells (pdgf-blox -). The animals were viable, but suffered from a diffuse defect in pericyte recruitment, such that pericyte numbers were reduced by as much as 90 of normal, leading to microvascular defects in multiple organs reminiscent of diabetic microangiopathy...

Visual input

Hendrickson and her colleagues have shown that the morphology and distribution of cone photoreceptors undergo marked changes after birth in both humans and monkeys (Hendrickson and Kupfer, 1976 Hendrickson and Yuodelis, 1984 Packer et al., 1990 Yuodelis and Hendrickson, 1986). The foveal concentration of cones that is characteristic of adult retinae is much less marked in neonates during development, cones migrate toward the center of the fovea. Figure 12.3A shows this effect in data from five macaque monkeys aged 1 week to adult. The data in Figure 12.3A are plotted in terms of units of visual angle, so they incorporate both the effects of retinal changes and the effects of eye growth (which act in the opposite direction to the increase in retinal cone density created by migration). The combination of these factors changes the linear sampling density of the foveal cone mosaic by about a factor of 3 from 1 week to adulthood. This change is captured in Figure 12.3A by plotting the...

Pegylation 369

Pediatric clinical signs and symptoms as well as disease progression are different in children than in adults. For children who become HIV-infected during gestation, clinical symptoms usually develop within six months after birth. Few children infected as fetuses live beyond two years, and survival beyond three years used to be rare. With the use of anti-HIV drugs and therapy for opportunistic diseases, some children born with HIV are still alive at five, 10, and 15 years of age.

Mouse studies

The timing of acquisition of methylation patterns differs greatly between the two germ lines. In the male, techniques like Southern blotting and bisulfite genomic sequencing have shown that acquisition of DNA methylation patterns begins before birth, in prospermatogonia, and is completed for most of the sequences after birth, before the end of the pachytene phase of meiosis (Davis et at., 1999, 2000 Kafri et at., 1992 Lees-Murdock et at., 2003 Li et at., 2004 Ueda et at., 2000 Walsh et at., 1998). Initial acquisition of methylation occurs between 15.5 and 18.5 days of gestation at this time germ cells begin to stain positively with an antibody directed against methylated cytosine, indicating increases in overall genomic methylation (Coffigny et at., 1999). H19, a maternally expressed gene that becomes methylated in the male germ line (and remains unmethylated in oocytes) has been extensively characterized (Bartolomei et at., 1991, 1993 Davis et at., 1999 Ferguson-Smith et at., 1993...


In the past, most children with the most severe cases of spina bifida (myelomeningocele) died soon after birth, but today immediate surgery saves the lives of most of these children. They usually must have a series of operations as they grow and usually need special devices to help them walk. With this treatment, about 80 percent of these children can walk by the time they enter school. Most need special training (such as how to insert catheters) to manage bowels and bladder and prevent serious bladder infections and kidney problems. Special diets and schedules allow many children to achieve

Premature babies 413

Low blood pressure This is a relatively common complication that may occur shortly after birth due to infection, blood loss, fluid loss, or medications given to the mother before delivery. Low blood pressure is treated by boosting fluid intake or giving medication. Respiratory distress syndrome (RDS) Breathing problems are one of the most common and serious problems of prematurity. With respiratory distress syndrome (RDS), (formerly known as hyaline membrane disease), the infant's immature lungs do not produce enough surfactant, which normally allows the inner surface of the lungs to expand properly when the infant makes the change from the womb to breathing air after birth. RDS is treatable and many infants do quite well. If premature delivery cannot be stopped, most pregnant women are given medication just before delivery to help prevent RDS. Immediately after birth and several times later, artificial surfactant can be given to the infant. Although most premature babies without...

Risk Factors

Experts suspect that the problem is not congenital, but that infants develop a progressive thickening of the pylorus after birth until it becomes so thick that the stomach can no longer empty properly. Although experts are not sure what triggers the muscle thickening, some researchers suspect that maternal hormones or allergies could be a contributing cause. Others believe that some babies lack receptors in the pyloric muscle that detect nitric oxide, a chemical that induces the pylorus muscle to relax, so that the muscle contracts almost continually, causing it to thicken over time.

