Dead Neonates Research Articles

English

OBJECTIVE: Aim was to evaluate clinical and associated risk factors for still births and neonatal deaths at tertiary health care centre. METHODS: A retrospective analytical study of new born at birth conducted at tertiary health care centre for three consecutive years. Demographic variables, status of new born at birth, NICU care and neonatal causes of death were analyzed. RESULTS: There were 1072,990,995 births for 2011, 2012, and 2013 year respectively Still births were 30, 36 and 41 and newborn deaths were 15,8,15 for three consecutive years. Mean age of mother was 25.35 yrs standard deviation 4.4. 82 % of still births were preterm. Maximum 67% of still births birth weight was less than 1.5 kg. NICU admission included 51% full term neonate, 44% preterm and 5% post term neonate. Maximum (51%) NICU admissions neonatal birth weight was less < 1.5 kg.79% of dead neonates were preterm. Life threatening congenital defects was seen in 26%. Cause of death birth asphyxia 37% hyaline membrane disease 15%. CONCLUSION: Statistically significant mean gestational age of baby with mother was 38.26 weeks (SD 2.260), NICU neonates 36.70 weeks (SD 3.3) and still births 31.34 weeks (SD 4.6). Maternal urinary tract infection, Hypertensive diseases, diabetes mellitus were major reasons for stillbirths. Neonatal mortality from 26% reduced to 8% with increasing birth weight. Major neonatal deaths are because of birth asphyxia, congenital defects. Low Birth Weight and prematurity were overlapping factor for neonatal death. Still birth rate was 35; perinatal mortality rate was 44/1000 live births. Early neonatal mortality rate & Total neonatal mortality rate was 12 /1000 live births each.

Reporting detection of Chlamydia trachomatis DNA in tissues of neonatal death cases

Objectiveto determine whether C. trachomatis was present in neonates with infection, but without an isolated pathogen, who died during the first week of life. Methodsearly neonatal death cases whose causes of death had been previously adjudicated by the institutional mortality committee were randomly selected. Endpoint and real-time poly-merase chain reaction of the C. trachomatis omp1 gene was used to blindly identify the presenceof chlamydial DNA in the paraffinized samples of five organs (from authorized autopsies) ofeach of the dead neonates. Additionally, differential diagnoses were conducted by amplifyinga fragment of the 16S rRNA of Mycoplasma spp. Resultsin five cases (35.7%), C. trachomatis DNA was found in one or more organs. Severe neonatal infection was present in three cases; one of them corresponded to genotype D of C. trachomatis. Interestingly, another case fulfilled the same criteria but had a positive polymerase chain reaction for Mycoplasma hominis, a pathogen known to produce sepsis in newborns. Conclusionthe use of molecular biology techniques in these cases of early infant mortality demonstrated that C. trachomatis could play a role in the development of severe infection and in early neonatal death, similarly to that observed with Mycoplasma hominis. Further study is required to determine the pathogenesis of this perinatal infection.

Reporting detection of Chlamydia trachomatis DNA in tissues of neonatal death cases

Objectiveto determine whether C. trachomatis was present in neonates with infection, but without an isolated pathogen, who died during the first week of life. Methodsearly neonatal death cases whose causes of death had been previously adjudicated by the institutional mortality committee were randomly selected. End-point and real-time polymerase chain reaction of the C. trachomatis omp1 gene was used to blindly identify the presence of chlamydial DNA in the paraffinized samples of five organs (from authorized autopsies) of each of the dead neonates. Additionally, differential diagnoses were conducted by amplifying a fragment of the 16S rRNA of Mycoplasma spp. Resultsin five cases (35.7%), C. trachomatis DNA was found in one or more organs. Severe neonatal infection was present in three cases; one of them corresponded to genotype D of C. trachomatis. Interestingly, another case fulfilled the same criteria but had a positive polymerase chain reaction for Mycoplasma hominis, a pathogen known to produce sepsis in newborns. Conclusionthe use of molecular biology techniques in these cases of early infant mortality demonstrated that C. trachomatis could play a role in the development of severe infection and in early neonatal death, similarly to that observed with Mycoplasma hominis. Further study is required to determine the pathogenesis of this perinatal infection.

