Hr Of Life Research Articles

No time to relax: Age-dependent infectivity of cercariae in marine coastal ecosystems.

Age dynamics of the ability of cercariae of two digenean species, Himasthla elongata (Himasthlidae) and Renicola parvicaudatus (Renicolidae), to infect the second intermediate host (SIH), mussels (Mytilus edulis), was investigated experimentally. This is the first study of this kind made on cercariae transmitted in the intertidal of the northern seas. The larvae of all tested ages (from 0.5 to 6 hr) were equally successful in infecting mussels. This finding disagrees with the literature data on cercariae of several freshwater digeneans, which are practically incapable of infecting the SIH during the first 1-3 hr of life. The presence of a time delay before the attainment of the maximum infectivity (TDMI) may be associated with the need for physiological maturation of cercariae in the very beginning of their life in the environment, the need for their broad dispersion, and the prevention of superinfection of the downstream host. The absence of TDMI in the cercariae examined in our study could be associated with the instability of environmental factors in the marine intertidal (wave impact, tidal currents). These factors promote a broad dispersion of cercariae in the intertidal biotope and prevent superinfection of potential SIHs. Biological and behavioural features may also play a role. We hypothesize that the presence or absence of TDMI does not depend on the taxonomic affiliation of the cercariae but is determined by the transmission conditions.

Outcome of Respiratory distress in Neonates with Bubble CPAP at Neonatal Intensive Care Unit of a Tertiary Hospital

Respiratory distress is one of the commonest problem seen in neonates during admission in Neonatal Intensive Care Unit. Hyaline Membrane disease, Meconium Aspiration Syndrome, septicemia, congenital pneumonia, Transient Tachypnea of Newborn are the major causes of respiratory distress in neonates. Bubble Continuous Positive Airway Pressure is a non-invasive respiratory support delivered to a spontaneously breathing newborn to maintain lung volume during expiration. The main objective of this study was to observe the outcome of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure. This was a descriptive cross-sectional study conducted at Kathmandu Medical College Teaching Hospital over six months (October 2018 - March 2019) period. All preterm, term and post term babies with respiratory distress were included. Ethical clearance was received from Institutional Review Committee of Kathmandu Medical College and statistical analysis was done with SPSS 19 version. Sixty three babies with respiratory distress were included in this study with 45 (71%) male predominance. The mean birth weight receiving Bubble Continuous Positive Airway Pressure was 2661.75±84 gms and gestational age was 36.67±3.4 wks. The Bubble Continuous Positive Airway Pressure was started at 8.05±2 hr of life and duration of Bubble Continuous Positive Airway Pressure required for settling respiratory distress was 95.71±3 hrs. Out of 63 babies, improvement of respiratory distress in neonates with Bubble Continuous Positive Airway Pressure was 39 (61%) with confidence interval of 38% to 62% whereas 24 (39%) babies required mechanical ventilation and other modalities. This study concludes usefulness of Bubble Continuous Positive Airway Pressure in neonates with respiratory distress.

Interleukin-1β, interleukin-6, and tumor necrosis factor-α in the cerebrospinal fluid of term infants with hypoxic-ischemic encephalopathy after postnatal treatment with magnesium sulfate

