THE ADRENAL CORTEX, STEROIDS, AND HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1971 ◽  
Vol 47 (4) ◽  
pp. 645-646
Author(s):  
John W. Reynolds
Keyword(s):  
Adrenal Cortex ◽  
Adrenal Glands ◽  
Direct Evidence ◽  
Matched Control ◽  
Newborn Infants ◽  
Hyaline Membrane Disease ◽  
Type Ii ◽  
Hyaline Membrane ◽  
Issue Reports ◽  
Number Of Cells

The paper by Naeye, et al.,1 in this issue reports a very interesting relation between adrenal gland size and the presence of hyaline membrane disease in newborn infants. Those infants with hyaline membrane disease had smaller adrenal glands than weight matched control infants, due to a decreased number of cells in both the permanent and fetal zones of the adrenal cortex. More direct evidence of possible relation between adrenal cortical size and the capacity of the lung to produce surfactant is brought out by their finding of a correlation between adrenal cortical size in anencephalic infants and the osmiophilic granule content of so-called type II alveolar lining cells.

THE BLOOD PRESSURE OF NEWBORN INFANTS IN ASPHYXIAL STATES AND IN HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1960 ◽  
Vol 26 (5) ◽  
pp. 735-744
Author(s):  
Gerald A. Neligan ◽  
D. M. Oxon. ◽  
Clement A. Smith
Keyword(s):  
Initial Level ◽  
Newborn Infants ◽  
Systolic Pressure ◽  
Hyaline Membrane Disease ◽  
Elective Cesarean Section ◽  
Maternal Illness ◽  
Direct Measurements ◽  
Hyaline Membrane ◽  
Elective Cesarean ◽  
Blood Pressures

The early changes in the systolic blood pressures in six clinical groups of newborn infants have been studied. Readings of the sphygmomanometer used have been compared with "direct" measurements during cardiac catheterization, and the results are reported. In 36 normal mature infants the systolic pressure fell by a mean of 25 mm Hg from the initial value recorded within the first 5 minutes after delivery, to the lowest value, reached as a rule between 1 and 4 hours after delivery. In 18 clinically asphyxiated mature infants, the mean fall (38.5 mm Hg) was significantlygreater because the initial level was significantly higher (by 15.1 mm Hg) than the comparable initial level in the infants who breathed promptly. Three episodes of apnea during anesthesia have also been observed in two infants aged less than 48 hours, and on each occasion there has been an abrupt rise in the systolic pressure, with or without a corresponding bradycardia. In a group of premature infants studied from within the first half-hour after delivery, the seven of them diagnosed as hyaline membrane disease had a significant hypotension between 5 minutes and 4 hours after birth, as compared with the lowest systolic pressures found at corresponding times in the 10 infants who remained well. Among infants of diabetic mothers, a similar relative hypotension was observed in the four severe cases of hyaline membrane disease as compared with blood pressures of the 11 who remained well and the three who were mildly affected. A group of 13 mature infants delivered by elective cesarean section, for indications other than maternal illness of any kind, showed no significant differences in the course of their lowest systolic pressures as compared with the group of mature infants delivered from below. Neither the cause nor the significance of the hypotension seen in hyaline membrane disease is yet sufficiently clear to allow recommendation as to treatment.

Early-Onset Haemophilus Sepsis in Newborn Infants: Clinical, Roentgenographic, and Pathologic Features

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 299-303
Author(s):  
Lawrence D. Lilien ◽  
Tsu F. Yeh ◽  
Gertrude M. Novak ◽  
Norman M. Jacobs
Keyword(s):  
Early Onset ◽  
Polymorphonuclear Leukocytes ◽  
Newborn Infants ◽  
Arterial Oxygen Tension ◽  
Hyaline Membrane Disease ◽  
Arterial Oxygen ◽  
Pathologic Features ◽  
High Incidence ◽  
Hyaline Membrane ◽  
Time Of Infection

Nine infants with early-onset Haemophilus sepsis were seen between January 1973 and July 1977. Of the five isolated strains that were typed, only one was type B. All infants had respiratory distress, metabolic acidosis, and large alveolar-arterial oxygen tension difference gradients. Eight infants weighed less than 1,500 gm and died; one infant weighed 1,701 gm and survived. Roentgenograms in six of eight showed hyaline membrane disease. Pulmonary pathologic specimens in eight infants revealed hyaline membranes in six and polymorphonuclear leukocytes in the alveolar spaces in four. In two infants, small Gram-negative bacilli were noted within proteinaceous exudates in alveolar ducts. The route and time of infection in these infants with early-onset Haemophilus sepsis are unclear. However, the possibility that the infection occurs before birth and that these infants represent septically aborted prematures is suggested by the high incidence of prematurity in infants with early-onset Haemophilus sepsis and early detection of bacteremia in three infants.

