Placental insufficiency with fetal intrauterine growth restriction (IUGR) is an important cause of perinatal mortality and morbidity and is subsequently associated with significant neurodevelopmental impairment in cognitive function, attention capacity, and school performance. The underlying biologic cause for this association is unclear. Twenty-eight preterm infants (gestational age 32.5 Ϯ 1.9 wk) were studied by early and term magnetic resonance imaging (MRI). An advanced quantitative volumetric three-dimensional MRI technique was used to measure brain tissue volumes in 14 premature infants with placental insufficiency, defined by abnormal antenatal Doppler measurements and mean birth weights Ͻ10 th percentile (1246 Ϯ 299 g) (IUGR) and in 14 preterm infants matched for gestational age with normal mean birth weights 1843 Ϯ 246 g (control). Functional outcome was measured at term in all infants by a specialized assessment scale of preterm infant behavior. Premature infants with IUGR had a significant reduction in intracranial volume (mean Ϯ SD: 253.7 Ϯ 29.9 versus 300.5 Ϯ 43.5 mL, p Ͻ 0.01) and in cerebral cortical gray matter (mean Ϯ SD: 77.2 Ϯ 16.3 versus 106.8 Ϯ 24.6 mL, p Ͻ 0.01) when measured within the first 2 wk of life compared with control premature infants. These findings persisted at term with intracranial volume (mean Ϯ SD: 429.3 Ϯ 47.9 versus 475.9 Ϯ 53.4 mL, p Ͻ 0.05) and cerebral cortical gray matter (mean Ϯ SD: 149.3 Ϯ 29.2 versus 189 Ϯ 34.2 mL, p Ͻ 0.01). Behavioral assessment at term showed a significantly less mature score in the subsystem of attention-interaction availability in IUGR infants (p Ͻ 0.01). Cerebral cortical gray matter volume at term correlated with attention-interaction capacity measured at term (r ϭ 0.45, p Ͻ 0.05). These results suggest that placental insufficiency with IUGR have specific structural and functional consequences on cerebral cortical brain development. These findings may provide insight into the structural-functional correlate for the developmental deficits associated with IUGR. An increasing number of developmental disorders (1, 2) and diseases (3, 4) in child and adult life are thought to have their origin in the fetal period. Central to this predisposition is fetal growth (5). The fetus receives its nutrients from the maternal/ uterine circulation via the placenta. Any disturbance in the placental-fetal circulation will therefore have severe consequences on the supply of important nutrients such as oxygen, glucose, and amino acids (6). The placenta itself is also an active endocrine organ and, therefore, changes in nutrient availability will also affect placental and, potentially, fetal endocrine function, in particular, the modification of the hypothalamo-pituitary-adrenal axis (7,8). Placental insufficiency, which is the most common cause of IUGR, has further been shown to be associated with a considerable perinatal mortality

Background Acoustic radiation force impulse (ARFI) imaging) is correlated with histopathological findings using METAVIR and semiquantitative scoring system (SSS) criteria for liver fibrosis.

ARFI is feasible in children at any age with an acceptable reliability. The depth of measurements in the liver seems to have no influence on test results. We set the standard ARFI elastography values for healthy liver in children.

The aim of this study was to illustrate the chest radiographs (CR) and CT imaging features and sequential findings of cavitary necrosis in complicated childhood pneumonia. Among 30 children admitted in the Pediatric Intensive Care Unit for persistent or progressive pneumonia, respiratory distress or sepsis despite adequate antibiotic therapy, a study group of 9 children (5 girls and 4 boys; mean age 4 years) who had the radiographic features and CT criteria for cavitary necrosis complicated pneumonia was identified. The pathogens identified were Streptococcus pneumoniae( n=4), Aspergillus( n=2), Legionella( n=1), and Staphylococcus aureus( n=1). Sequential CR and CT scans were retrospectively reviewed. Follow-up CR and CT were evaluated for persistent abnormalities. Chest radiographs showed consolidations in 8 of the 9 patients. On CT examination, cavitary necrosis was localized to 1 lobe in 2 patients and 7 patients showed multilobar or bilateral areas of cavitary necrosis. In 3 patients of 9, the cavitary necrosis was initially shown on CT and visualization by CR was delayed by a time span varying from 5 to 9 days. In all patients with cavities, a mean number of five cavities were seen on antero-posterior CR, contrasting with the multiple cavities seen on CT. Parapneumonic effusions were shown by CR in 3 patients and in 5 patients by CT. Bronchopleural fistulae were demonstrated by CT alone ( n=3). No purulent pericarditis was demonstrated. The CT scan displayed persistent residual pneumatoceles of the left lower lobe in 2 patients. Computed tomography is able to define a more specific pattern of abnormalities than conventional CR in children with necrotizing pneumonia and allows an earlier diagnosis of this rapidly progressing condition. Lung necrosis and cavitation may also be associated with Aspergillus or Legionella pneumonia in the pediatric population

The aim of the present study was to quantify changes in human skeletal muscle pennation angle (F θ ) values during growth and adult life. The human gastrocnemius medialis muscle of 162 subjects (96 males and 66 females) in the age range 0-70 years was scanned with ultrasonography. The subjects were laying prone, at rest, with the ankle maintained at 90° with all muscles relaxed. F θ increased monotonically starting from birth (0 years) and reached a stable value after the adolescent growth spurt. There was a significant (p<0.05) linear relationship between F θ and muscle thickness (TK). F θ = 0.84 (± 0.09) * TK + 3.15 (± 1.13). Human gastrocnemius medialis F θ and TK data found in the literature seem to fit the F θ -TK plot in a coherent manner, i nd epend ent of the phys iological or ana to mical characteristics of the subject. The present findings indicate that F θ is not a constant parameter but evolves, as is the case for bone length and height, as a function of age.

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