Proinflammatory cytokines play a role in the pathogenesis of hypoxic-ischemic encephalopathy (HIE). We aimed: 1) to characterize the expression of interleukin-1 β (IL-1 β ), IL-6 and tumor necrosis factor- α (TNF- α ) in the cerebrospinal fluid (CSF) of term infants with HIE, and 2) to determine the impact of a single dose of magnesium sulfate (MgSO 4 ) on their concentrations. We analyzed the samples of CSF that were collected during a randomized controlled trial on the use of MgSO 4 in neonatal asphyxia. Two samples were obtained from each subject; one was obtained on admission and the second sample was collected at 72 hr of life. The grades of HIE in the 47 included newborns were mild ( n = 15), moderate ( n = 17), and severe ( n = 15). After the collection of the first CSF sample, 23 newborns received a single dose of MgSO 4 , whereas the other 24 newborns received an equal volume of normal saline placebo. Concentrations of IL-1 β , IL-6 and TNF- α in the CSF were quantified by enzyme-linked immunosorbent assay in all CSF samples. The initial concentration of IL-1 β and IL-6 correlated with the severity grades of HIE ( P = 004 and P = 0001, respectively) while TNF- α did not. At 72 hr, a significant decline in the concentration of TNF- α (pg/mL) was observed in samples of MgSO 4 -treated infants when compared to the control group (–28 ± 90 vs. 102 ± 404, P = 0.01), whereas the two treatment groups did not differ in IL-1 β or IL-6. Short-term clinical outcomes correlated best with IL-1 β at baseline, IL-6 at baseline and IL-6 at 72 hr. We conclude that cytokine activation, as manifested by increased IL-1 β and IL-6 in the CSF, is positively correlated with the severity of HIE. Treatment with a single dose of MgSO 4 was efficacious in aborting the activation of TNF- α but did not alter the expression of IL-1 β or IL-6.

EEG and the newborn

Despite the evolution of new technologies for assessing neonatal brain function, electroencephalography (EEG) remains a powerful tool for neurological diagnosis and prognosis in neonates. It is considered the gold standard for distinguishing epileptic seizures from non-epileptic paroxysmal events and for detecting subclinical seizure activity in high-risk babies. In those babies severely ill, EEG is even more efficient as predictive test than the neurological examination. The prognostic value of neonatal EEG has been long recognized in term as well as in preterm infants. Background patterns, more that patterns of ictal discharges, correlate significantly with the long-term outcome. Although most abnormalities on the neonatal EEG are nonspecific, certain patterns can be highly suggestive for diagnosis. Prognostic value can be increased by obtaining early recordings, possibly within the first 48 hr of life, prolonged recordings to include samples of different activity states, and serial EEGs at short intervals to assess rapid changes that are likely to occur in high-risk infants. It is important to distinguish neonatal seizures from neonatal-onset epilepsies and epilepsy syndromes. Both benign and malignant neonatal epilepsy syndromes exist. While benign familial neonatal seizures represents a neonatal syndrome with benign outcome, early myoclonic encephalopathy and Ohtahara syndrome are the earliest form of age-dependent severe epilepsy syndromes. Early myoclonic encephalopathy and Ohtahara syndrome are both characterized by the presence of a burst-suppression EEG pattern. This pattern is usually associated with a poor prognosis and is considered the electroencephalographic correlate of a complete disconnection within the thalamocortical systems. Migrating partial seizures in infancy is a newly recognized epilepsy syndrome whose onset can be in the neonatal period. It is characterized by multifocal intractable seizures associated with psychomotor impairment. No etiology has been found so far. Different drugs currently used in neonatal intensive care unit, especially if in the toxic range, can alter the EEG background. Those effects need to be taken in account in the interpretation of neonatal EEG.

Right heterotaxy with Hirschsprung's disease—A new association

A baby girl with prenatal diagnosis of complex cardiac anomalies and diaphragmatic hernia was born at 36 weeks of gestation. At 4 hr of life, the baby developed respiratory distress and was intubated. She was found to have right hetetrotaxy with total anomalous pulmonary venous drainage into the portal vein, five hepatic veins draining the liver and intrathoracic herniation of the stomach. The child also developed abdominal distension on the second day of life with passage of scanty meconium. The diagnosis of Hirschsprung's disease (HD) was confirmed by histology. HD in association with right heterotaxy has not been reported earlier. The association of heterotaxy with HD in our patient raises a possible genetic link between the two anomalies that needs further research.

