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Biomedical subjects

H F Krous

Publications and source records attributed to H F Krous.

At least 73 records · Page 4Linked to original sources
PubMed1984

A necropsy study of distribution of petechiae in non-sudden infant death syndrome.

The distribution of visceral petechiae in patients whose deaths were caused by upper airway obstruction and disorders other than sudden infant death syndrome (SIDS) has not been systematically studied. The clinical and necropsy records and microscopic slides of 50 such cases were retrospectively reviewed. In cases in which the cause of death could reasonably be ascribed to lethal upper airway occlusion, petechiae were found only in thoracic viscera. When death was apparently not preceded by terminal changes in intrathoracic pressure, petechiae were found in viscera above and below the diaphragm. These findings suggest that intrathoracic petechiae occur as a consequence of pressure changes within the chest and indirectly support the hypothesis that the terminal mechanism in SIDS is upper airway obstruction.

Airway Obstruction↗
PubMed1984

The microscopic distribution of intrathoracic petechiae in sudden infant death syndrome.

The microscopic distribution of thoracic visceral petechiae in 100 consecutive victims of sudden infant death syndrome (SIDS) was retrospectively analyzed. Thymic and cardiac petechiae were more numerous near their surfaces than in the central parenchyma, suggesting that abnormal intrathoracic pressure changes were important in their pathogenesis. Low intrathoracic pressures may have preferentially distended, to the point of rupture, the outer rather than central microvasculature of these two organs. The distribution of pulmonary petechiae in association with lung congestion and edema indicated left ventricular failure. Low intrathoracic pressures generated by breathing against an occluded airway could have caused heart failure by increasing the afterload and decreasing the compliance of the left ventricle. These petechiae occur in more than 80% of SIDS cases, suggesting that abnormal intrathoracic pressure, perhaps caused by breathing against an obstructed airway, is a common terminal event.

Airway Obstruction↗
PubMed1983

Absence of hepatic uptake of Tc-99m sulfur colloid in an infant with Coxsackie B2 viral infection.

After the intravenous administration of Tc-99m sulfur colloid, there was found homogeneous lung, renal, and splenic uptake with absence of uptake by the liver and bone marrow of a nine-day-old female infant. More than 20 other doses were dispensed from the same Tc-99m sulfur colloid preparation with the expected biodistribution. A necropsy done two days later showed diffuse hepatic hemorrhagic necrosis without evidence of intravascular fibrin deposition in the lungs or kidneys. The underlying cause of the infant's disease was a Coxsackie B2 viral infection, based upon positive postmortem viral cultures of kidney and liver tissues and characteristic histopathologic lesions of the central nervous system and viscera. The altered biodistribution presumably reflected marked impairment of Kupffer cell function and an apparent increase in pulmonary macrophages.

Coxsackievirus Infections↗
PubMed1981

Maternal nicotine administration and fetal brain stem damage: a rat model with implications for sudden infant death syndrome.

Several recent studies have established maternal smoking as a significant risk factor for sudden infant death syndrome (SIDS). To test our hypothesis that nicotine, a component of cigarette smoke, may exert an injurious effect on the fetal brain stem, we administered nicotine in drinking water to Sprague-Dawley rats prior to and throughout the first 20 days of gestation. The nicotine dose and schedule of consumption in this experiment paralleled that of human usage. Fetuses from nicotine-treated mothers had significantly more dead cells in a standard section of the medulla than controls, but little difference was observed in the postnatal respiratory responses of treated and control animals to the inhalation of various gas mixtures. The birth weights of nicotine-exposed fetuses were significantly less than those of controls. Although the degree of fetal brain stem injury produced by nicotine in this experiment is small, it is our concern that maternal smoking might cause a more severe lesion in the human fetus and thereby increase the risk of SIDS by contributing to aberrant postnatal respiratory responses to noxious stimuli.

Animals↗
PubMed1981

Bilateral juvenile granulosa cell tumors in a 4-month-old dysmorphic infant. A clinical, histologic, and ultrastructural study.

Juvenile granulosa cell tumors were encountered within bilateral cystic ovarian masses in a 4-month-old infant. The child was the product of a consanguinous pregnancy, and manifested poor growth, relative microcephaly, facial asymmetry, and a malformed left ear. There was no history of gestational drug or hormone ingestion, and no evidence of abnormal endocrine activity after birth, however, the serum alpha-fetoprotein level was mildly elevated. The tumors were well defined by sonography and there was no evidence of metastasis. Histologically, a dense proliferation of round to oval tumor cells showed considerable individual cell necrosis and frequent microcyst formation. There was no evidence of luteinization and only mild nuclear pleomorphism. Immunoperoxidase study failed to reveal alpha-fetoprotein. Ultrastructural study supported the granulosa cell nature of the tumor, but a few cells contained bundles of intracytoplasmic filaments. There has been no evidence of recurrent disease during a 16-month follow-up period, and serial alpha-fetoprotein determinations have remained in the reference range. Comparison with two previously reported bilateral juvenile granulosa cell tumors suggests that this tumor occurs in young infants, and is amenable to conservative therapy.