Postmortem Examinations on Deceased Neonates: A Rarely Utilized Procedure in an African Referral Center

Postmortem examination remains the gold standard for the correct diagnosis of many diseases and for unraveling unexplained causes of death. This paper reports on the poor utilization of autopsy services and encourages parents/caregivers and practitioners to perform postmortem examinations on deceased neonates in sub-Saharan Africa. In a retrospective study, the records of 1093 neonates (653 males and 440 females, ratio 1.5∶1) who died at the University of Benin Teaching Hospital and who were brought to the mortuary between 2006 and 2010 were reviewed to determine the utilization of and factors influencing postmortem examination. Sixty-two percent of the neonates died within the 1st week of life, and only 9 (0.8%) underwent a postmortem examination. Findings in the 9 postmortem studies performed on 7 males and 2 females provided additional information on the causes of death. The religious beliefs that neonates should not be subjected to postmortem study and beliefs that dead neonates are taboo and a punishment by the gods for past wrongdoings influenced 511 (46.8%) parents/caregivers to refuse postmortem analysis. The practitioners did not request postmortem study in 281 (25.7%) of the cases. The utilization of postmortem examination was marginal in this setting. We advocate the need for public enlightenment campaigns to modify the attitudes of parents/caregivers toward the postmortem study of deceased neonates. Policies should be formulated to mandate postmortem examinations of deceased neonates to enhance insight into neonatal disease, unravel unexplained causes of death, and improve the standard of neonatal care in this subregion.

The prevalence and challenges of abandoned dead neonates in an African referral center

Background Dead neonates are often preserved in the mortuary pending until parents/caregivers’ collect them for formal burial. This study reports the prevalence and challenges of abandoned dead neonates in an African referral center. Materials and methods The clinical and mortuary records of all dead neonates at the University of Benin Teaching Hospital between January 2006 and December 2010 were retrospectively reviewed to determine the prevalence, influencing factors, and challenges of abandoned dead neonates. Results A total of 1093 (22.9%) mortalities were recorded among 4781 neonates. The prevalence of abandoned dead neonates was 77.2% as 844 of the 1093 dead neonates were abandoned to the hospital and given mass burial by an assigned government agency after at least 3 months of abandonment. This was challenging as an average of 85 dead neonates were given mass burial every 6 months to decongest the mortuary. Of 618 illiterate parents/caregivers of low socioeconomic class, 520 (84.1%) abandoned their dead babies. This was extremely significant statistically when compared with 324 (68.2%) bodies abandoned by 475 literate parents/caregivers in upper/middle class (P < 0.0001). Surgical neonates, neonates with obvious congenital anomalies, and babies from the third birth positions onward were mostly abandoned. Conclusion We advocate the need for public enlightenment campaign to modify present parents/caregivers’ attitudes toward dead neonates. Hospital-based postbereavement programs should be organized to help parents/caregivers adjust appropriately to neonatal deaths. Those with dead neonates should be exempted from paying hospital bills. Keywords : abandonment, challenges, dead neonates, prevalence

Distribution pattern of cholinesterase enzymes in human tooth germs

The two distinct molecular forms of cholinesterase (ChE) are acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). Our previous studies have reported that ChE is involved in tooth development. However, further experiments are needed to understand the precise action of ChE in tooth development. This study aimed to localise types of ChE in human tooth germs, and identify their distribution pattern. ChE were localised in frozen sections of jaws which were prepared from dead fetuses, neonates and stillborns who were free from visible abnormalities by Karnovsky and Root method. AChE was identified in the inner and outer enamel epithelia including the cervical loop region, stratum intermedium and preameloblasts of tooth germs at bell stage. Secretory ameloblasts were free from staining. The bud and cap stages of permanent tooth germs showed AChE activity on the lingual aspect and top surface of the epithelial ingrowths, respectively. BuChE activity was localised in the degenerating dental lamina. Our study reported the first evidence of localisation of ChE in human tooth development and identified the possible molecular form of ChE in tooth germs as AChE. Also, our results have provided strong evidence to speculate the action of AChE is on the cells of enamel organ during tooth development.