Thrombin activatable fibrinolysis inhibitor activity, thrombin‐antithrombin complex and D‐dimer levels in preterm neonates with early respiratory distress syndrome

Intraalveolar fibrin deposition found in neonates with respiratory distress syndrome (RDS) is explained by the activation of the coagulation system and inefficient fibrinolysis. However, thrombin activatable fibrinolysis inhibitor activity (TAFIa), an inhibitor of fibrinolysis, and the ratio of D-dimer to thrombin-antithrombin complex (D-dimer/TAT), an index of fibrinolytic activity, have not been reported previously in neonatal RDS. Aim of this study is to evaluate the influence of plasma TAFIa levels on the fibrinolytic state in neonatal RDS. The RDS group (Group 1) consisted of 29 neonates, and 18 neonates served as the control group (Group 2). Plasma TAFIa levels and D-dimer/TAT ratios were evaluated in all neonates in the first 6 hr of life. Neonates in the RDS group were further divided into two subgroups; Group 1a consisted of 12 neonates with evidence of mild asphyxia (Apgar score at 5 min <7 and cord pH <7.26), and Group 1b consisted of 17 nonasphyxiated neonates. No significant difference was found in TAFIa levels and D-dimer/TAT ratios between Groups 1 and 2 [214% (56.2-361%) and 124.3 (4.4-3,921) in Group 1 and 201% (60.3-381%) and 147 (5.9-1,426) in Group 2]. There were negative correlations between cord pH and TAFIa levels in both groups. Increased TAFIa levels and decreased D-dimer/TAT ratios and platelet counts were detected in mildly asphyxiated neonates when compared with nonasphyxiated ones. TAFIa is not responsible for the hypofibrinolytic state reported in RDS. However, asphyxia influences TAFIa levels and increased TAFIa levels depress fibrinolysis.

Infection Dynamics of Centrocestus armatus Cercariae (Digenea: Heterophyidae) to Second Intermediate Fish Hosts

The infection dynamics of Centrocestus armatus cercariae with respect to second intermediate fish hosts were investigated using cercariae collected from naturally infected Semisulcospira libertina. Cercariae survival and infectivity were recorded at 2-hr intervals. Survival remained constant but decreased abruptly at 30 hr of age. An age-dependent model presented the best-fit curve for the survival data (r2 0.936), implying that cercariae tended to allocate resources equally among themselves and then died once those resources were depleted. Cercariae infectivity remained constant over the first 10 hr of life and then declined; an age-dependent model also provided a better fit (r2 = 0.956). The transmission rate of C. armatus cercariae to the fish host was relatively low near the time of emergence from the snail host but peaked at 85% after 1 hr and then maintained a plateau period until 5 hr of exposure to fish. The pattern of transmission was also investigated initially at varying densities of cercariae and then by maintaining a constant cercariae density but varying the total number. Results revealed that the pattern of transmission was frequency-dependent.

Randomized trial comparing two natural surfactants (Survanta vs. bLES) for treatment of neonatal respiratory distress syndrome

Exogenous surfactants have been used as an effective treatment of neonatal respiratory distress syndrome (RDS). Different preparations of surfactant carry different biophysical and clinical properties. To study the response pattern and treatment outcome of two natural surfactants (bLES and Survanta) for the treatment of RDS, we conducted a randomized clinical trial at the neonatal unit of a university teaching hospital. Premature babies with birth weight between 500-1,800 g who developed RDS requiring mechanical ventilation with an oxygen requirement of more than 30% within 6 hr of life were randomized into two treatment groups. Oxygenation indices (OIs) within 12 hr of treatment were compared as primary outcomes, while neonatal complications were analyzed as secondary outcomes of the study. Sixty babies were recruited, with 29 in the bLES and 31 in the Survanta treatment group. Both groups had significant and sustained improvements in OI after surfactant replacement therapy (SRT), while the bLES group was associated with a significantly lower OI throughout the initial 12 hr after treatment compared with the Survanta group. There was no difference in secondary outcomes including mortality, ventilator days, and occurrence of chronic lung disease. We conclude that infants with RDS respond favorably to both types of surfactant replacement, and that bLES achieved a faster clinical response in terms of improvement in OI than Survanta.

Perinatal expression of leptin in rat stomach.

