Tissue In Children Research Articles

Regeneration of Subcutaneous Connective Tissue in Children

Enzyme histochemical patterns of healing subcutaneous connective tissue were studied histo‐chemically in 20 pediatric patients using the CELLSTIC device. This wound drain consists of a standard size viscose cellulose sponge inside a thin silicone rubber tube. The CELLSTICs were drawn out of the wound 3–96 h after implantation. The sponges were studied for the activity of the following enzymes: acid and alkaline phosphatases, adenosine triphosphatase, aminopeptidase, hexokinase, and isocitrate dehydrogenase. During the first 12 h the enzyme histochemical pattern in the sponge resembled that of peripheral blood, whereafter the number of polymorphonuclear leukocytes increased. These cells exhibited an increasing enzyme activity when accumulating and invading, but their activity decreased concomitantly with their degeneration between 36–48 h. The polymorphonuclears were followed by monocytes and macrophages, showing increasing enzyme activities. Fibroblasts usually appeared at the end of the third postoperative day. Both their number and enzyme activity increased later on, especially when the fibroblasts appeared as clusters. Maximum activity of isocitrate dehydrogenase and hexokinase was reached relatively early in the youngest children. Wound healing is thus an age‐dependent process reflected by the increased time needed for the maximal activation of certain enzymes and for cellular transformation.

Transport of Therapeutic Cyanocobalamin in the Congenital Deficiency of Transcobalamin II (TC II)

Cobalamin (Cbl) transport was studied in the circulation of a child deficient in transcobalamin II (TC II) after 1.0 mg of cyanocobalamin (CN-Cbl) either intramuscularly or orally. Pertinent observations include the following: (1) There was no detectable TC II in the serum as measured immunologically or by binding capacities in vivo or in vitro. (2) Transcobalamin I (TC I) was present in at least normal amounts, but, in contrast to the normal, TC I was completely saturated with Cbl. (3) The TC I of the child was qualitatively the same as that of normal persons and there was no evidence that TC I, or any other R-type binder, assumed the functions of the apparently absent TC II. (4) There was, however, an incompletely characterized circulating large molecular sized complex containing R-type binder. (5) After intake of 1.0 mg CN-Cbl orally, the usual daily therapeutic dose and route in this child, free Cbl was present in the serum. HeLa cells in culture took up free Cbl much less efficiently than Cbl bound to TC II, but the free Cbl followed the normal sequence in being bound to an intracellular binder and converted from CN-Cbl to the functioning forms adenosyl and methyl Cbl. Therefore entry to free Cbl into the child's tissues was considered to be a therapeutic possibility.

Regeneration of subcutaneous connective tissue in children. A histological study with application of the CELLSTIC device.

Cellular patterns of healing subcutaneous connective tissue were studied histologically in 22 pediatric surgical patients using the CELLSTIC device. This wound drain, specially developed for this purpose, consists of a standardized, viscose cellulose sponge inside a thin silicone rubber tube. When left between the wound edges, wound exudate flows through the drain, allowing its cells to attach themselves to the sponge surface. The sponge serves as a framework within which the cells may migrate, divide and transform. During the first 12 h the cellular pattern in the sponge resembles that of peripheral blood, whereafter the number of polymorphonuclear leukocytes, almost exclusively neutrophils, gradually increases. Later on, monocytes, macrophages and lymphocytes invade. Fibroblasts were usually seen at the end of the third day postoperatively, but in some cases the first fibroblasts appeared even earlier. CELLSTIC neither disturbs normal wound healing nor increases the rate of wound infections. CELLSTIC, as a cell culture in situ, provides a practical way to study human connective tissue regeneration under both physiological and pathological conditions.

