Equilibrium potential for the postsynaptic response in the squid giant synapse.

The reversal potential for the EPSP in the squid giant synapse has been studied by means of an intracellular, double oil gap technique. This method allows the electrical isolation of a portion of the axon from the rest of the fiber and generates a quasi-isopotential segment. In order to make the input resistance of this nerve segment as constant as possible, the electroresponsive properties of the nerve membrane were blocked by intracellular injection of tetraethylammonium (TEA) and local extracellular application of tetrodotoxin (TTX). Thus, EPSP's could be evoked in the isolated segment with a minimal amount of electroresponsive properties. The reversal potential for the EPSP (EEPSP) was measured by recording the synaptic potential or the synaptic current during voltage clamping. The results indicate that EEPSP may vary from +15 to +25 mV, which is more positive than would be expected for a 1:1 conductance change for Na(+) and K(+) (approximately -15 mV) and too negative for a pure Na(+) conductance ((+)40 mV). This latter value (E(Na)) was directly determined in the voltage clamp experiments. The results suggest that the synaptic potential is probably produced by a permeability change to Na(+) to K(+) in a 4:1 ratio. No change in time-course was observed in the synaptic current at clamp levels of -100 and +90 mV. The implications of a variable ratio for Na(+)-K(+) permeability in subsynaptic-postsynaptic membranes are discussed.

Pacemaker synchronization of electrically coupled rabbit sinoatrial node cells.

The effects of intercellular coupling conductance on the activity of two electrically coupled isolated rabbit sinoatrial nodal cells were investigated. A computer-controlled version of the "coupling clamp" technique was used in which isolated sinoatrial nodal cells, not physically in contact with each other, were electrically coupled at various values of ohmic coupling conductance, mimicking the effects of mutual interaction by electrical coupling through gap junctional channels. We demonstrate the existence of four types of electrical behavior of coupled spontaneously active cells. As the coupling conductance is progressively increased, the cells exhibit: (a) independent pacemaking at low coupling conductances, (b) complex dynamics of activity with mutual interactions, (c) entrainment of action potential frequency at a 1:1 ratio with different action potential waveforms, and (d) entrainment of action potentials at the same frequency of activation and virtually identical action potential waveforms. The critical value of coupling conductance required for 1:1 frequency entrainment was <0.5 nS in each of the five cell pairs studied. The common interbeat interval at a relatively high coupling conductance (10 nS), which is sufficient to produce entrainment of frequency and also identical action potential waveforms, is determined most by the intrinsically faster pacemaker cell and it can be predicted from the diastolic depolarization times of both cells. Evidence is provided that, at low coupling conductances, mutual pacemaker synchronization results mainly from the phase-resetting effects of the action potential of one cell on the depolarization phase of the other. At high coupling conductances, the tonic, diastolic interactions become more important.

Effects of cGMP on L-type calcium current of adult and newborn rabbit ventricular cells.

OBJECTIVE: Cyclic GMP has been shown to be in some respects an inhibitory modulator of heart function. Various studies on the modulation of cardiac L-type calcium current (ICa) by cGMP in different species show inconsistency and the role of cGMP remains unclear and controversial. The present study was focused on the differences in the modulation of basal ICa by cGMP in adult and newborn rabbit ventricular cells. METHODS: Enzymatically isolated adult and newborn (1-4-day-old) rabbit ventricular myocytes were used to measure ICa under whole-cell voltage clamp conditions with internal perfusion of isolated cells. RESULTS: We have shown that in adult ventricular cells, the intracellular perfusion of 8BrcGMP did not produce any effect on basal ICa, while intracellular perfusion of 8BrcGMP or 8CPT-cGMP in newborn ventricular cells significantly and reversibly increased basal ICa without changing the voltage dependence for activation of ICa. Both methylene blue and LY-83583 (which inhibit guanylyl cyclase and thus lower cGMP levels), in adult ventricular cells, failed to produce any significant effect on basal ICa, while in newborn ventricular cells the application of methylene blue or LY-83583 produced irreversible inhibition of basal ICa. Similarly, KT-5823, an inhibitor of cGMP-dependent protein kinase, also inhibited basal ICa in newborn ventricular cells but not in adult ventricular cells. However, extracellular application of methylene blue during the intracellular perfusion of 8BrcGMP was unable to inhibit ICa. Extracellular application of nitrosoglutathione which releases nitric oxide produced a significant increase in ICa in newborn but not in adult ventricular cells. Intracellular application of a cAMP-dependent protein kinase inhibitor peptide blocked the stimulatory effect of cAMP but not of 8CPT-cGMP, while the stimulatory effect of nitrosoglutathione on ICa was not blocked by the presence of a phosphodiesterase inhibitor (isobutylmethyl-xanthine). CONCLUSIONS: We propose that, for newborn rabbit ventricular cells, cGMP plays a crucial role in maintaining basal ICa by a mechanism mediated via protein-kinase-G-dependent phosphorylation of calcium channels or some associated protein.