It has been reported recently that the stomach can produce and store leptin and release it, both into the blood and into the gastrointestinal lumen, in response to food intake. Here, we have followed the ontogenic pattern of leptin mRNA expression and leptin levels in stomach during the perinatal period, which were compared with adults. Leptin mRNA expression was assessed by reverse transcriptase-polymerase chain reaction, and tissue leptin content by enzyme-linked immunosorbent assay and localised by immunohistochemistry. Leptin mRNA is expressed at low levels in rat stomach in prenatal stages. It increased from 4 to 8 hr of life in suckling rats, an increase not observed in the fasted pups, which were separated from their mothers immediately after birth. Leptin expression rose steadily after birth during the first month of life, with a marked increase from 15-day-old rats, followed by a parallel increase in leptin levels from day 21 of life, which was coincident with the change from suckling to a solid diet. The immunohistochemical analysis showed leptin immunoreactivity at different levels of the stomach mucosa, suggesting that during early development leptin could derive from different sources. During the pre- and neonatal periods, leptin is mainly located at the superficial epithelium (suggesting maternal origin from amniotic cells and mammary glandular cells, respectively). At the beginning of the chow diet, the stomach produces leptin in the glands (main source from 15 days of life), suggesting an endogenous production of the protein after that period. The present work demonstrates the expression of leptin mRNA and leptin protein in the stomach of neonate rats, and shows that the ontogenic profile of leptin appearance in the stomach during the perinatal period is probably related to the onset of suckling and to the change of diet from milk to solid chow.

Maternal risk factors for perinatal septicemia due to the Enterobacteriaceae.

Cases of perinatal septicemia due to the Enterobactericeae, which manifest in the first 24 hr of life were analyzed for the presence or absence of the maternal risk factors defined in the CDC group B streptococcus (GBS) risk-factor protocol. Microbiological data involving blood culture isolates were reviewed for the recovery of an Enterobacteriaceae from January 1975 through June 1995. Enterobacteriaceae perinatal septicemia was defined as the recovery an Enterobacteriaceae from one or more set of blood cultures in the first 24-36 hr of life in conjuncture with clinical evidence of neonatal stress in the first 24 hr. A case would also be considered of perinatal origin for cultures obtained up to 36 hr provided that evidence of clinical disease was present in the first 24 hr of life. Fifteen cases of perinatal septicemia due to the Enterobacteriaceae were analyzed. All but four shared one or more maternal risk factors. The maternal risk criteria established to avert early-onset GBS disease are commonly encountered in women destined to have newborns with perinatal septicemia due to the Enterobacteriaceae. Antibiotic selection for risk-driven protocols for GBS avoidance may need to be broadened to address the issue of coverage for penicillin-sensitive and penicillin-resistant Enterobacteriaceae.

Perinatal factors predicting severe intracranial hemorrhage.

The objective of this paper is to determine the importance of perinatal factors predicting occurrence of severe intracranial hemorrhage (ICH) in premature newborns. A post-hoc analysis of a previously published randomized, double-blinded, prospective trial was performed. Logistic regression analysis was used to assess the importance of obstetrical variables and umbilical cord blood coagulation studies and acid-base status in predicting severe ICH (grades 3 and 4). The trial lasted 42 months; 401 pregnant women were invited to participate and 48 declined. The most important predictors of severe ICH in order of decreasing significance were: gestational age at delivery (p=0.0001), duration of painful labor (p=0.0077), duration of antenatal antibiotic therapy (p=0.0203), maternal age (p=0.0247), and factor X activity in umbilical cord blood (p=0.0302). Mode of delivery, cord blood acid-base, and coagulation status did not correlate with severe ICH. The majority of severe ICHs were late in onset; only two of 31 were known to have occurred in the first 24 hr of life. Gestational age, duration of painful labor, duration of antibiotic therapy, and maternal age were the most important predictors of severe ICH.

Intermediate filaments in the developing type II cell of fetal monkey lung.

