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Biomedical subjects

K Skullerud

Publications and source records attributed to K Skullerud.

At least 37 records · Page 2Linked to original sources

[Ultrasonography and neuropathological findings in premature infants].

At most maternity units all premature infants are investigated by cranial ultrasonography as a routine. We examined the correlation between autopsy findings and ultrasound examination in 30 premature newborn. The ultrasound examination demonstrated bleeding in 17 (65%) of the 26 cases where autopsy had revealed bleeding. In these 17 patients good correlation was found between the degree of bleeding in the two examinations (ultrasonography and autopsy). In ten patients autopsy showed periventricular leucomalacia, but ultrasonography showed this condition in only two of these. In five cases bleeding made the examination and interpretation of the ultrasound findings difficult. In three patients ultrasonography was thought to be normal, while autopsy demonstrated periventricular leucomalacia.

Autopsy↗

[Prognosis in primary tumors of the central nervous system. A patient material from the Norwegian Radium Hospital 1960-94].

We present the results of a retrospective survey of 1,218 patients treated at the Norwegian Radium Hospital during the years 1980-94 for primary tumours of the central nervous system. Median survival for patients with glioblastoma (n = 492) was 12 months, for patients with anaplastic astrocytoma (n = 83) 25 months, astrocytoma (n = 260) 95 months, oligodendroglioma (n = 85) 74 months, mixed glioma (n = 68) 65 months, and medulloblastoma (n = 53) 109 months. Median survival for patients with brain stem tumours (n = 37) was nine months, while 74% of patients with tumours in the pineal region (n = 38) survived for five years. The histology and localisation of the tumour, as well as age and functional status, are important prognostic factors for survival in patients with primary CNS tumours.

Adolescent↗

[Tapeworms in the brain--a current problem in Norway?].

Cestode infections of the human central nervous system are reviewed. These conditions represent a major health problem in many countries, and neurocysticercosis is one of the major causes of epilepsy worldwide. Neither cysticercosis nor echinococcosis are endemic to Norway. Therefore, little attention has been paid to these conditions. However, owing to increased travelling and immigration, occasional cases are found. Five cases of neurocysticercosis and one case of presumable brain echinococcosis have recently been diagnosed in our department.

Adult↗

[Rhabdomyolysis in carnitine palmitoyltransferase deficiency].

A 45 year old man had had recurrent rhabdomyolytic episodes from the age of 16 following prolonged exercise or infection. During one episode he developed respiratory and renal failure, but recovered completely. Biochemical investigation of muscle biopsy showed deficiency of carnitine palmityl transferase (CPT), an enzyme involved in the beta-oxidation of fat metabolism.

Acute Kidney Injury↗

[Teratoma of the medullary cone as a cause of peripheral polyneuropathy].

This paper describes a 45 year-old man who had a teratoma in the conus medullaris. The symptoms started about 20 years earlier, and for several years consisted of peripheral motor and sensory signs. Therefore the disease was interpreted as a motor and sensory neuropathy. The tumour was diagnosed by magnetic resonance imaging. Histological examination revealed respiratory epithelium with connective tissue and fat.

Diagnosis, Differential↗

[Muscle tissue for diagnosis of neuromuscular diseases. Procedures of specimen taking, transport and preparation].

In this review we describe surgical methods for open muscle biopsy. In order to obtain optimal tissue quality, correct handling of the muscle specimens at all stages of the procedure is essential. A technologist who is familiar with the procedure should be present in the operating room. This is important to ensure that specimens for histochemical or biochemical studies are frozen immediately and specimens for electron microscopy are fixed without delay. We describe procedures for processing the specimens for cryostat sections, paraffin sections and electron microscopy, and a simple method for handling muscle specimens in local hospitals before transfer to a hospital with a neuropathological service.

Biopsy↗

[Brain injuries after transient circulatory and/or respiratory failure (cerebral hypoxic injury) in newborn infants].

A clinico-pathological survey of different types of cerebral hypoxic/ischemic injuries in foetuses and infants is presented. The lesions may occur before, during and after the birth. Some of them occur only in foetuses and infants less than two months old. The topic has been simplified in order to be useful as a basis for evaluating these lesions in daily diagnostic work. Cerebral hypoxic/ischemic injuries are frequently seen in preterm infants and term infants with severe cardiac anomalies. Extensive damage may be fatal or may involve severe permanent psychomotoric deficits in the survivors. The severity of the deficiencies depends on the type, location, and extent of damage. A severe lesion is a common cause of cerebral palsy, and a mild lesion is probably one cause of minimal brain dysfunction. Recent studies indicate that the lesions seen in preterm infants frequently occurred in utero. Thus, autopsies of perinatal deaths should include neuropathological examination of the brain to disclose possible cerebral/hypoxic damage, and its distribution, severity and age.

Brain↗

Beta-endorphin immunoreactivity in spinal fluid and hypoxanthine in vitreous humour related to brain stem gliosis in sudden infant death victims.