cGMP-dependent protein kinase mediates stimulation of L-type calcium current by cGMP in rabbit atrial cells.

OBJECTIVES: cGMP has been shown to exert both stimulatory and inhibitory effects on cardiac L-type calcium current (I(Ca)). The physiological role of cGMP in regulation of cardiac activity is still controversial. cGMP may be of importance in regulation of I(Ca) in atrial cells. The present study was focused on the role of cGMP in the modulation of I(Ca) in rabbit atrial cells. METHODS: Enzymatically isolated adult rabbit atrial cells were used to measure I(Ca) using whole cell voltage clamp. Expressed levels of cGMP-dependent protein kinase (PKG) were determined by Western blotting using PKG specific antibody in homogenates from atrial and ventricular cells. RESULTS: Nitrosoglutathione (GSNO), a nitric oxide donor that stimulates soluble guanylyl-cyclase to elevate cGMP levels increased I(Ca) while soluble G-cyclase inhibitors, ODQ or methylene blue inhibited I(Ca). Intracellular application of 8BrcGMP increased I(Ca) and blocked the inhibitory effect of methylene blue. KT-5823, an inhibitor of PKG inhibited I(Ca) and the stimulatory effect of GSNO was completely blocked ODQ or KT-5823. Inhibition of cAMP dependent protein kinase (PKA) by the 6-22 peptide completely blocked the stimulation of I(Ca) by the beta-agonist isoproterenol but not by GSNO. The potency of isoproterenol to stimulate I(Ca) was very high for atrial cells (EC(50) 2.4+/-0.6 nM) and only 100 nM isoproterenol was required to stimulate I(Ca) maximally (21.4+/-0.7 pA/pF) to a level (23.8+/-1.6 pA/pF) achieved with the inclusion of 100 microM cAMP in the pipette solution. GSNO produced an additive effect on I(Ca) already stimulated by either 10 microM isobutylmethylxanthine (phosphodiesterase inhibitor) or a low concentration (1 nM) isoproterenol but failed to produce any effect on I(Ca) maximally stimulated by 100 nM isoproterenol. Inhibition of PKG by KT-5823 significantly decreased the efficacy of isoproterenol and the maximal I(Ca) achieved with 100 nM isoproterenol was decreased to 8.2+/-0.6 pA/pF in the presence of KT-5823. Western blot analysis showed much higher expression of PKG in atrial cells compared to ventricular cells. CONCLUSIONS: These findings suggest that stimulatory effects of cGMP on I(Ca) in rabbit atrial cells are likely to be mediated via PKG dependent phosphorylation of calcium channels or associated proteins and that the effects of cGMP are not antagonistic to cAMP. PKG is highly expressed in atrial cells and PKG dependent phosphorylation may be necessary for maintaining basal I(Ca) and fully stimulating I(Ca) by beta-adrenergic activation in atrial cells.

Acute urinary toxicity following transperineal prostate brachytherapy using a modified Quimby loading method.