ADRENAL GLAND STRUCTURE AND THE DEVELOPMENT OF HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1971 ◽  
Vol 47 (4) ◽  
pp. 650-657
Author(s):  
Richard L. Naeye ◽  
Howard T. Harcke ◽  
William A. Blanc
Keyword(s):  
Adrenal Glands ◽  
Hyaline Membrane Disease ◽  
Alveolar Cells ◽  
Cortical Function ◽  
Lung Maturation ◽  
Cortical Cells ◽  
Corticosteroid Administration ◽  
Osmiophilic Granules ◽  
Hyaline Membrane ◽  
Type Ii Alveolar Cells

Adrenal cortical function may influence the development of hyaline membrane disease. Corticosteroid administration to animal fetuses reportedly accelerates some parameters of lung maturation. Analysis of 387 consecutive autopsies on human neonates demonstrated that adrenal glands were 19% lighter in infants with hyaline membrane disease than in those without the disorder owing to a greater number of adrenal cortical cells in the latter infants. A positive correlation was found between the presence of infection arising before birth and the absence of hyaline membrane disease, the infected infants having larger adrenal glands. It was found that anencephalic neonates who had little or no adrenal fetal cortical zone and half sized adult zones had 45% the mass of osmiophilic granules in pulmonary type II alveolar cells as did nonanencephalic control infants. The osmiophilic granules are reportedly the anatomic representation of surfactant.

Alveolar Lining Film of the Lungs in Newborn Infants with Hyaline Membrane Disease

Neonatology ◽  
1966 ◽  
Vol 10 (5-6) ◽  
pp. 348-358 ◽  
Author(s):  
Janusz Groniowski ◽  
Wieslawa Biczyskowa
Keyword(s):  
Newborn Infants ◽  
Hyaline Membrane Disease ◽  
Hyaline Membrane

Continuous Positive Transpulmonary Pressure in Hyaline Membrane Disease: A Simple Device

PEDIATRICS ◽  
1971 ◽  
Vol 48 (2) ◽  
pp. 296-299
Author(s):  
D. Vidyasagar ◽  
V. Chernick
Keyword(s):  
Artificial Respiration ◽  
Newborn Infants ◽  
Transpulmonary Pressure ◽  
Hyaline Membrane Disease ◽  
The Body ◽  
Subatmospheric Pressure ◽  
Rapid Reduction ◽  
Simple Modification ◽  
Hyaline Membrane ◽  
Arterial Po2

A simple modification of the Isolette incubator -respirator such that a constant negative (subatmospheric) pressure (CNP) may be applied to the body chamber is described. A constant subatmospheric pressure around the thorax (constant positive transpulmonary pressure) has been used in the treatment of five newborn infants with severe hyaline membrane disease with favourable results. Arterial Po2 increased significantly while the alveolar-arterial Po2 difference decreased. There was no significant influence on arterial Pco2. This approach appears to be a useful adjunct to the treatment of hyaline membrane disease since it increases arterial Po2, allows more rapid reduction of inspired o2 concentrations to levels not toxic to the lung, and may obviate the need for endotracheal intubation and artificial respiration.

CARBOHYDRATE AND ENERGY METABOLISM IN THE NEWBORN—AN INTERNATIONAL EXPLORATION

PEDIATRICS ◽  
1967 ◽  
Vol 39 (4) ◽  
pp. 582-602
Author(s):  
Marvin Cornblath
Keyword(s):  
Distress Syndrome ◽  
Fat Metabolism ◽  
Newborn Infants ◽  
Hyaline Membrane Disease ◽  
Similar Nature ◽  
Hyaline Membrane ◽  
International Attention ◽  
Idiopathic Respiratory Distress Syndrome ◽  
The Subject ◽  
The One

Dr. Smith (Chairman): To start the evening, I might remind you that 6 years ago a similar group took advantage of their presence at the International Congress in Montreal to gather together informally for the exchange of ideas about hyaline membrane disease. The one major result of that discussion was the agreement that, whatever hyaline membrane disease is, it should thereafter always be called the idiopathic respiratory distress syndrome. As you may know, the syndrome is now referred to more firmly than ever as hyaline membrane disease; nevertheless, something of value was accomplished in the exchange of ideas and in the focusing of international attention upon central rather than peripheral aspects of a previously ill-defined problem. In organizing tonight's meeting, I know Dr. Cornblath hopes something of a similar nature can occur with regard to problems of carbohydrate and fat metabolism in newborn infants. Some of us, I am afraid, would have said 6 years ago that newborn infants actually had no problems of this sort. It was largely through Marvin Cornblath's alertness and continued investigations that we now know the subject as one of great importance and interest. Yet, I think one of the reasons we are here is not only to discuss how these matters look to all the rest of us, but to find out if anyone else sees quite as many infants with significant hypoglycemia as seem to be encountered in Chicago. What it is that we are missing in other cities, or what Dr. Cornblath is doing that we are not, are aspects which, I hope, can come out in the discussion tonight.

Sign in / Sign up

Export Citation Format

Share Document