Here, we demonstrate that gene-expression profiles reflect clinical parameters. Our results suggest that microarray technology and clinical variables can be used for the future identification of central molecular pathways in plaque instability.

No abstract

Total serum bilirubin level was assessed in a group of jaundiced low birth weight infants using three different methods. Transcutaneous bilirubinometry was compared with conventional capillary and arterial methods to investigate the over-or underestimation of neonatal jaundice. Sampling site did not influence bilirubin levels. Capillary and arterial results showed a linear correlation (r = 0.9) suggesting no influence of environmental light on peripheral bilirubin isomerization. Similar results were obtained comparing both serum levels with transcutaneous values (r = 0.7). We conclude that treatment decisions may be made on the basis of one of the three mentioned methods in healthy low birth weight infants with neonatal jaundice.

Changes of cerebral blood flow were determined in 20 preterm infants undergoing blue-light phototherapy for hyperbilirubinemia. All were healthy very-low-birth-weight infants (< 1,500 g) with normal brain sonograms and not under pharmacological treatment at the time of the investigation. Blood flow velocity (pulsatility index and area under velocity curve) was measured by Duplex Scan technique during and after phototherapy. No changes of global cerebral blood flow were observed in the anterior cerebral artery (p < 0.5). Our results suggest no functional disturbance of cerebral autoregulation in low-birth-weight infants treated with phototherapy.

The potential of exogenous replacement therapy in surfactant-deficient states such as neonatal respiratory distress syndrome (RDS) is an area of intense clinical interest today. At present, a fundamental problem with any type of exogenous surfactant is the uncertainty about potential effects on physiological defense mechanisms, such as differentiation and mobilization of peripheral leukocytes. Considering that newborn infants with proven bacterial infections have abnormal values of segmented (neutrophil) and nonsegmented (band) polymorphonuclear leukocytes, we studied 42 placebo- versus Curosurf-treated babies with severe RDS. Differential white blood cell (WBC) count was serially performed before and after treatment during the first days of life. The statistically significant increase in the proportion of bands in surfactant-treated babies did not coincide with clinical and bacteriologic evidence of possible infection. Some molecular interaction mechanisms influencing immature to mature WBC ratio are supposed. Among a variety of influences on the leukocyte count, surfactant replacement therapy needs to be considered for proper interpretation of hematologic data in babies treated for RDS.

Surfactant replacement therapy in patients with neonatal respiratory distress syndrome (RDS) is a new therapeutic approach. There is now convincing evidence that the incidence and severity of RDS can be reduced. Surfactant (CUROSURF) was intratracheally applied to a group of fifteen intubated preterm infants with severe RDS (29 +/- 2.1 weeks of gestation and 1204 +/- 301 g birth weight) at 9.1 +/- 2.5 hours of life. For detection of potential neurological risk we performed serial ultrasound examinations (US), serial measurements of Creatine-Kinase Isoenzyme levels (CK-BB) looking for the presence of human antibodies to different brain antigens (BSA) as markers for neonatal cerebral injury. Using these diagnostic methods, there was no evidence of any negative influence of surfactant therapy on cerebral function of treated preterm infants.

No abstract

Parenteral human immunoglobulin (IVIG) administration is widely used in low birth weight (LBW) infants for prevention and therapy of neonatal infection. In previous studies, IVIG preparations containing IgG and low IgM concentrations were commonly used. In this study we compare immunoglobulin serum levels in two groups of healthy preterm infants receiving prophylactically standard IVIG (Sandoglobulin, 0.1 mg/kg IgM) or IgM-enriched IVIG (Pentaglobin, 30 mg/kg IgM). Immunoglobulin levels were assayed by rate nephelometry at birth and at 3, 5, 7, and 14 days after birth. The two groups of patients were matched for gestational age (31 +/- 2.3 weeks), birth weight (1320 +/- 340 g), and serum IgG (4.1 +/- 1.9 milligram) and IgM (0.22 +/- 0.18 milligram) levels at birth. Significantly higher IgM levels were observed at 3 and 5 days after IgM-enriched IVIG administration (p less than 0.01). Higher IgG levels were attained and persisted for 2 weeks after standard IVIG administration (p less than 0.01). These data indicate different IgG and IgM target levels in LBW infants treated with different immunoglobulin preparations.