Beta-endorphin may induce respiratory depression and bradycardia. Elevated levels of hypoxanthine (HX) in vitreous humour (VH) may possibly indicate hypoxia before death. Furthermore, gliosis in the brain stem may reflect a previous hypoxic/ischaemic injury in the brain. In the present study we relate beta-endorphin immunoreactivity (BENDI) in the CSF to the presence or absence of reactive astrocytosis in the nucleus olivae inferior (NOI). The relationship between the HX concentration in VH and the number of reactive astrocytes in sudden infant death (SID) cases (n = 17) and controls (n = 23) was also studied. The number of reactive astrocytes was examined in the NOI by immunohistochemical demonstration of glial fibrillary acidic protein (GFAP). The BENDI in CSF and the number of reactive astrocytes in the NOI divided the SID victims into two subpopulations (P < 0.01). One had a median of < 4 fmol/ml BENDI in CSF (range < 4) and 2 reactive astrocytes (range 0-15), and was similar to the controls that died from infections. The other subpopulation had a median of 260 fmol/ml BENDI in CSF (range 160-400) and 13 reactive astrocytes (range 7-33), similar to the control infants with previous hypoxia. In this latter SID subpopulation the number of reactive astrocytes correlated positively with BENDI in CSF (r = 0.7, P < 0.05). All the SID victims had elevated levels of HX in VH. In the SID subpopulation with high level of BENDI in CSF and increased number of activated astrocytes, the correlation factor between HX in VH and activated astrocytes was r = 0.7 (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Astrocytes↗

Slow progression to AIDS in intravenous drug users infected with HIV in Norway.

STUDY OBJECTIVE: To study the rate of progression to AIDS and to death, and the causes of death among intravenous drug users in Norway. DESIGN: This was a prospective study. The study population was followed from diagnosis of HIV seropositivity until death or the end of the study period. The mean follow up was 56 months (range 1-73 months). SETTING: Subjects were recruited from a public HIV test clinic and followed by linkage to the National AIDS Registry and the National Cause of Death Registry. PARTICIPANTS: A total of 131 HIV positive intravenous drug users were included. The study population represented 75% of all intravenous drug users who had been diagnosed as HIV positive in Norway before 1987. None were lost to follow up. MAIN RESULTS: Four years after study entry, 3% (95% confidence interval, 0, 6%) had developed AIDS, while 15% (95% CI, 9, 21%) had died. Of the 25 subjects who died during the follow up period, 21 died from unnatural causes. Drug overdose accounted for 17 of these deaths. AIDS was the cause of death of three subjects only. Age more than 30 years at entry to the study was associated with short survival. CONCLUSIONS: These results suggest that the progression rate to AIDS in intravenous drug users is slow.

Acquired Immunodeficiency Syndrome↗

Neurocutaneous melanosis. Case report and a brief review.

Neurocutaneous melanosis is a rare congenital syndrome characterised by large or numerous congenital pigmented naevi and excessive proliferation of melanin-containing cells in the leptomeninges. The process is diffuse or multifocal, and has a tendency to infiltrate the neural tissue and the cerebrospinal cord; remote metastases may occur. There is usually histological evidence of malignancy (cellular pleomorphism and mitotic activity). Involvement of the basal cisterns is apt to cause internal hydrocephalus, and the prognosis is grave even when there is no histological evidence of malignancy. We present the case history and necropsy findings of a baby boy with neurocutaneous melanosis, followed by a brief review.

Fatal Outcome↗

A fatal, systemic mitochondrial disease with decreased mitochondrial enzyme activities, abnormal ultrastructure of the mitochondria and deficiency of heat shock protein 60.

We report on a girl presenting with facial dysmorphic features and breathing difficulties upon birth. She was hypotonic, developed a metabolic acidosis, and died two days old of heart failure. Post-mortem examination revealed abnormalities of brain, lungs, heart and liver. In cultured skin fibroblasts activities of enzymes of oxidative phosphorylation, pyruvate metabolism, beta-oxidation and other mitochondrial (mt) metabolic pathways were markedly decreased. Activities of enzymes localized in the mt outer membrane or in other cell organelles were found to be normal. The mitochondria appeared swollen and were located mainly around the nucleus. Electron micrographs showed locally disintegrated mt inner membranes and large mt vacuoles. The amount of mt heat shock protein 60 (hsp60) was about one fifth of that in controls. We conclude that this mt disorder is most likely caused by defective synthesis and maintenance of mitochondria, possibly due to a defect in mt protein import or enzyme assembly resulting from deficiency of hsp60.

Cells, Cultured↗

VACTERL or MURCS association in a girl with neurenteric cyst and identical thoracic malformations in the father: a case of gonosomal mosaicism?

We report on a female infant with lethal congenital malformations including extreme hydrocephalus due to aqueductal stenosis, vertebral segmentation anomalies, fused costae, anal atresia, renal dysplasia, and bicornuate uterus with a double blind vagina. The VACTERL and the MURCS associations are possible diagnoses. Her father had a neurenteric cyst in infancy. He has identical vertebral and costal malformations as his daughter but is otherwise healthy. The possibility of dominant inheritance with gonosomal mosaicism in the father is discussed.