Anticytokeratin monoclonal antibody was used to study epithelial cell development in fetal monkey lungs taken from animals of different ages. It is well established that the overall maturity of fetal lung depends greatly on the maturation of type II epithelial cells in the alveolus. In this study, we have correlated the cytokeratin phenotype of mammalian epithelial cells with pneumocyte maturation. We show that differentiation and maturation of the type II cell is related to intermediate filament expression. Twenty-four fetal monkeys (Macaca nemestrina) were delivered by cesarean section at a gestational age of 135-140 days (term = 168 days) and divided into two groups. One group of animals was sacrificed during the first 3 hr of life, and the other group was maintained in incubators for 92-120 hr. Anticytokeratin monoclonal antibody recognizes only alveolar type I and type II epithelial cells. In the first 3 hr of life, the cytokeratin was localized only at the alveolar surface and at the cytoplasmic periphery of the type II cells of these premature animals. However, at the age of 92-120 hr, the epithelia in the lungs reacted more intensely than they did during the first 3 hr. Electron microscopy revealed and confirmed that the type II cells were matured and abundant intermediate filaments appeared in the cytoplasm. The filaments appeared to form either aggregates or parallel filament bundles and few were closely associated with the lamellar bodies. In the immature type II cells at 0-3 hr of life, few intermediate filaments could be localized in the cytoplasm, and no parallel filament bundle was observed, though many appeared in the 92-120 hr lungs. This suggests that the intermediate filaments have a functional significance in the development and maturation of the type II cell. The location and stability of keratin filaments in type II cells may confer the structural strength necessary for cells covering a free surface in the alveoli during lung maturation.

NORMALIZING FUNCTIONAL RESIDUAL CAPACITY (FRC) IN RDS

PEEP is used in infants with RDS to counter atelectasis and maintain FRC. FRC is controlled by PEEP yet blood gases, not FRC, are the bases for selecting ventilator settings. To test the hypothesis that maintenance of normal FRC leads to improved pulmonary function and reduced mortality, six paired twin lambs delivered prematurely (125-132 days, term is 147) were ventilated, initially, with peak inspiratory pressures (PIP) of 32 cm H2O, 6 cm H2O PEEP, 0.33 sec inspiratory time and 60 BPM while on 100% O2 and then monitored for 24 hr. In the control group ventilator settings were adjusted using criteria based on arterial blood gas analyses. In the study group, FRC was maintained within normal limits (25±2SE ml/kg) by adjusting PEEP. The study group FRC on the initial PEEP of 6 cm H2O ranged from 9 to 55 ml/ kg. PEEP required adjustment in 5 of these 6 lambs. Mean PIP, PEEP and mean airway pressures (Paw) during the 1st 8 hr of life were 29.6, 5.5 and 7.1 cm H2O (study group) and 40.4, 2.8 and 6.8 cm H2O (control). Of the 12 lambs studied, 6 died before 24 hr; 4 control and 2 from the study group. Even though Paw of the two groups were not different for the 8 hr period, PaO2/FiO2 of the study group was significantly greater than the control group (156±20 vs 112±16 mmHg). Also, the driving pressure (PIP-PEEP) was less in the study group, yet, PaCO2 was significantly less in the study group than the control group (28±2 vs 39±3 mmHg). These preliminary data suggest that the normalization of FRC improves pulmonary function and may reduce mortality of lambs with RDS.

A Quantitative Model for Hyaline Membrane Disease

A model based on the course of 31 infants with uncomplicated hyaline membrane disease is described. Based on data collected over the first 12 hr of life, it predicts the course of an infant for the next 60 hr, and estimates the outcome in terms of length of oxygen requirement and assisted ventilation. For the construction of the model, right-to-left intra- and extra-pulmonary shunting, expressed as venous admixture, was considered as the principal mechanism of hypoxemia in hyaline membrane disease and mean applied proximal airway pressure was used to quantify management. The model provides an objective estimate of severity early in the course of disease, uses variables routinely available in an intensive care unit, and its use would strengthen the interpretation of clinical studies in which the comparability of experimental and control groups is critical.

Fetal and neonatal responses to maternal canine starvation: circulating fuels and neonatal glucose production.