Angiogenic Disorders

After birth, angiogenesis still contributes to organ growth, but during adulthood most blood vessels remain quiescent angiogenesis only occurs in the cycling ovary and placenta during pregnancy. However, endothelial cells (ECs) retain the remarkable ability of dividing rapidly in response to a physiological stimulus, such as hypoxia and inflammation. Angiogenesis is also reactivated during wound healing and repair. In many disorders, however, this stimulus becomes excessive, and the balance between stimulators and inhibitors is disturbed, resulting in an angiogenic switch. The best-known conditions in which angiogenesis is switched on are malignant, ocular and inflammatory disorders, but many additional processes are affected-such as atherosclerosis, asthma, diabetes, cirrhosis, multiple sclerosis, endometriosis, acquired immunodeficiency syndrome (AIDS), bacterial infections and autoimmune diseases (Table 1). In obesity, adipose tissue may also show excessive growth. A high-fat diet...


Immunoreative trypsinogen (IRT) test is used for those newborns who do not produce enough sweat. In this test, blood is drawn 2 to 3 days after birth and is analyzed for the presence of trypsinogen protein. It is, however, not a confirmatory test. CF is later confirmed by sweat and other tests.

The mind problem

This classic contrast between nature and nurture, between heredity and environment, between genotype and phenotype, has also dominated the theories of language, and the recent discovery of inborn mental rules appears to have suggested a sort of compromise solution up to the moment of birth mental development is under genetic control, while after birth it becomes dependent upon environmental stimuli. With the terminology that has been adopted today, the universal grammar would be determined by the genes, whereas the individual grammar would be almost entirely a product of the environment. The real problem, here, is that the development of the mind is characterised by a convergent increase of complexity both before and after birth, and the present compromise solution on language doesn't help us in the least to understand this fundamental process. The stumbling-block is that any dualistic scheme such as heredity-environment, or genotype-phenotype, is a priori incapable of solving the...

Islet Maintenance

Dynamic control of p-cell mass in the adult pancreas has been suggested by studies of pregnancy during which the mother's p-cell mass expands greatly as metabolic demands increase in response to the altered hormonal milieu.97,98 However, shortly after birth, when the hormonal environment reverts to the non-pregnant state, the expanded p-cell mass involutes, returning to normal levels through p-cell atrophy, increased p-cell apoptosis, and decreased p-cell replication.97 Similar cell mass regulation has also been reported for lacrimal glands and breast tissue.99-105 Thus, it appears that common control mechanisms in different tissues may serve to align cell mass with functional need, and it seems that such mechanisms are operative and particularly responsive not only in the neonatal, but in the adult pancreas as well.


More than 50 cases of apparently nonmosaic triploidy, either 69,XXX or XXY, have been reported in liveborns. Most patients died shortly after birth. Eight patients with survival longer than 2 months have been reported (reviewed in ref. 190), with the longest being 10 months (191). The origin of the extra set of chromosomes was determined by cytogenetic polymorphisms or human leukocyte antigen (HLA) to be maternal in three cases and paternal in one case (192). One study based on DNA polymorphism in an infant who survived for 46 days indicated a maternal meiosis II failure as the origin of the triploid (reviewed in ref. 192). These findings suggest that, in general, digynic triploids survive longer than diandric triploids. The most frequent phenotypic abnormalities include intrauter-ine growth retardation, hypotonia, craniofacial anomalies (macro hydrocephalus, low-set dysplastic ears, broad nasal bridge), syndactyly, malformation of the extremities, adrenal hypoplasia, cardiac defects,...

Infantile Period

One of Freud's (1905 1953b, 1923 1961b) most important assumptions is that infants possess a sexual life and go through a period of pregenital sexual development during the first 4 or 5 years after birth. At the thne Freud originally wrote about infantile sexuality, the concept, though not new, was met with some resistance. Today, however, nearly all close observers accept the idea that children show an hiterest in the genitals, delight hi sexual pleasure, and manifest sexual excitement. Childhood sexuality differs from adult sexuality in that it is not capable of reproduction and is exclusively autoerotic. With both children and adults, however, the sexual hnpulses


The disorder often appears in the fiber tracts which should myelinate after birth. The diseased tissues contain granular material that results from a defect in the metabolism of fatty substances (sulfatides) appearing in the nerves, pituitary gland, liver, testes, and kidneys and is excreted in the urine.