PURPOSE: To examine the acute urinary toxicity following transperineal prostate implant using a modified Quimby loading method with regard to time course, severity, and factors that may be associated with a higher incidence of morbidity. METHODS AND MATERIALS: One hundred thirty-nine patients with prostate adenocarcinoma treated with brachytherapy from 1997 through 1999 had follow-up records available for review. Patients considered for definitive brachytherapy alone included those with prostate specific antigen (PSA) < or = 6, Gleason score (GS) < or = 6, clinical stage < T2b, and prostate volumes generally less than 40 cc. Patients with larger prostate volumes were given neoadjuvant antiandrogen therapy. Those with GS > 6, PSA > 6, or Stage > T2a were treated with external beam radiation therapy followed by brachytherapy boost. Sources were loaded according to a modified Quimby method. At each follow-up, toxicity was graded based on a modified RTOG urinary toxicity scale. RESULTS: Acute urinary toxicity occurred in 88%. Grade I toxicity was reported in 23%, grade II in 45%, and grade III in 20%, with 14% requiring prolonged (greater than 1 week) intermittent or indwelling catheterization. Overall median duration of symptoms was 12 months. There was no difference in duration of symptoms between patients treated with I-125 or Pd-103 sources (p = 0.71). After adjusting for GS and PSA, multivariate logistic regression analysis showed higher incidence of grade 3 toxicity in patients with larger prostate volumes (p = 0.002), and those with more seeds implanted (p < 0.001). Higher incidence of prolonged catheterization was found in patients receiving brachytherapy alone (p = 0.01), with larger prostate volumes (p = 0.01), and those with more seeds implanted (p < 0.001). CONCLUSION: Interstitial brachytherapy for prostate cancer leads to a high incidence of acute urinary toxicity, most of which is mild to moderate in severity. A prolonged need for catheterization can occur in some patients. Patients receiving brachytherapy alone, those with prostate volumes greater than 30 cc, and those implanted with a greater number of seeds have the highest incidence of significant toxicity.

Postsynaptic factors controlling the shape of potentials at the squid giant synapse.

The roles of rectification and cable properties of the squid giant axon in determining the shape of synaptic potentials generated at the giant synapse were investigated. Excitatory postsynaptic potentials were recorded in response to selective stimulation of the main presynaptic axon at various temperatures. Excitatory postsynaptic potentials elicited at low temperatures (less than 18 degrees C) exhibited a marked after-hyperpolarization or undershoot, while those recorded at higher temperatures did not. The postsynaptic current, recorded under voltage clamp conditions, did not show an undershoot. Furthermore, intracellular injection of tetraethylammonium chloride, to block the voltage-dependent rise in potassium conductance, also eliminated the undershoot of the excitatory postsynaptic potential. These results indicate that the duration of synaptic potentials at the squid giant synapse is reduced by rectification due to a delayed rise in potassium conductance. Computer simulations of these synaptic potentials suggested that the effects of rectification will be more prominent in spherical (isopotential) cells than in cells with more complicated geometries.

Fluorescein appearance time curves. Continuous recordings of iris and anterior chamber dye flow contours.

Fluorescein appearance time (FAT) curves were recorded at 5-s intervals from the feline iris and anterior chamber using a modified video-frame store unit. Anterior chamber washout slopes were also recorded following intracameral injection. The iris FAT interval following intravenous injection was maximally 5 s. Passage of the dye bolus then appeared during the next 10 s, followed by a rapid (100-s) rise to maximum levels. In contrast to the iris, anterior chamber FAT curves recorded from the pupillary space showed an approximate two-minute delay after injection (mean = 1.92 +/- 0.360 minutes), followed by a gradual (20-minute) rise to maximum recordable levels. The mean anterior chamber washout rate following intracameral injection of 10(-6) g/mL of dye levels was 2.323% +/- 0.810%/min. There are potential applications of the method and a need for shorter recording intervals.

Leukocyte myeloperoxidase and salivary lactoperoxidase: identification and quantitation in human mixed saliva.

Human salivary lactoperoxidase (HS-LP) is synthesized and secreted by the salivary glands, whereas myeloperoxidase (MPO) is found in PMN leukocytes, which migrate into the oral cavity at gingival crevices. HS-LP levels vary with changes in salivary gland function, but increased numbers of MPO-containing leukocytes indicate infection or inflammation of oral tissues. To determine the contribution of each enzyme to the peroxidase activity of mixed-saliva samples, activity was assayed at pH 5.4 with tetramethylbenzidine as the substrate, with and without the inhibitor dapsone (4,4'-diaminodiphenylsulfone). Dapsone blocked the activity of HS-LP but not MPO. The enzymes were also separated and partially purified from the soluble portion of saliva samples and from detergent extracts of the saliva sediment. Chromatographic properties of the proteins were similar to those of LP from bovine milk (BM-LP) and MPO from human leukocytes. The identity and amounts of the enzymes were confirmed by the absorption spectra and by immunoblotting with antibodies to BM-LP and human MPO. Eosinophil peroxidase (EPO), a distinct enzyme found in eosinophilic leukocytes, was not detected by chromatography or with antibodies to human EPO. On average, 75% of the activity in samples from normal donors was due to MPO and 25% to HS-LP. When corrected for the lower specific activity of HS-LP in this assay, the average amount of MPO (3.6 micrograms/mL) was twice the amount of HS-LP (1.9 micrograms/mL). The amount of MPO corresponded to 1 x 10(6) PMN leukocytes/mL of saliva. The enzymes were distributed differently: Eighty-nine percent of the HS-LP was in the soluble portion of saliva, and 78% of the MPO was in the sediment, which contained 51% of the total activity. In contrast to results obtained with PMN leukocytes from blood, detergent was not required for MPO activity to be measured in saliva, indicating that the enzyme was accessible to peroxidase substrates. The results indicate that MPO is responsible for a large portion of peroxidase-catalyzed reactions in mixed saliva. The unique function of HS-LP may be carried out within the salivary glands, prior to secretion into the oral cavity.