Abnormalities, Multiple↗

Affection of the hippocampal granule cells in pontosubicular neuron necrosis.

The dentate fascia of the hippocampus was studied in 25 infants with pontosubicular necrosis and in 21 control cases without hypoxic cerebral lesions. Of the control cases 19 were completely normal and 2 showed one single necrotic cell in the granule cell layer. In contrast 15 of the cases with pontosubicular necrosis showed varying degrees of neuronal karyorrhexis in the dentate fascia. The severity of these changes largely parallelled those in the subiculum but there were exceptions to this rule. It is concluded that the dentate fascia is frequently involved in pontosubicular necrosis.

Blood Glucose↗

[Mitochondrial diseases--more common than we realize?].

The last two decades have revealed a novel group of inborn errors with defects on the pathways of aerobic energy substrates into the mitochondria or the capacity to generate reducing potential from these substrates, as well as those that block the oxidative phosphorylation pathway itself. The mitochondrial diseases are clinically heterogenous disorders that can affect multiple organ systems, mainly the skeletal muscle and nervous system (mitochondrial encephalomyopathies). There are a few distinctive syndromes such as Leigh's syndrome, Alper's syndrome, Kearns-Sayre's syndrome, myoclonus epilepsy with "ragged-red fibres" (MERRF), and MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, strokelike episodes). The last year our department has evaluated ten children with mitochondrial disorders. Among these are two siblings with Leigh's syndrome and cytochrome c-oxidase defect. The first child, a girl, developed the first symptoms at the age of four months and died 13 months old. The younger brother showed the same clinical picture as his sister. However, the clinical neurological picture was stabilized when he was 18 months old, and he is still alive at six years of age and slightly psychomotorically retarded.

Brain Diseases↗

Cerebral lesions and causes of death in male alcoholics. A forensic autopsy study.

Autopsies on 195 male alcoholics aged 30-64 years who died outside hospitals and nursing homes in Oslo from 1984 to 1988, were carried out at the Institute of Forensic Medicine, Rikshospitalet. In 127 cases brain tissue was examined neuropathologically, 86 (67.7%) showed abnormalities and 28 contained lesions of more than one type. Lesions associated with alcoholism were found in 61 cases (48%), 18 (14.2%) showed Wernicke's encephalopathy, 47 (37%) cerebellar atrophy, 2 central pontine myelinolysis and 1 hepatic encephalopathy. Subdural haematoma and/or cortical contusions were found in 30 cases (23.6%) and cerebrovascular lesions in 19 (15%). Of the 195 cases, 22 had a history of recurrent convulsive attacks of which 19 were examined neuropathologically and 13 had focal damage that could have caused epileptic fits. Although cerebral damage was more frequent among vagrants and other persons dependent on social support, 50% of the alcoholics living in their own homes were also affected. Alcohol-related disease was considered the cause of death in 15 of 127 cases examined neuropathologically and 9 of these died from acute Wernicke's encephalopathy all of whom were sober at death. Although the post mortem analyses included neuropathological examination of the brain, the cause of death remained unknown in 27 (21%) of the 127 cases.

Adult↗

[Brain tumors in children].

Brain tumour was diagnosed by computer tomography or magnetic resonance imaging in 100 children aged 0 to 19 years. They consecutively underwent primary surgical treatment during the years 1984 to 1988. Non-neoplastic lesions and operations for residual tumours are not included. 54 tumours were localized supratentorially. 72% of these were benign or low grade malignancies. 46 tumours had an infratentorial localisation. 59% of these were high grade malignancies. Children tolerate major-neurosurgical procedures better than adults and restitution is usually favourable. 42 children with high grade malignancies underwent postoperative radiotherapy. Per- and postoperative mortality in this series was 1%. 80 children are alive. 62 of these are in excellent condition after a median observation time of 40 months.

Adolescent↗

[Alcohol and statistics of causes of death in middle-aged men in Oslo. A forensic study].

The study comprised male citizens of Oslo, aged 30-64 years, who died outside hospital and were autopsied at the Institute of Forensic Medicine, Rikshopsitalet, from 1984 to 1988. Of the 636 cases, 195 (30.7%) were classified as alcoholics and 441 as non-alcoholics. The cause of death remained unknown after autopsy and toxicological analyses in 17.4% of the alcoholics and in 5.4% of the non-alcoholics. Suicide by other methods than medicamental poisoning was 6-7 times more frequent among non-alcoholics than among alcoholics, while death from poisoning was definitely more common among alcoholics. The frequency of lethal accidents other than intoxications was similar in both cases. Coronary heart disease was the cause of 72.7% of the natural deaths among the non-alcoholics. Among the alcoholics, however, infections (24.3%) and alcohol-related disorders (15.9%) caused nearly as many deaths as coronary heart disease (25.3%). There was a high rate of blood-alcohol concentration (greater than or equal to 0.5%) in men who died from accidents, suicides and homicides, irrespective of whether they were alcoholics or not. The findings give evidence that alcohol has a strong impact on the mortality statistics for Norwegian middle-aged men.

Accidents↗