The developmental toxicity of 1‐methyl‐3‐octylimidazolium bromide on Daphnia magna

The developmental toxicity of 1-methyl-3-octylimidazolium bromide ([C(8)mim]Br) on Daphnia magna was investigated. The 24 and 48 h LC(50) values for [C(8)mim]Br in D. magna were 1.99 and 0.95 mg/L, respectively. A series of multigenerational toxicity tests were then used to explore [C(8)mim]Br effects in D. magna. [C(8)mim]Br significantly inhibited the body lengths of the F0 and F1 1st generations. After 21 days of exposure, [C(8)mim]Br lowered the reproductive ability of the F0 and F1 1st generations. In F1 3rd generation, 21 days of [C(8)mim]Br exposure prolonged the time to bear the first egg and the time to the first brood compared with the control, but the number of first-brood offspring and the number of broods produced by these animals were reduced. After the recovery period all the reproductive parameters returned to normal in F1 1st generation except for the number of broods. The dead neonates increased with prolonged exposure and increasing concentrations, and the dead neonates of the F1 3rd generation went far beyond that of the F1 1st and F0 generations. The intrinsic rate of natural increase (r) values of the three D. magna generations significantly decreased after exposure to higher concentrations of [C(8)mim]Br compared with control groups. Collectively, these results suggest that [C(8)mim]Br exerts a toxic effect on the development of D. magna. This study also highlights the importance of systematically evaluating the potential effects of aquatic ecosystems of ionic liquids that may be released into bodies of water.

Effect of indomethacin on complications of preterm neonatal respiratory distress syndrome after pulmonary surfactant treatment or prevention

目的 探讨预防性应用吲哚美辛减少肺表面活性物质治疗或预防新生儿呼吸窘迫综合征的合并症.方法临床诊断为新生儿呼吸窘迫综合征的早产儿40例,用肺表面活性物质(固尔苏)治疗,按有无用吲哚美辛预防分为A1组22例与B1组18例.胎龄＜32周未发生新生儿呼吸窘迫综合征的早产儿37例,用肺表面活性物质预防,按有无用吲哚美辛预防分为A2组24例与B2组13例.分别比较A1与B1组、A2与B2组的辅助通气(含鼻塞CPAP和机械通气)时间和发生动脉导管未闭、肺出血、脑室内出血及死亡情况分布并做统计学分析.结果A1与B1两组辅助通气时间分别为(94.9±61.5)h、(105.8±103.0)h,差异无统计学意义(P＞0.05);发生动脉导管未闭例数分别为8、14例,差异有统计学意义(P＜0.05);发生肺出血、脑室内出血例数的差异无统计学意义(P＞0.05);死亡例数≤3 d分别为0和3例,差异有统计学意义(P＜0.05),＞3 d各为3例,差异无统计学意义(P＞0.05).A2与B2两组辅助通气时间分别为(24.0±20.8)h、(44.0±25.9)h,发生动脉导管未闭例数分别为2和5例,差异均有统计学意义(P＜0.05);发生肺出血例数的差异无统计学意义(P＞0.05);发生脑室内出血例数较少,死亡例数≤3 d分别为0和1例,＞3 d各为1例,未做统计学分析.结论肺表面活性物质治疗或预防新生儿呼吸窘迫综合征时,用吲哚美辛预防可减少合并动脉导管未闭、肺出血和早期死亡。

Is corticosterone-mediated phenotype development adaptive? Maternal corticosterone treatment enhances survival in male lizards

Hormones are an important interface between genome and environment, because of their ability to modify the phenotype. More particularly, glucocorticoids are known to affect both morphological, physiological and behavioral traits. Many studies suggest that prenatal stress (associated with an elevation of corticosterone) has deleterious effects on offspring, an altered physiology resulting in retardation of fetal growth and higher percentage of dead neonates. In this study, we investigate the consequences of an artificial increase of corticosterone in pregnant female Lacerta vivipara on two important fitness components: growth and survival. Do stressed females decrease or enhance offspring survival? In 2000 and 2001, we collected pregnant females from four populations of the Cévennes and kept them in the laboratory until parturition. We applied a corticosterone solution daily onto the backs of some females. A similar solution, but without corticosterone, was applied to the remaining females as a control. Immediately after birth, we measured juveniles' morphological characteristics and released them on the field. In September of the year of release and in May of the following year, we recaptured offspring to estimate growth and survival. The elevation of the corticosterone level in pregnant females L. vivipara had a profound impact on juvenile traits. The size, the body condition and the growth of juveniles were decreased by the corticosterone treatment. In contrast, in male juveniles, survival was higher for juveniles from corticosterone-treated females than from placebo females. Thus, corticosterone does not seem to have detrimental effects on offspring survival, suggesting that it may have an adaptive function.

