scholarly journals Preliminary Study on the Cytoarchitecture of the Human Parabrachial/Kölliker-Fuse Complex, with Reference to Sudden Infant Death Syndrome and Sudden Intrauterine Unexplained Death

2004 ◽  
Vol 7 (2) ◽  
pp. 171-179 ◽  
Author(s):  
Anna Maria Lavezzi ◽  
Giulia Ottaviani ◽  
Gianmario Ballabio ◽  
Lino Rossi ◽  
Luigi Matturri
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Animal Species ◽  
Experimental Studies ◽  
Sudden Infant Death ◽  
Parabrachial Nucleus ◽  
Control Group ◽  
Sudden Infant ◽  
Human Beings ◽  
Unexplained Death

The parabrachial/Kölliker-Fuse complex has been defined, in different animal species, to lie in the dorsolateral part of the pontine tegmentum and to be subdivided into three well-defined regions: the medial parabrachial nucleus, the lateral parabrachial nucleus, and the Kölliker-Fuse nucleus. Experimental studies have shown that the parabrachial/Kölliker-Fuse complex is involved in a variety of functional activities and above all plays an important role in respiratory modulation. In human brainstem, the cytoarchitecture and physiology of this complex have not yet been fully characterized. The aim of the present study was to examine fetal and infant human brainstems in order to define the precise morphology of the three nuclei of the parabrachial/Kölliker-Fuse complex, and to determine whether this nervous center shows morphologic alterations in sudden infant death syndrome (SIDS) and in sudden intrauterine unexplained death (SIUD). In serial sections of 31 brain-stems of subjects aged from 32 gestational wk to 10 months of life, we studied, by morphologic and morphometric analyses, the cytoarchitecture and the extension of the three nuclei of the parabrachial/Kölliker-Fuse complex. All the morphometric parameters were very similar in SIUD and SIDS cases to those of the respective control group, as shown by the absence of significant statistical differences between the two fetus and infant groups. We observed that the features of both the lateral and the medial parabrachial nuclei are largely consistent with those reported in experimental studies. In contrast, the Kölliker-Fuse nucleus appears to be more developed in human beings than in other animal species, showing a greater extension and a more complex structure, as well as subdivision into two subnuclei (compactus and dissipatus).

Apnea, Hypoxemia, and Aborted Sudden Infant Death Syndrome

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5) ◽  
pp. 686-691
Author(s):  
June P. Brady ◽  
Ronald L. Ariagno ◽  
John L. Watts ◽  
Steven L. Goldman ◽  
Fe M. Dumpit
Keyword(s):  
Heart Rate ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Total Duration ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Control Group ◽  
Sudden Infant ◽  
Nasal Catheter ◽  
End Tidal

To find out whether there is any relationship between the ventilatory response to hypoxia and the sudden infant death syndrome (SIDS), we studied the effects of mild induced hypoxia (PIO2, 120 mm Hg = 17% oxygen) in 16 infants aged 2 weeks to 6 months. Eight had recurrent apneic spells (apnea group) (five had aborted SIDS and three had recurrent apnea in the intensive care nursery) and eight were "well" preterm infants about to fly in a pressurized airplane (PIO2, 120 mm Hg) (control group). Mean birth weights were 2,245 and 1,400 gm and mean gestational ages were 35 and 30 weeks. Postconceptual ages (41.8 and 41.3 weeks) were almost identical. Heart rate was obtained from an ECG, and respiratory rate and pattern were obtained from a pneumogram. In addition, end-tidal PCO2 and PN2 or PO2 were obtained with a nasal catheter and gas analyzers. In the apnea group with inhalation of 17% oxygen, we observed an increase in periodic breathing and an increase in both rate and total duration of respiratory pauses. In the control group there were no significant changes. Heart rate and PCO2 did not change in either group. Our findings suggest that infants prone to apnea may have unique respiratory responses to mild induced hypoxia.

Selected Hormone Levels in Victims of the Sudden Infant Death Syndrome

PEDIATRICS ◽  
1980 ◽  
Vol 65 (6) ◽  
pp. 1134-1136
Author(s):  
Richard L. Naeye ◽  
Russell Fisher ◽  
H. Robert Rubin ◽  
Laurence M. Demers
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Normal Level ◽  
Infant Death ◽  
Experimental Studies ◽  
Pulmonary Arteries ◽  
Sudden Infant Death ◽  
Blood Levels ◽  
Sudden Infant ◽  
Hormone Levels ◽  
Final Stress

Hormone levels were measured in victims of the sudden infant death syndrome (SIDS) to look for clues to the cause of death. SIDS victims who had petechiae on their intrathoracic organs had higher blood levels of cortisol than victims without such petechiae (25 vs 9 µg/100 ml, P < .005). This raises the possibility that SIDS victims who had petechiae had a longer period of predeath stress than did victims without petechiae since experimental studies have shown that the circulation must continue for a time after stress begins to produce such petechiae. The low normal level of cortisol (9 µg/ 100 ml) in SIDS victims who did not have petechiae raises the possibility that their circulation stopped rather promptly after the final stress began. Hypoxemia may have been the mechanism of death in many of the SIDS victims with petechiae. These victims had 20% more muscle in their pulmonary arteries than did victims without petechiae (P < .05). This muscle increase is a presumed marker for chronic hypoventilation which leads to hypoxemia.

