This is a case of a 7-year-old boy with acute lymphoblastic leukemia presenting with cholestasis and elevated transaminase levels. Acute lymphoblastic leukemia is the most common malignancy in children and can have variable presenting clinical manifestations. However, cholestasis is less commonly encountered in the pediatric population and can be a diagnostic challenge. We present a case of a 7-year-old boy discovered to have elevated transaminase levels while undergoing an evaluation for motor tics, which subsequently progressed to cholestasis and acute liver failure secondary to acute lymphoblastic leukemia. He demonstrated marked improvement after induction therapy and is in clinical remission. Clinicians should be ever mindful of the potentially unique presentations of childhood leukemia.

A system based on a Fourier transform infrared spectrometer is developed to perform bidirectional reflectivity measurements on material surfaces, providing the ability to measure this property simultaneously for multiple infrared wavelengths. Calibration is based on a relative method that relates the system output to absolute spectral bidirectional reflectivity. Results are presented for rough gold and grooved nickel surfaces, considering the variation with incident and reflected angle. The surface reflectivity for gold is largely independent of wavelength in the infrared region of interest, while the nickel surface exhibits spectral variation. The experimental results are compared to complete electromagnetic theory predictions and other measurements.

22q11 deletion syndrome (22q11DS), also known as DiGeorge syndrome or velocardiofacial syndrome, is the most common human genetic microdeletion. Hypocalcemia secondary to hypoparathyroidism is a common finding in this condition and may present with seizures. We describe a case of an 11-day-old male presenting with hypocalcemic seizures and a positive newborn screen for severe combined immunodeficiency as the primary manifestations of 22q11DS. Given the potential for wide phenotypic variability, clinicians should maintain a high index of suspicion for this syndrome, especially in the neonate presenting with hypocalcemia.