Derivação vésico-amniótica no tratamento intra-uterino das uropatias obstrutivas: revisão e análise crítica da experiência de um Centro de Medicina Fetal

OBJETIVO: avaliar a eficácia, a segurança e os benefícios do uso do cateter de derivação vésico-amniótico no tratamento intra-uterino das uropatias obstrutivas. MÉTODOS: análise retrospectiva dos registros de 35 fetos portadores de uropatia obstrutiva, acompanhados em um centro de Medicina Fetal, no período compreendido entre 1990 e 2004, tratados pela insersão do cateter de derivação vésico-amniótica. As pacientes consentiram em submeter-se ao procedimento. Os casos selecionados seguiram os seguintes critérios de inclusão: gestação única; idade gestacional até 32 semanas; ausência de outras malformações; cariótipo normal; ultra-sonografia mostrando lesão obstrutiva no trato urinário, bilateral ou unilateral com comprometimento do rim contralateral, caracterizando hidronefrose (diâmetro ântero-posterior da pelve maior que 10 mm), associada ou não a megaureter e megabexiga; oligoâmnio, dado por índice de líquido amniótico menor que 8; função renal normal, dada por critério ecográfico (aspecto dos rins à ecografia) e por estudo bioquímico da urina fetal (osmolaridade). Considerou-se normal a osmolaridade de até 210 mOsm como indicativo de função renal preservada. Após o nascimento foram acompanhados pelo setor de Nefrologia Pediátrica do Hospital das Clínicas da UFMG. Os neomortos ou natimortos foram encaminhados para o setor de Anatomia Patológica. Foi realizada análise descritiva dos seguintes parâmetros: diagnóstico pré-natal da uropatia, idade gestacional à insersão do cateter, tempo de permanência do cateter, complicações pós-procedimento, mortalidade perinatal e sobrevida neonatal. RESULTADOS: a válvula de uretra posterior foi a uropatia mais freqüente (62,8%). A idade gestacional média da insersão do cateter foi 26,1 semanas. O tempo médio de permanência do cateter após a colocação até o parto foi de 46 dias (variando entre um e 119 dias). Ocorreram 4 mortes fetais e 17 mortes neonatais (mortalidade perinatal de 60%). A principal causa dos óbitos foi a hipoplasia pulmonar. O oligoidrâmnio esteve presente em 33 dos 35 fetos acompanhados (94,3%), tendo sido revertido em 23 casos (70%), dos quais 14 sobreviveram ao período neonatal. Há 4 crianças em acompanhamento no setor de Nefrologia Pediátrica do Hospital das Clínicas da UFMG. Duas estão em diálise peritoneal, com expectativa de transplante renal, e duas apresentam-se com função renal preservada, com idades variando entre 2 meses e 4 anos. CONCLUSÃO: a derivação vésico-amniótica apresenta-se como uma alternativa viável de tratamento intra-uterino das uropatias graves, apresentando índice de sobrevida neonatal de 40% entre fetos que provavelmente evoluiriam para o óbito. Entretanto, o sucesso do procedimento esteve diretamente relacionado com a adequada seleção dos fetos e a precocidade da intervenção intrauterina, isto é, restringindo o procedimento àqueles fetos com menos de 32 semanas, com obstrução bilateral, sem malformações associadas e com função renal ainda preservada. A reversão do oligoidrâmnio não garantiu melhor prognóstico neonatal. Permanece controverso se a derivação vésico-amniótica é capaz de garantir a função renal preservada a longo prazo.

Capacidade reprodutiva de Bothrops jararaca (Serpentes, Viperidae)

The relationship between female body size and egg number was examined in the snake Bothrops jararaca (Wied, 1924). Some authors have demonstrated that the estimated clutch size may be affected by the inclusion or exclusion of dead neonates or non-developed eggs. The reproductive system of 254 mature females newly arrived from nature was examined and 29.55% (n=75) had eggs in the oviducts in different stages of embryonic development. The presence of atresic eggs was observed in 34.5% of those females. A significant difference was observed in the number of eggs in the right and left oviducts (t=9.48, P<0.001), but not in the number of atresic eggs (t=1.110, P=0.278). The correlation of female body size and egg number was greater when all, the normal and atresic eggs were considered (r=0.63, P<0.001). The exclusion of atresic eggs from the clutch size decreased slightly this correlation (r=0.54, P<0.001).