Sudden Infant Death Syndrome in a Twin: A Comparison of Sibling Histories

PEDIATRICS ◽  
1986 ◽  
Vol 78 (1) ◽  
pp. 146-150
Author(s):  
A. Kahn ◽  
D. Blum ◽  
M. F. Muller ◽  
L. Montauk ◽  
A. Bochner ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Clinical Risk Factor ◽  
Control Group ◽  
Sudden Infant ◽  
First Year ◽  
Control Infant ◽  
The Mean ◽  
First Year Of Life

To determine possible characteristics of infant victims of sudden death, we examined 114 items related to the pre- and postnatal histories of 42 pairs of twins one of whom died of sudden infant death syndrome (SIDS) leaving a surviving sibling. Interviews with the parents were conducted after the occurrence of SIDS, and the data were checked with records held by gynecologists and pediatricians. To evaluate the specificity of any factors, we studied a control group of 42 age- and sex-matched pairs of twins, both of whom survived the first year of life. Only 11 of 114 characteristics were significantly related to SIDS: future victims had a smaller weight and height at birth, stayed longer in the nursery, and followed a moving object with their eyes, had head control, and smiled at a later age than their surviving siblings. They also fatigued more often during feeding (11/42) and had reduced arm and neck tonus (9/42). They were described as longer sleepers than their surviving siblings. During sleep, some SIDS twins, but no surviving twin, were found to be cyanotic at least once or pale (4/42) and were repeatedly covered with abundant sweat (8/42). In the control group of normal twins, the occurrence of most of these characteristics was found with a frequency comparable to that seen in the SIDS infants; the specificity of these characteristics is thus considered doubtful. The mean birth weight and height were significantly greater in the control group, and no control infant had an episode of cyanosis or pallor or repeated episodes of profuse sweating observed during their sleep. It is concluded that, if further research validates the occurrence of night hyperhydrosis in some future SIDS victims, this symptom could be a clinical risk factor.

Diaphragm Strength in Near-Miss Sudden Infant Death Syndrome

PEDIATRICS ◽  
1982 ◽  
Vol 69 (6) ◽  
pp. 782-784
Author(s):  
Charles B. Scott ◽  
Bruce G. Nickerson ◽  
Charles W. Sargent ◽  
Paula C. Dennies ◽  
Arnold C. G. Platzker ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Diaphragm Muscle ◽  
Control Group ◽  
Sudden Infant ◽  
Transdiaphragmatic Pressure ◽  
Airway Occlusion ◽  
The Mean

Diaphragm muscle strength was measured as maximal transdiaphragmatic pressure during airway occlusion in ten near-miss sudden infant death syndrome infants aged 4.1 ± 0.6 (SE) months post-term, range 2 to 7 months, and ten control infants aged 4.5 ± 0.8 months post-term, range 0.8 to 8 months. In the near-miss sudden infant death syndrome group, the mean maximal transdiaphragmatic pressure was 106 ± 6 cm H2O, range 78 to 132 cm H2O, compared with a mean maximal transdiaphragmatic pressure of 86 ± 4 cm H2O, range 69 to 106 cm H2O, in the control group. Diaphragm strength is normal or increased in near-miss sudden infant death syndrome infants.

Oculocardiac Reflex in Near Miss for Sudden Infant Death Syndrome Infants

PEDIATRICS ◽  
1983 ◽  
Vol 71 (1) ◽  
pp. 49-52 ◽  
Author(s):  
André Kahn ◽  
Jalil Riazi ◽  
Denise Blum
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Cardiac Response ◽  
Control Group ◽  
Sudden Infant ◽  
First Year ◽  
First Year Of Life

To gain insight into the role of the vagus nerve in sudden infant death syndrome (SIDS), 180 infants ranging in age from 1 to 66 weeks were examined with respect to cardiac response to ocular compression. There were 35 near-miss infants, 76 normal siblings of SIDS victims, and 69 normal control infants. Asystoles within the control group ranged from 0.3 to 1.8 seconds. Ten of 35 (28%) near-miss infants and 10/76 (13%) siblings had asystoles >2.0 seconds when first tested. When statistically compared, the near-miss infants were significantly different from both the control infants and the siblings (Kruskal-Wallis procedure: P < .01, and P < .05, respectively). It is concluded that in the first year of life a significant number of near-miss infants have an exaggerated cardiac response to ocular compression. Furthermore, the presence of prolonged asystoles in certain siblings indicates that vagal hypersensitivity, as manifested by ocular compression, may be, in part, hereditary.

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