Pregnant dogs were starved for 72 hr while controls were fasted overnight. Maternal starvation significantly reduced fetal birth weight (269 +/- 7.2 versus 294 +/- 4.4 g). Total caloric deprivation had no effect on maternal or fetal blood glucose concentration at the time of delivery; however, fasting neonatal blood glucose levels were depressed during the first 9 hr of life. Starvation produced a large elevation of maternal free fatty acids (1.68 +/- 0.39 versus 0.74 +/- 0.2 mM) and ketone bodies (2.99 +/- 0.70 versus 1.04 +/- 0.48). Although fetal free fatty acids increased minimally (0.39 +/- 0.03 versus 0.22 +/- 0.07), ketone body levels were markedly elevated (2.53 +/- 0.35 versus 1.01 +/- 0.32). After birth, plasma-free fatty acid and beta-hydroxybutyrate levels were lower in pups of starved mothers at 3 hr, and acetoacetate was lower at 6 and 9 hr. Other alternate fuels such as amino acids demonstrated lower levels of glutamine in pups of starved mothers throughout the day (except 3 hr), whereas alanine levels declined significantly only at 24 hr (114.9 +/- 15 versus 187.6 +/- 26 microM. Glucose production was significantly depressed in pups of starved mothers at 3 (13.7 +/- 1.4 versus 22.7 +/- 3) and 9 hr (17.5 +/- 2.2 versus 26.0 +/- 2.8 mumoles/kg/min), whereas glucose clearance rates were elevated at 3, 6 and 9 hr of age. Lactate carbon incorporation into glucose increased throughout the day but was not significantly affected by prior maternal starvation.

Fetal and neonatal cerebral metabolism following maternal canine starvation.

Pregnant dogs were starved for 72 hr before a term delivery. Maternal (1.68 +/- 0.39 versus 0.74 +/- 0.20 mM) and fetal (0.39 +/- 0.03 versus 0.22 +/- 0.07) circulating free fatty acids and maternal (2.99 +/- 0.79 versus 1.04 +/- 0.84) and fetal (2.53 +/- 0.35 versus 1.01 +/- 0.32) ketones were elevated whereas blood glucose values remained unchanged at the time of delivery. After birth, pups born to starved mothers had significantly lower blood glucose values during 3, 6, 9, and 24 hours of neonatal fasting. Intracerebral glucose concentrations paralleled those in the blood as they were depressed at 3, 6, and 9 hours of age. Cerebral glycogen content was lower in pups born to starved mothers at 6 (2.72 +/- 0.43 versus 4.32 +/- 0.56 mumoles/g) and 24 (2.31 +/- 0.17 versus 3.48 +/- 0.39 mumoles/g) hr, whereas UDP-glucose concentrations were significantly elevated in these pups during fetal, 3, 9, and 24 hr of age. Phosphoenolpyruvate was higher after maternal starvation in the fetus and at 6 and 9 hr, whereas cerebral pyruvate concentrations were elevated at 3, 6, and 9 hr of age. The elevation of pyruvate with no alteration of lactate concentration resulted in an elevated cytoplasmic NAD/NADH ratio at 3 hr of age (1381 +/- 194 versus 792 +/- 198). Cerebral alpha-ketoglutarate and calculated oxaloacetate concentrations were elevated throughout the day after maternal starvation whereas malate concentrations were depressed at 3 and 9 hr of age. Cerebral energy charge was unaffected, whereas the calculated energy reserve was lower at 3, 6, and 24 hours. Cerebral amino acids demonstrated elevated aspartate concentrations at 3 and 6 hr. Cerebral glutamine concentrations were lower during fetal stage (7.86 +/- 0.52 versus 10.01 +/- 0.41 mumoles/g) and 3, 6, and 9 hr of life.

