Cord serum inhibits allogeneic mixed lymphocyte reaction and stimulates lymphokine production.

An inhibitory activity on the two-way allogeneic mixed lymphocyte reaction (MLR) was detected in maternal and cord serum at delivery. The inhibitory effect of the maternal serum was found to be more pronounced and was detected in almost all sera tested, whereas the inhibitory capacity of cord sera was observed in only 70% of the cases. In addition, a lower stimulatory activity for interleukin-2 (IL-2) production was found in the maternal serum, suggesting an additional mechanism for the suppression of the maternal immune system during pregnancy. On the other hand, a higher stimulatory activity for IL-2 production was observed in cord serum as compared with adult normal serum. The possibility that a fetal humoral factor is involved in the regulation of the immune system via the stimulation of IL-2 production is discussed.

Bart's syndrome: a mechanobullous disease of the newborn. Report of five cases and review.

Bart's syndrome is one among the lesser known presentations of epidermolysis bullosa. It is characterized by congenital localized bullae of skin and mucous membranes sometimes associated with nail deformities, all of which disappear during the neonatal period. Early recognition allows for avoidance of inappropriate systemic or local therapy.

Breast milk jaundice in preterm infants.

A retrospective study was performed comparing bilirubin levels in 40 preterm newborns with uncomplicated courses fed a combination of premature breast milk and formula to those of 60 comparable preterm newborns fed formula only. A significantly higher bilirubin level was noted in the group fed the combined diet on the 6th day of life and on the day of discharge. Seventy-six and seven tenths percent of the preterm infants fed breast milk and formula met the criteria for phototherapy, whereas only 45 percent were treated in the group fed formula alone. Our findings indicate that premature breast milk might cause early and late increase in bilirubin levels in healthy preterm newborns.

Neonatal factor XIII deficiency.

We describe a patient diagnosed in the neonatal period as having factor XIII deficiency who presented with persistent umbilical bleeding. Factor XIII deficiency is the only coagulation factor deficiency that cannot be detected by classical hemostatic tests, and a rapid diagnosis is vital during the first decade of life. A newborn presenting with persistent umbilical stump bleeding should be screened for factor XIII deficiency when routine coagulation tests prove normal.

Teratoma of the mastoid region in a newborn.

Teratomas are congenital tumours arising from pluripotent cells and usually consisting of tissue arising from all 3 embryonic germ layers. Teratomas are quite uncommon in head and neck sites and to date only 150 such cases have been reported. A rare case of teratoma of the mastoid region in a newborn is reported. The method of diagnosis and treatment are discussed and the literature is reviewed.

An infant with multiple deformations born to a myasthenic mother.

An infant with multiple deformations born to a mother with untreated myasthenia gravis presented with arthrogryposis multiplex, craniofacial dysmorphism, kyphoscoliosis of the thoraco-lumbar spine, severe hypotonia, absence of the sucking reflex, and other neurological deficits. The neurological state of the infant supported the diagnosis of congenital myasthenia gravis, but the negative Tensilon test and the lack of clinical improvement after prolonged Mestinon treatment ruled out this diagnosis. We believe that the multiple deformations and reduced fetal movements are related to the maternal myasthenic environment associated with mild polyhydramnion.

Fracture of the clavicle in the newborn. An ultrasound diagnosis.

Forty-one cases of clavicle fracture in newborn babies were examined by both radiographic and ultrasonic methods. No substantial difference has been found between these two modalities. It is suggested that ultrasound should be the procedure of choice in the diagnosis of clavicle fracture. This is especially true in those cases where impaired movement of the arm is the only clinical sign.

Beta glucuronidase and hyperbilirubinaemia in breast fed infants of diabetic mothers.