The effect of in utero exposure to hexachlorobenzene on the developing immune response of BALB/c mice.

BALB/c mice were exposed to 0.0, 0.5 and 5.0 mg/kg maternal body weight hexachlorobenzene (HCB) throughout gestation by daily per os dosing of the females. At 45 days of age selected immune functions of the offspring were assessed. The delayed-type hypersensitivity (DTH) response to oxazolone was severely depressed in animals exposed to either 0.5 or 5.0 mg/kg HCB, however, only those animals exposed to 5.0 mg/kg HCB showed a significant decrease in their mixed lymphocyte response (MLR) levels. The ability of isolated spleen cells to undergo a blastogenic response to concanavalin A (ConA), phytohemagglutinin (PHA) and lipopolysaccharide (LPS) showed no significant changes due to HCB exposure. Similarly, no significant difference in the induction of direct hemolytic plaque-forming cells was seen. A significant increase in the relative distribution of splenic T cells and a significant decrease in splenic B cells was measured in the offspring of HCB-treated females. These results suggest that HCB is capable of affecting the development or maturation of the immune response in mice, perhaps at the T cell level.

Interactions between spontaneously pacing and quiescent but excitable heart cells.

The authors previously developed a technique for studying a mathematical model cell with spontaneous activity, namely, a 'real time' simulation of a rabbit sinoatrial node (SAN) model cell that is simultaneously electrically coupled via a 'coupling clamp' circuit to a real, isolated ventricular myocyte. This technique was applied to investigate the effects of coupling conductance (Gc), cell size and modulation of membrane potential by elevated extracellular potassium ion concentrations on the ability of an ectopic focus, represented by the SAN model cell, to successfully drive a ventricular cell. Values of Gc and the relative sizes of the two cells define three possible outcomes: spontaneous pacing of the SAN model cell but not driving of the ventricular cell; cessation of spontaneous pacing; or pacing of the SAN model cell and driving of the ventricular cell. Below a critical size of the SAN model cell, only the first two outcomes are possible. Above this critical size, there is a range of Gc that allows successful operation of the system as an ectopic focus. Elevation of extracellular potassium ion concentrations from 4 to 8 mM increases both the lower and upper boundaries of Gc for this range. Elevation of extracellular potassium ion concentrations, commonly observed in myocardial ischemia, may affect either inhibition or release of inhibition of an ectopic focus.

Optimized graphical analysis of Gaussian and lognormal assumptions for intraocular and vascular pressure distributions.

The design of optimized histogram and probability graphs needed to detect a lognormal distribution in surveys of intraocular pressure (IOP), mean ophthalmic arterial pressure (OAP) and mean ocular perfusion pressure (OPP) is described. Applications are demonstrated in a sample of 58 normal adult eyes. A lognormal distribution was found for IOP and for OAP and OPP estimates obtained with a noncontact noncompressive method. Conversely, the absence of an identifiable linear distribution for OAP and OPP estimates obtained with compression ophthalmodynamometry was noteworthy. The implications of lognormality for definitions of a normal range and for correlations involving IOP, OAP and OPP data are briefly discussed.

Tracheal hamartoma: report of a child with a neck mass.