Do Babies Have Culture?

Alma Gottlieb. The Afterlife Is Where We Come From: The Culture of Infancy in West Africa. Chicago: University of Chicago Press, 2003. '[B]efore local officials of the Ivoirian government ordered all thatch-roofed houses to be destroyed in the late 1960s, the Beng [of the Côte d'Ivoire] lived in large, round dwellings that accommodated an extended family, which was meant to include not only the living but also the dead. Every night someone in the household would put out a small bowl of food for the ancestors of the family, and the last person to retire would close the door, locking in the living and the dead to sleep together. In the morning, the first person to open the door released the wrus, who travelled back to wrugbe for the day—only to return at night for their dinner and sleeping spot once again' (Gottlieb 2003:.82). Today all the dead spirits (wru) of "all the world's ethnic groups live together harmoniously" (98) in spirit villages (wrugbe) that are "dispersed among invisible neighbourhoods in major cities in Africa and Europe" (80). The dead may be invisible to us, but we live alongside them. Are we invisible to them? Presumably so. It would seem likely that from their own point of view the dead lead a material existence, but why today is it an urban one? Perhaps the existence [End Page 167] of the dead alongside us has to do with the wealth of the city and its plentiful food; there, one might suppose, the dead have access to everything they need. But perhaps the dead are not able just to have what they want? Perhaps access to what may be obtained by the dead requires the mediation of the living? Certainly it seems that living Beng have to make the dead recognize them, remember their ties to them as kin, and in doing so at once protect the living from all forms of evil and ill chance and promote their well-being and fertility. By the same token, it may be the case that from the spirits' point of view wrugbe finds its material continuity in the dutiful behaviour of the living towards the dead. 1 Wrugbe—the domain of the dead—may be accessible to adults in dreams (82), but otherwise adults must undertake special procedures via diviners to consult the dead and gain their support. Babies, however, have unmediated access to wrugbe where they spend a good deal of time (p169): "all infants and young children, as well as adult diviners, tack back and forth between past and present by travelling—one might even say commuting—to wrugbe" (80). Considered as a spatiotemporal location, wrugbe is always present; and like our own lived present, this one contains with in it its own past and its potential future. 2 Beng neonates incarnate specific ancestors, though often enough the ancestor remains unknown in that s/he cannot be identified with a named, now dead, once living, person (89). The living baby and the dead ancestor are, however, aspects of an entity whose substance and sociality is slowly differentiated over the years of infancy and early childhood—a process that cannot itself really begin until the stump of the newly born child's umbilical cord withers and drops off (83). A child who dies before this time is not yet classified as a person, so the death is not announced publicly, the neonate being deemed simply to have returned to wrugbe (p83); indeed, it is perhaps because it is wru that the dead neonate is "buried in a muddy patch behind the home" but is given no funeral (90). The neonate is so closely at one with wrugbe that until the umbilical stump drops off he or she must be washed four times a day using a special soap that is otherwise used only to wash a person newly deceased, and four times a day the child's mouth too must be washed with half a newly-cut...

How many blastomeres of the 4-cell embryo contribute cells to the mouse body?

The aim of this study was to estimate how many blastomeres of the 4-cell mouse embryo contribute cells to the embryo proper and finally to the animal. To this end, 4-cell embryos of pigmented and albino genotypes were disaggregated and single blastomeres (henceforth called '1/4' or 'quarter' blastomeres) were reaggregated in the following combinations: one 'pigmented' blastomere + three 'albino' blastomeres or vice versa (henceforth called '1+3') and two pigmented blastomeres + two albino blastomeres (henceforth called '2+2'). The aggregations were cultured in vitro and transferred as blastocysts either to the oviduct or uterus of pseudopregnant females. Recipients were allowed to litter naturally, or the foetuses were removed by Caesarian section and raised by lactating foster mothers. Chimaerism was assessed on the basis of coat (adults) or eye pigmentation (dead neonates). Among 28 '1+3' animals, there were 13 chimaeric and 15 non-chimaeric individuals. The pigmentation of non-chimaeras was always concordant with the genotype of the three 1/4 blastomeres and not with the genotype of the single blastomere in the given aggregation. These results make rather unlikely the possibility that the mouse is built of cells derived either from one or all four 1/4 blastomeres. Both two remaining options (2 or 3 1/4 blastomeres) are conceivable but the observed ratio of chimaeras to non-chimaeras among '1+3' animals (13:15) fits better the assumption of two 1/4 blastomeres contributing cells to the animal body. This assumption finds additional support in the observation that among '2+2' animals there were non-chimaeras (5 out of 7) and these would not have been expected should three 1/4 blastomeres contribute cells to the mouse body.

