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S t a t e Unlv., Hutzel osp. ~? l~p . % t~l i c h . , Dept. of Peds., D e t r o i t , Mich.H(Intr? by P.V.Woolley, J r . )A number of h o s p i t a l s s t i l l e x i s t w i t h t h e i r neonatal I C U n o t w i t h i n t h e v i c l n i t y of the d e l i v e r y rooms.Thismeans t r a n s p o r t i n compromised & u n s t a b l e i n f a n t s some d i s t a n c e t o reach t h e I~U . At Hutzel Hosp. t h i s problem was solved by t h e u s e of a NRRU i n t h e d e l i v e r y s u i t e . This r e p o r t e v a l u a t e s our experience. The NRRU was deslgned a s a miniature I C U & can accomodate 2 i n f a n t s . Hieh-risk i n f a n t s w i t h ~r o b l e m s d u r i n e d e l i v e r v and those born c i t h low APGAR scores were admitted Fo t h e NRRb f o r observation s t a b i l i z a t i o n of v i t a l s i g n s and/or f u r t h e r treatmenf. A nurAe from t h e neonatal ICUwas c a l l e d t o t h e NRRU i f a p a t i e n t was a n t i c i p a t e d . The i n f a n t s w e r e transf e r r e d o u t of t h e NRRU on1 a f t e r v i t a l s i g n s had s t a b i l i z e d & s k i n temp. was a t l e a s t 87 F.RESULTS: During a 10-monthperiod t o e.(1) t r a n s f u s i o n f o r seve;e va L n d z % meconium a s p i r a t i o n (67) 5 t677) & 4 normal APGAR but high-&k l m i n ;~~& d = 3 . 6 f 2.7 w i t h 89% r e q u i r i n g birthweight=2183*954g.Mean d u r a t i o n of s t a y = 4 8 . 3 m i n . 43% o f those admitted subsequently died b u t t h i s roup h a d a s i gn i f i c a n t l y lower gestational age weight &AP&R s c o r e corn ared t o those who survlved (P<0.005). f t cannot be concluded wtethe r theNRRUhas 1m roved s u r v i v a l but t h e 58% s u r v i v a l o f Inf a n t s w i t h m e a n~f G A~o f 3 6 i s encouraging One f a c t o r f o r t h i s might be t h e b e t t e r ;emp. of t h e babies upon a r r i v a l a t t h e ICU (97 I t 0 9) I n c o n t r a s t s k i n temp. on admission t o t h e NRRU = 95.8 ' l . f~. . I t was a l s o Aoted t h a t working i n t h e NRRU was more convenient because a e d i a t r i c nurse a s s i s t e d & n e ce s s a r y e uipment was on hand $he NRRU a l s o prevented th? holdi n up 03 a d e l i v e r y room (mean = 48.3 min.) because of an I n f a n t . ~h f s allowed more tlme f o r t h e i n f a n t t o s t a b i l i z e c o m p l e t e l y b e f o r e being transported.It i s f e l t t h a t a NRRU can be used f o r optimal c a r e t o I n f a n t s . THE ROLE OF A PEDIATRIC NURSE PRACTITIONER (PNP) I N A NEONATAL UNIT. ( I n t r . n g 3 . , v . Hutzel Hosp., D e t r o i t , Mich.The Hutzel Hos i n D e t r o i t has an annual d e l i v e r y r a t e of 56862 96 l i v e b i r t k LB & a neonatal m o r t a l i t y &morbldity r a t e o f 18 6* 1 0 & 286*$0 !!per 1000 LB r e s p e c t i v e l y Theprematur r t ;ate i s 11 2 * i 6%. I t was f e l i t h a t w i t h a 'significant n u d e r of high-kjsk ' & s i c k newborns r e q u i r i n g c a r e l e s s e r a t t e n t i o n was belng given t o t h e w e l l newborns a s t a r a s more frequent ...

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Cells from three patients with early gonadal failure and a balanced reciprocal translocation involving the long arm of the X chromosome and an autosome were studied. Fibroblasts from a patient with a similar balanced reciprocal translocation but normal reproductive capabilities were also studied. Two of the four patients were found to have serologically detectable H-Y antigen on their cells. Since H-Y antigen has been found on the cells of other patients with X chromosome abnormalities but without a Y chromosome, it is thought that the X chromosome plays a role in the regulation of H-Y antigen expression. This study suggests that the long arm of the X chromosome may be involved but the location of a regulatory gene cannot be identified in these studies. These cases do not permit us to implicate H-Y antigen as a cause of gonadal dysgenesis and early gonadal failure in females who have structurally abnormal X chromosomes.