The Enigma

Birth after birth the line unchanging runs, And fathers live transmitted in their sons Each passing year beholds the unvarying kinds, The same their manners, and the same their minds Till, as erelong successive buds decay, And insect-shoals successive pass away, Increasing wants the pregnant parent vex With the fond wish to form a softer sex

Autosomal Monosomies

Triploid Karyotype

Four cases of mosaic monosomy 22 in liveborns have been reported (171-174). All four were male. One was a 34-week premature infant with gastroschisis who died from intracranial hemorrhage shortly after birth. No dysmorphic features were noted, and an autopsy was not performed (173). Two patients had growth and developmental deficiencies, microcephaly, and mild facial dysmorphism. The fourth patient was a 30-week premature infant with facial features of DiGeorge syndrome, hyperto-nicity, limited extension of major joints, and flexion contractures of all fingers.


Spermatogenesis Waves

The unique architecture of seminiferous epithelium, based on the succession of spermatogonia, spermatocytes and spermatids from BM toward the lumen of seminiferous tubule is established in a stepwise manner during postnatal development. Subsequently, we can only find Sertoli cells, spermatogonia and preleptotene sper-matocytes in a newborn mammal. Advanced spermatocytes (leptotene, zygotene, pachytene and dividing ones) and spermatids appear in the peri-pubertal and adult testis only (see Fig. 1.3). Such a succession greatly facilitates developmental expression profiling of sperm proteins. For example, in order to learn at which stage of spermatogenesis a particular protein is present, it would be necessary to harvest proteins or mRNAs from all appropriate stages of spermatogenic cell development. Instead of using labor intensive separation of individual spermatogenic cell types from an adult testis, one can simply harvest testicular tissue from young rodent animals at each week after...

Why Study Twins

Genetic, shared environment, and nonshared environment factors. The detailed mathematical procedures are beyond the scope of this chapter, but a few points may help the reader understand the basic logic of the analyses. MZ twins share their genes and their family school environment, so any differences within MZ twin pairs is logically due to nonshared environment influences. Such influences could include differential stress during gestation, accidents, or disease after birth, and unusual differences in educational opportunity. DZ twins within a pair will also have nonshared environmental influences, but in addition, they may have genetic differences relevant to the studied behavior. Thus, any greater behavioral differences between DZ twins compared to MZ twins may be due to genetic factors. In this chapter, we are focusing on the genetic contributions to extreme reading deficits or dyslexia. Thus, if MZ and DZ twins shared dyslexia equally often, we would conclude that there is no...


Porencephaly An extremely rare disorder of the central nervous system involving cysts or cavities in a cerebral hemisphere that are the remnants of destructive lesions, but are sometimes the result of abnormal development. The disorder can occur before or after birth most affected infants show symptoms of the disorder shortly after birth.

Extrastriate cortex

We have until now considered the development of and effects of abnormal visual experience on the structure and function of the visual pathway, up to and including the primary visual cortex, V1. But in primates, there is a very extensive collection of cortical areas outside V1, which in aggregate involve about three times as much cortical tissue as V1 (Felleman and Van Essen, 1991). The functional properties of neurons in these areas and their relationship to behavior are a very active focus of study (see, for example, Chapter 34, Ventral and Dorsal Cortical Processing Streams Chapter 78 Chapter 81 and Chapter 103), yet little attention has been paid to the way that they change during development or after abnormal visual experience. The visual responsiveness of extrastriate areas has been documented using 2-deoxyglucose autoradiography (Bachevalier et al., 1991 Distler et al., 1996). These measurements show that higher cortical areas are relatively delayed in their development compared...

Strep throat 469

Strawberry birthmark Also called strawberry nevus, this is a bright red birthmark that usually appears shortly after birth, when it enters a rapid growth phase during the first several months. Growth then gradually slows down and stops, beginning to regress by age one. Most of these birthmarks will have disappeared completely by age seven.