Fetal and Neonatal Cerebral Metabolism Following Maternal Canine Starvation

Summary: Pregnant dogs were starved for 72 hr before a term delivery. Maternal (1.68 ± 0.39 versus 0.74 ± 0.20 mM) and fetal (0.39 ± 0.03 versus 0.22 ± 0.07) circulating free fatty acids and maternal (2.99 ± 0.79 versus 1.04 ± 0.84) and fetal (2.53 ± 0.35 versus 1.01 ± 0.32) ketones were elevated whereas blood glucose values remained unchanged at the time of delivery. After birth, pups born to starved mothers had significantly lower blood glucose values during 3, 6, 9, and 24 hours of neonatal fasting. Intracerebral glucose concentrations paralleled those in the blood as they were depressed at 3, 6, and 9 hours of age. Cerebral glycogen content was lower in pups born to starved mothers at 6 (2.72 ± 0.43 versus 4.32 ± 0.56 μmoles/g) and 24 (2.31 ± 0.17 versus 3.48 ± 0.39 μmoles/g) hr, whereas UDP-glucose concentrations were significantly elevated in these pups during fetal, 3, 9, and 24 hr of age. Phosphoenolpyruvate was higher after maternal starvation in the fetus and at 6 and 9 hr, whereas cerebral pyruvate concentrations were elevated at 3, 6, and 9 hr of age. The elevation of pyruvate with no alteration of lactate concentration resulted in an elevated cytoplasmic NAD/NADH ratio at 3 hr of age (1381 ± 194 versus 792 ± 198). Cerebral α-ketoglutarate and calculated oxaloacetate concentrations were elevated throughout the day after maternal starvation whereas malate concentrations were depressed at 3 and 9 hr of age. Cerebral energy charge was unaffected, whereas the calculated energy reserve was lower at 3, 6, and 24 hours. Cerebral amino acids demonstrated elevated aspartate concentrations at 3 and 6 hr. Cerebral glutamine concentrations were lower during fetal stage (7.86 ± 0.52 versus 10.01 ± 0.41 μmoles/g) and 3, 6, and 9 hr of life. Speculation: These data suggest that cerebral glycogen synthesis was diminished and that the oxidation of cerebral amino acids, in particular glutamine, may contribute to maintain cerebral energy production during the relative fasting neonatal hypoglycemia which develops in pups after maternal starvations.

Increased Serum Gastrin Concentrations and Gastric Acid Hyposecretion in the Immediate Newborn Period

Thirty-two infants and their mothers were studied to determine the source of elevated serum gastrin concentrations in umbilical blood and to learn whether neonates hypersecreted acid in response to hypergastrinemia. Gastrin concentrations in the umbilical artery and vein were similar. Both were significantly higher than maternal gastrin concentrations. No significant amount of gastrin could be measured in placental extracts. These results suggest that the increased neonatal gastrin concentrations were fetal in origin. Continuous basal acid secretory studies done for 4 hr in 32 infants and for 8 hr in 9 infants demonstrated hyposecretion of gastric acid for the first 5 hr of life. Acid secretion from hour 6 to 8 was similar to that in older children. Increased gastrin levels were still present at hour 8 and were associated with normal gastric acid secretion.

Bochdalek hernias in infants:Factors determining mortality

From 1950 through 1974, 76 infants with Bochdalek hernias have been surgically repaired. Mortality has been confined to those admitted at under 30 hr of age, and the highest mortality has been among those infants admitted within the first 8 hr of life. A recent increase in mortality is explained by the arrival of a new group of infants who arrived intubated, had large diaphragmatic defects, required postoperative ventilatory assistance, and had hypoplastic lungs at autopsy. Six infants might have benefited from an early intervention to hasten closure of their patent ductus arteriosus. Since we cannot be positive that intubation of these infants prior to arrival will not have a deleterious effect, we urge great discretion in choosing which infants to intubate.

Weight gain as a consequence of maternal behavior in the rat

The purpose of this paper was to determine whether a relationship existed between maternal behavior during the first few hours of life and subsequent growth of rat pups. One-hour old pups were weighed and were then returned to their natural mother or fostered to 10-day lactators. Observations were taken of maternal behavior between Hours 1–2 and Hours 11–12. At Hour 12 all pups were reweighed, and those who had been with their own mothers were fostered to 10-day lactators while the others were returned to their foster mothers. Pups who were with their own mothers for the first 12 hr of life weighed more at weaning than did pups who were with 10-day lactators for the first 12 hr. The behavioral observations found that newly parturient females became quiet when 1-hr old pups were presented to them, and the pups began nursing shortly thereafter. In contrast, 10-day lactators given 1-hr old pups spent half as much time nursing them as did newly parturient mothers; they licked the pups and left them alone more often, and spent more time grooming themselves and eating. These findings show that persistent weight differences through weaning are associated with characteristics of the maternal environment during the first few hours of life. The implications of these findings for other research areas are discussed.