Homotransplantation of Bone Tissue in Children

Homotransplantation of Bone Tissue in Children

Effects of Chronic Hypoxemia on the Electrophysiological Properties of Right Atria Tissue in Children

The purpose of this study was to determine the electrophysiological properties of normal right atrial tissue in children and to evaluate the role of chronic hypoxemia in the genesis of atrial arrhythmias. Using standard mocroelectrode techniques we studied the electrophysiological properties of preparations of right atrial tissue obtained during open heart surgery in two groups of patients. Group A consisted of 6 patients with uncomplicated ventricular septal defects. Group B comprised 6 patients with tetralogy of Fallot with arterial O2 saturations of 80-84%. All patients underwent cardiovascular diagnostic studies and had normal right atrial pressures and no evidence of atrial shunting. In Group A mean resting potential (RP) was −86±5.7 mV, action potential duration was 210±8 msec at a cycle length of 1,000 msec and conduction velocity was 0.45±0.05 M/sec. The relationship between the rate of rise of phase 0 of the action potential (AP) and the membrane potential at which the AP was elicited (membrane responsiveness) was ‘S’ shaped. Cells were unresponsive at a mean RP of −56±1.6 mV and maximum rate of rise occured at a mean RP of −86±5.7 mV. An increase in extracellular [K+] above control caused a decrease in the RP which was linearly related to log [K+]. When [K+] was reduced below control levels, RP decreased slightly. There were no significant differences (p = >0.05) between Group A and Group B for all properties measured. Results from Group A can be used for ‘normal’ reference values. Chronic hypoxemia does not seem to alter the electrophysiological properties of right atrial tissue. This is consistent with the clinical observation of the lack of atrial arrhythmias in cyanotic congenital heart disease when there is no pressure or volume overloading of the right atrium.

Roentgen Treatment of Infections of the Tonsils and Post-Pharyngeal Lymphoid Tissues in Children

The purpose of this paper is to stress the value of roentgen therapy in the treatment of infections of the tonsils and the post-pharyngeal tissues in children. The lack of material in the literature on this method of treatment indicates a failure to realize its importance. No attempt is being made to compare results obtainable by roentgen therapy with those obtainable by other methods. Neither is it our object to show the superiority of irradiation to surgery, or vice versa. Any statement made concerning a patient “without tonsils or adenoids” is made with the intention of indicating that they have been removed surgically. No reflection upon surgery is intended. Tonsillar and adenoid tissue may still be present, not because of the failure of complete removal, but because of persistent infection, causing regeneration of lymphoid tissue. Crowe writes: “Adenoids recur in more than 75 per cent of the children whose tonsils and adenoids have been removed before the age of puberty. It is so common that it must be regarded as normal.” In no instance was roentgen therapy administered with the view of eradicating tonsillar or adenoid tissue. Where tonsils appeared to be reduced in size, it was felt that the reduction was due to relief of infection in the tonsil and adjacent tissues. Although many cases of apparent primary tonsillitis were seen and treated, most cases appeared to be secondary to post-pharyngeal disease. A statistical study based on the total number of cases treated has not been made because of inability to obtain complete returns to a questionnaire. Results have been determined by questioning parents directly, when possible, and by expressions of satisfaction on the part of referring physicians. Confidence of physicians in the method is indicated by the fact that they have continued to refer patients, in increasing numbers. In most instances, responses to other forms of therapy, both medical and surgical, had been unsatisfactory, and the attending physician referred the patients for roentgen therapy. In some cases, children were referred on insistence by the parents. The number of referring physicians, including pediatricians, is indicative of the part this form of therapy is playing in our community. Indications Roentgen therapy to the pharyngeal tissues was first used only in cases in which tonsils and adenoids had been removed surgically. The symptoms which had led to operation either persisted or recurred after a short period of relief. These symptoms included recurrent or persistent colds, with or without cough; varying degrees of colored nasal and post-nasal drainage; recurrent sore throat, usually preceded by a cold. In some instances discharge from the ears, decreased acuity of hearing, or even deafness was noted. Examination of the nose and throat showed evidence of chronic infection. There was swelling of the membrane of the nasal cavity, with mucopurulent or purulent discharge.

The Growth of Bone, Muscle and Overlying Tissues in Children Six to Ten Years of Age as Revealed by Studies of Roentgenograms of the Leg Area

The Growth of Bone, Muscle and Overlying Tissues in Children Six to Ten Years of Age as Revealed by Studies of Roentgenograms of the Leg Area