Pathology of brucellosis in bison from Yellowstone National Park.

Between February 1995 and June 1999, specimens from seven aborted bison (Bison bison) fetuses or stillborn calves and their placentas, two additional placentas, three dead neonates, one 2-wk-old calf, and 35 juvenile and adult female bison from Yellowstone National Park (USA) were submitted for bacteriologic and histopathologic examination. One adult animal with a retained placenta had recently aborted. Serum samples from the 35 juvenile and adult bison were tested for Brucella spp. antibodies. Twenty-six bison, including the cow with the retained placenta, were seropositive, one was suspect, and eight were seronegative. Brucella abortus biovar 1 was isolated from three aborted fetuses and associated placentas, an additional placenta, the 2-wk-old calf, and 11 of the seropositive female bison including the animal that had recently aborted. Brucella abortus biovar 2 was isolated from one additional seropositive adult female bison. Brucella abortus was recovered from numerous tissue sites from the aborted fetuses, placentas and 2-wk-old calf. In the juvenile and adult bison, the organism was more frequently isolated from supramammary (83%), retropharyngeal (67%), and iliac (58%) lymph nodes than from other tissues cultured. Cultures from the seronegative and suspect bison were negative for B. abortus. Lesions in the B. abortus-infected, aborted placentas and fetuses consisted of necropurulent placentitis and mild bronchointerstitial pneumonia. The infected 2-wk-old calf had bronchointerstitial pneumonia, focal splenic infarction, and purulent nephritis. The recently-aborting bison cow had purulent endometritis and necropurulent placentitis. Immunohistochemical staining of tissues from the culture-positive aborted fetuses, placentas, 2-wk-old calf, and recently-aborting cow disclosed large numbers of B. abortus in placental trophoblasts and exudate, and fetal and calf lung. A similar study with the same tissue collection and culture protocol was done using six seropositive cattle from a B. abortus-infected herd in July and August, 1997. Results of the bison and cattle studies were similar.

A study for functions of prostaglandin E receptor EP4 subtype by analysing knockout mice

The physiological role of the prostaglandin (PG) E2 receptor EP4 subtype was investigated by the generation of EP4-deficient mice by gene targeting. Loss of the EP4 receptor was not lethal in utero, but most EP4 (-/-) neonates became pale and lethargic approximately 24 h after birth, and died within 72 h. Less than 5% of the EP4 (-/-) mice survived and grew normally more than a year. Marked congestion in the pulmonary capillaries were observed before death, suggesting that EP4 (-/-) neonates had left-sided heart failure. Histological examination revealed that the ductus arteriosus in dead neonates remained open, while it was partially closed in the survivors. In situ hybridization study showed that EP4 mRNA was strongly expressed in the ductus. The treatment of indomethacin, an inhibitor of PG synthesis, on wild-type fetus induced constriction of ductus arteriosus, while the ductus in EP4 (-/-) fetus was insensitive to indomethacin. These results suggest that neonatal death is at least partly due to patent ductus arteriosus, and that the EP4 receptor plays a role in the regulation of the patency of this vessel. They also indicate that the normal function of the EP4 receptor is essential in neonatal adaptation of the circulatory system.

Intrauterine growth retardation as a cause of perinatal mortality in Japanese black beef calves.

Perinatal death is one of the major causes of calf mortality in Japanese Black beef herds. A series of experiments were carried out to determine causes of perinatal calf mortality in a region of northern Japan. An aetiological survey revealed that the incidence of perinatal mortality in 6475 calves was 4.5% and the majority of neonatal deaths were caused by weak calf syndrome. The weak calves delivered after a normal gestation period had a significantly lower body weight at birth than normal calves (P < 0.01), indicating growth retardation in the uterus during pregnancy. Haematological and histopathological examinations showed that the weak calves had anaemia characterized by a significant decrease of blood cell values and bone marrow hypofunction. The anaemia due to bone marrow hypofunction presumably caused intrauterine growth retardation of the foetus. Dams delivering the weak calves showed significantly lower serum concentrations of estrone sulphate during late pregnancy than those with normal calves (P < 0.01), indicating foeto-placental dysfunction as a possible cause of growth retardation. Effects of sires as well as the maternal family on the incidence of neonatal death and on the rate of weak calves in dead neonates were found in the survey. Intrauterine growth retardation associated with anaemia may be the most important cause of weak calf syndrome in Japanese Black beef calves. The bull and maternal family may also have an influence on the incidence of neonatal death.