Abnormalities, Multiple↗
PubMed1981

Massive pulmonary hemorrhage and fulminant renal failure associated with immune complex glomerulonephritis.

A 54-year-old man had massive pulmonary hemorrhage and fulminant renal failure. Although his clinical presentation was similar to that of Goodpasture's syndrome, his renal disease was associated with deposition of immune complex rather than with production of antiglomerular basement membrane antibody. Serum cryoglobulins were present, presumptive evidence of circulating immune complexes; serum antiglomeral basement membrane antibodies were absent. Renal biopsy revealed a crescentic, exudative glomerulonephritis with a granular immunofluorescence pattern; subepithelial deposits were demonstrated by electron microscopy. This immune complex glomerulonephritis was thought possibly to be postinfectious in origin, with characteristics distinguishing it from Goodpasture's syndrome. Pulmonary hemorrhage and crescentic immune-complex-mediated glomerulonephritis are reviewed.

Acute Kidney Injury↗
PubMed1981

Fetal alcohol syndrome: a dilemma of maternal alcoholism.

The existence of FAS can no longer be denied; reports of greater than 200 cases which fall into a phenotypically recognizable continuum justify its existence. At this point, however, it is probably prudent to withhold judgment of the specific human teratogenicity of alcohol until more refined information regarding dose-risk relationships are available not only from humans, but also from animal models, including primates. It may be that Fetal Alcohol Syndrome, at this point, should be considered the Fetal Alcoholism Syndrome. At any rate, until much more is known, it would seem advisable to observe the Biblical admonition the "thou shalt conceive, and bear a son; and (therefore now drink no wine or strong drink" (Judges 13:7).

Abnormalities, Drug-Induced↗
PubMed1980

The impact of chemotherapy and radiation therapy on secondary operations for neuroblastoma.

From January, 1969 through July, 1979, 37 children with neuroblastoma were cared for at the Oklahoma Children's Memorial Hospital. Nineteen patients with extensive disease were studied to examine the interrelationships of chemotherapy, radiation therapy and secondary surgery. Eleven children had secondary surgery in the abdomen or cervical region with one postoperative death. All patients had chemotherapy and ten had radiation therapy between the primary and secondary operation or death. Five children survived. Four of five survivors were less than one year of age at diagnosis and initial treatment. Fourteen of 15 patients, one year of age or older, died. Each case had pathologic examination of tumor before and after therapy. All survivors showed sequential maturation of tumor tissue but only one nonsurvivor had this finding. Unusual metastatic spread was found in patients having combined therapy. Multimodal therapy for advanced neuroblastoma accentuates the need for sensible timing and utilization of secondary operative procedures. The secondary procedures ideally eradicate the primary focus of tumor, and may also serve to excise selective areas of metastatic disease or to biopsy residual disease in aiding continuing therapy. Secondary surgery ought to follow the onset of radiation therapy by four to six weeks, or of chemotherapy by 12 to 24 weeks. This delay allows maximum control of primary and generalized disease, as well as maturation, differentiation, encapsulation and shrinkage of extensive initially unresectable primary tumors.

Abdominal Neoplasms↗
PubMed1980

Familial renal cystic dysplasia associated with maternal diabetes mellitus.

Two of eight children born to unrelated parents were found to have cystic renal dysplasia, but no other malformations. A third sibling was presumed to have similar renal disease based upon typical clinical and radiographic findings. In addition to possible genetic causes, maternal diabetes mellitus is suggested as a potential etiologic factor.

Adult↗
PubMed1980

Congenital cystic adenomatoid malformation in bilateral renal agenesis. Its mitigation of Potter's syndrome.

Potter's syndrome develops secondary to a deficiency of amniotic fluid, such as occurs in renal agenesis. Congenital cystic adenomatoid malformation (CCAM), on the other hand, is frequently accompanied by polyhydramnios. We describe a newborn with both renal agenesis and CCAM who had only mild features of Potter's syndrome. The pathogenesis of polyhydramnios in CCAM is discussed with regard to the ultrastructural findings of numerous type 2 pneumocytes lining the cysts. The association between CCAM and bilateral renal anomalies is emphasized.

Abnormalities, Multiple↗
PubMed1979

Premature onset of labor, neonatal patent ductus arteriosus, and prostaglandin synthetase antagonists--a rat model of a human problem.

Premature labor and patent ductus arteriosus are two potentially fatal hazards of the human newborn infant. Prostaglandin synthetase antagonists have thus been used to suppress early labor and to close the ductus of the neonate. Indomethacin has been most effective but not free of significant complications. Neuronal necrosis may result from numerous systemic aberrations. A controlled rat model study was therefore devised to investigate fetal neuronal necrosis in relation to maternal indomethacin dose. Dams were given various treatments of 2 mg/kg of 4 mg/kg indomethacin within the last 3 days of gestation. Liquid chromatography was used to assess serum maternal and fetal drug levels. From light microscopy of more than 200 brains it was apparent that fetal neuronal necrosis correlates with maternal dose.

Animals↗