Tracheal hamartoma represents an oddity in children. Only one case was found in the English literature as a distal tracheal intraluminal lesion causing obstructive symptoms. All other reported cases were in older patients, who were presumed to have asthma or chronic obstructive pulmonary disease. The authors report on a 21-month-old girl who presented with an anterior neck mass fixed to the trachea. Imaging studies showed a lesion (2.5 x 2.3 x 1.7 cm) anterior to the right lobe of the thyroid, extending to the trachea posteriorly and down to the thoracic inlet inferiorly. The mass had a mixture of soft tissue densities with a focus of calcification. Results of thyroid studies were normal, and there was no adenopathy. Neck exploration showed a white, firm, lobulated mass fixed to the trachea, which was resected completely. The postoperative course was unremarkable. Histological studies showed a mixture of mature cartilage, fat, fibroconnective tissue, and spindle cells with myxoid degeneration, consistent with tracheal hamartoma. Based on a literature search, this is the first reported case of extraluminal tracheal hamartoma presenting as a neck mass in a pediatric patient.

The suitability of automatic tissue morcellation for the endoscopic removal of large specimens in pediatric surgery.

UNLABELLED: Now that endoscopic removal of tumors and other solid structures from the abdomen and chest is possible, it is important to know the suitability of this technique for the removal of solid pediatric malignancies where accurate histological assessment becomes important for prognosis and staging. The authors tested an automatic tissue morcellator on a variety of pediatric tissues to assess the interpretability of the material obtained. The morcellator consists of a rotary blade within a 1-cm sleeve. When suction is applied to the morcellator and the device is activated, the solid material is shaved or morcellated into bits of tissue that are aspirated and collected for analysis. To test the interpretability of morcellated tissue, the device was used on six Wilms' tumors, three hepatoblastomas, a lung resection, a splenectomy, and a bowel resection. The average size of the pieces of tissue was 1.33 x 0.58 x 0.43 cm. In every instance, the histology was as good as the evaluation of sections from the gross tumor. It was difficult to distinguish the edge of tissue procured by the morcellator from an edge cut by the pathologist's knife. CONCLUSIONS: (1) Morcellated pediatric tissues are available by experienced pediatric pathologists. (2) The adoption of this technique should not interfere with proper histological evaluation of solid pediatric tumors.

Histologic appearance of the islet organoid.

The authors have attempted to develop a hybrid organoid capable of supporting the engraftment of human pancreatic islet tissue transplants. In this report, they we report the histologic appearance of this organoid structure for implantation periods up to 16 days. Both pancreatic duct-like and glandular cells were present inside the organoid. Insulin positive cells were identified within the pancreatic tissue. Although polymorphonuclear (PMN) cells were seen in association with tissue necrosis, the authors observed no lymphocyte infiltration in the area of the xenografted human pancreatic islet tissue in the implanted organoid. Endothelial cell growth factor induced neovascularization inside the organoid sufficient to support the engraftment of transplanted pancreatic islet tissue. This organoid model may provide an alternative for clinical pancreatic transplantation.

Interval appendectomy for perforated appendicitis in children.

To determine the efficacy, safety, and cost of managing perforated appendicitis with intravenous antibiotics followed by an interval appendectomy, the charts of 87 children with ruptured appendicitis were retrospectively reviewed. These patients were treated with intravenous fluid resuscitation and antibiotics (consisting of clindamycin and ceftazidime) and underwent appendectomy, either on that admission (n = 46) or as a delayed interval procedure (n = 41). Antibiotics in all cases were discontinued either at home or in the hospital after the child was a febrile for 48 hours with normal white and differential blood cell counts, and the two groups were compared. Seven patients (17%) "failed" the interval appendectomy protocol. All but one "failure" was due to the development or persistence for >72 hours of a bowel obstruction. The data are described below as percent or mean +/- 1 standard deviation. [table: see text] We conclude that antibiotics and interval appendectomy is a safe effective alternative for the management of perforated appendicitis. When successful, hospitalization, charges, and morbidity are less with this approach. A persistent bowel obstruction for 72 hours is an indication to proceed with appendectomy on admission.

Temporal occurrence of third-stage larvae of Elaeophora schneideri in Tabanus lineola hinellus on South Island, South Carolina.