Patent Ductus Arteriosus and Neonatal Death in Prostaglandin Receptor EP4-Deficient Mice

The physiological role of the prostaglandin E2receptor EP4 subtype was investigated by generation of EP4-deficient mice by gene targeting. Loss of the EP4 receptor was not lethalin utero,but most EP4 (−/−) neonates became pale and lethargic approximately 24 h after birth and died within 72 h. Less than 5% of the EP4 (−/−) mice survived and grew normally more than a year. Histological examination revealed that the ductus arteriosus in dead neonates remained open, while it was partially closed in the survivors.In situhybridization study showed that EP4 mRNA was strongly expressed in the ductus. These results suggest that neonatal death is at least partly due to patent ductus arteriosus and that the EP4 receptor plays a role in regulation of the patency of this vessel. They also indicate that normal function of the EP4 receptor is essential in neonatal adaptation of the circulatory system.

SMALL INTESTINAL TRANSPLANTATION IN (SIT) IN CHILDREN

After experiments on piglets and rats SIT using Cyclosporine A (CsA) and after obtaining consent form from parents, we performed six SIT in children (6mths-9yrs) with short gut syndrome on home TPN for 0.5 to 6 years. All but one donor and recipients were isoblood group ABO, with negative cross match reaction. Graft were harvested on brain dead neonates (n=2) or children 6-17 yrs, 110 ± 10 cm of jejuno ileum underwent both vascular and luminal washing using Collins (n=3) or UW (n=3). After aorta and inferior vena cava anastomosis total ischemic time ranged from 1 hr 20 to 6 hr 30. Graft was anastomosed on proximal end; both distal graft and own intestine were exteriorized as stomas. Initial immunosuppression included solumedrol 2 mg/Kg/d and Cyclosporine as a contlnous infusion for RIA serum levels 200-300 ng/ml. Antilymphoglobuline (ALG) (5 mg/Kg/d) for 14 days were added in the last 4 cases. Systemic antibiotics and total decontamination of the graft are associated. The first graft was removed after 8 hours for ischemia; the child was discharged on home PN. Early (< 15 days) or delayed (2-6 mths) acute graft rejection (GR) occured in all cases. Late clinical symptoms included increased ileostomy drainage while histologic pattern changed earlier including progressively : T cell infiltrates (CD4+, CD8+, CD25+), increased HLA DR expression by crypts enterocytes, villi oedema, destruction of crypt and surface epithelium, crypt sbcesse and finally mucosal sloughing. GR was treated with ALG or OKT3 but leaded to graft removal in 3 cases 3 wks to 6 mths after SIT. One graft was removed on the 17th mth because of chronic rejection. Four graft were progressively used from the 4th wk tolerating up to 90 % of total energy intakes, like in one patient still living with the graft for 10 mths. Functionnal assesment included baryum transit, enzyme activities, and absorption tests. Those results show that SIT is possible but depending on important immunosuppression. No GVH reaction was observed. GR can be limited by repeated immunohistochemical study and early treatment.

Fetal weight estimation from ultrasonic three-dimensional head and trunk reconstructions: Evaluation in vitro

The theoretical usefulness of volume as a predictor of fetal weight was assessed on 25 dead neonates with weight ranges between 364 and 3,650 gm. The correlation between volume, measured by water displacement, and weight was r = 0.999, with a standard error of 37 gm. A method is described for using volume, calculated from three-dimensional ultrasonic head and trunk reconstructions, to predict fetal weight. For the dead neonates, the correlation between measured weight and calculated head plus trunk volume was r = 0.985, with a standard error of 190 gm. The regression coefficient was 1.73, thus indicating that head and trunk volumes underestimate weight, as might be expected since limbs were not included. We conclude from this “ideal” situation that volume measurements will eventually provide the best estimates of fetal weight, and that three-dimensional head trunk reconstructions are reasonably accurate measures of overall volume.