The occurrence of third-stage larvae of the arterial worm (Elaeophora schneideri) in populations of the horse fly, Tabanus lineola hinellus, was studied on South Island, Georgetown County, South Carolina. Over the period from mid-April to mid-October 1982, horse flies had a bimodal pattern of abundance with peak populations in June and September. During individual bimonthly horse fly collections, the prevalence of infection of T. l. hinellus ranged from 0 to 1.23%. Prevalence of infected horse flies was biphasic with peaks in mid-May (1.23%) and mid-August (1.22%), 2 to 4 wk prior to peaks in horse fly populations. The intensity of infection of T. l. hinellus increased as time progressed and was highest in late summer. This increase resulted in greater recovery of infective larvae during August-September (mean intensity = 25) than in May-June (mean intensity = 4). Both prevalence and intensity of infection of T. l. hinellus were low compared to primary intermediate hosts of E. schneideri in the western U.S.

Elaeophorosis in white-tailed deer: pathology of the natural disease and its relation to oral food impactions.

The lesions of naturally occurring elaeophorosis in white-tailed deer (Odocoileus virginianus) were studied. Arterial changes caused by adult Elaeophora schneideri occurred mainly in cephalic arteries and were characterized by circumferential intimal thickening, disruption of the internal elastic lamina, and verminous thrombosis. Microfilariae caused focal necrosis and fibrosis in the myocardium, but produced only minor changes in other tissues. Radiographic studies indicated that E. schneideri can cause impairment of the cephalic arterial circulation in white-tailed deer. Eleven of 14 (78%) infected deer had oral food impactions, with sublingual impactions being most common. Seven deer with impactions had other oral pathologic conditions, such as gingivitis, loose or absent premolar and/or molar teeth, and remodeling and/or lysis of mandibular bone. The evidence indicates a relation between food impactions and infection by E. schneideri in white-tailed deer, but no definitive connection was established.

Prerequisites for oral immunization of free-ranging raccoons (Procyon lotor) with a recombinant rabies virus vaccine: study site ecology and bait system development.

A model baiting system suitable for the delivery of an oral rabies vaccine to free-ranging raccoons (Procyon lotor) was developed and tested on barrier islands in South Carolina (USA). Features of barrier island physiography and ecology were studied relative to selective bait deployment and site biosecurity. Capture-mark-recapture data were obtained from 228 raccoons. Raccoon density estimates, using a modified census assessment technique, were one raccoon per 1.8 to 2.7 ha. Mean (+/- SE) and range home area estimates of radio-collared raccoons were 84 (+/- 15.6) ha (27 to 176 ha) by a minimum convex polygon method and 138 (+/- 22.8) ha (43 to 241 ha), by a harmonic mean transformation method. Habitat utilization determinations of radio-collared raccoons were conducted to identify study areas to potentially maximize selectivity of bait towards raccoons and to reduce the absolute number of baits deployed. Island raccoons showed a habitat preference for maritime forest, maritime shrub and marsh areas. Additionally, there was no evidence of inter-island or mainland exchange of ear-tagged or radio-collared raccoons. A disease and mortality survey was conducted to identify baseline pathology and incidental lesions in the target raccoon population, prior to actual vaccination initiation. Thirty-eight percent of 30 clinically suspect raccoons sampled had intracytoplasmic eosinophilic inclusions diagnostic of canine distemper; no other lesions suggestive of viral etiologies were found. Serological surveys for raccoon poxvirus and rabies virus antibodies were negative. Antibody titers to canine adenovirus 1 and 2 indicated a moderate level of exposure (approximately 10 to 16%) in the raccoon population. Overall, 93 to 100% of placebo baits were consistently disturbed by 7 days post-bait deployment, and bait acceptance rates by raccoons ranged from 49 to 85%, by using a modular systems approach to select the optimum combination of bait attractant, biomarker, matrix, density, and distribution. These results suggest that a large proportion (up to 85%) of a free-ranging island raccoon population can be selectively and safely targeted, marked and monitored utilizing a proposed oral bait delivery system for recombinant or other rabies vaccines.

Granular cell tumor of the larynx: report of two pediatric cases.

Granular cell tumors are uncommon neoplasms of the head and neck that usually involve the tongue. The larynx is an atypical site of involvement in adults and a rare site in children. We report two cases of subglottic granular cell tumors, one in a 10-year-old boy and the other in a 6-year-old girl. Although both were initially misdiagnosed as having asthma, radiologic, laryngoscopic, and histologic evaluation of the obstructions eventually furnished the correct diagnosis. The patients were successfully treated by surgical excision of their subglottic masses. The history, presentation, pathologic findings, management, and prognosis of this rare pediatric laryngeal tumor are explored.