A prospective study was performed comparing bilirubin concentrations in 10 breast fed term infants of diabetic mothers (IDM) to those of 10 breast fed normal term infants. The beta-glucuronidase concentrations in serum and breast milk were assayed in the respective mothers. Significantly higher bilirubin concentrations were noted in the IDM group. Serum and breast milk beta-glucuronidase concentrations were significantly higher in diabetic mothers as compared with those of non-diabetic mothers. We suggest that the high concentration of beta-glucuronidase in breast milk of diabetic mothers is an additional important cause leading to hyperbilirubinaemia in their breast fed infants.

Production of interleukin-1 by mononuclear cells of newborns and their mothers.

The ability of peripheral blood mononuclear cells derived from newborn infants, their mothers and healthy adults to produce interleukin 1 (IL-1) was examined. It was found that newborn and maternal mononuclear cells have a normal capacity to produce IL-1. In addition, a lower stimulatory activity of IL-1 production was found in maternal serum, suggesting another mechanism for the suppression of the maternal immune system during pregnancy. Furthermore, evidence is presented on the existence of sex-related blocking factors in the maternal serum which affect IL-1 production.

Normal ranges of hip motion of preterm infants.

The hip motion of 158 preterm infants with gestational ages between 25 and 36 weeks was measured. The results of this study, compared with those of previous studies of term infants, show that hip motion changes with increasing gestational age above 25 to 27 weeks.

Expression of transferrin receptor on human maternal and neonatal peripheral blood lymphocytes.

The levels of peripheral blood lymphocytes expressing the receptor for transferrin (TSR) on untreated and phytohemagglutinin (PHA)-stimulated cell samples from maternal-neonate pairs were evaluated 4-12 h postpartum. Significantly increased levels of TSR+ cells were observed on fresh, unstimulated neonatal and maternal cells, as compared to control cells from young adult males and females, and the values seemed to correlate with the sex of the neonate and with birth order. The level of TSR+ cells in culture was found to be increased on neonatal cells and decreased on maternal cells.

Difference in the placental ferritin levels measured by a specific monoclonal antibody enzymoassay in preterm and term delivery.

The use of a new monoclonal antibody (MoAb) enzymoassay for the specific measurement of placental ferritin (PLF) enabled it to be quantitatively determined in the sera of pregnant women, women at full-term and preterm delivery, and in their newborns. High levels of PLF were measured in the sera of pregnant women at 17 weeks of gestation up to full-term delivery as compared with normal adult women who mostly lack PLF. The level of PLF in the serum was irrespective of the total ferritin level. In full-term newborns, PLF concentration was lower than that found in their mothers although it increased compared to healthy adults. It was further found that in the blood of women who delivered at 29-36 weeks, PLF was undetected or was very low. Accordingly their preterm infants also exhibited very low or undetectable PLF in their serum. These results suggest the possible use of PLF as a prognostic indicator in pregnancy.

X-ray microanalysis of the fingernails in term and preterm infants.

The element content of the fingernails of 10 term and 14 preterm infants, clipped for the first time after delivery, was determined by x-ray microanalysis. The results showed a decrease in sulfur and aluminum, and a higher chlorine content in term infants in comparison with preterm ones, the difference being statistically significant. Sodium, potassium, calcium, and zinc content did not differ in the two groups. Copper, iron, magnesium, aluminum, and phosphorus were detected in trace amounts only. Cobalt was not detected in the fingernails of newborns in either group. The elevated content of aluminum in the fingernails of preterm infants may be a clue to the osteopenia observed in these infants.

In vivo and in vitro effects of theophylline on the peripheral blood mononuclear cells from preterm infants.

The in vivo effect of aminophylline (theophylline ethylenediamine) on cAMP levels and the mitogenic response of peripheral blood mononuclear cells (PBMC) from preterm infants were investigated. Increased cAMP levels and reduced response of these cells to concanavalin A (Con A) were found in preterm newborns who received intravenous aminophylline. No inhibitory effect of the drug on phytohemagglutinin (PHA)-induced proliferation was observed. cAMP levels of PBMC derived from preterm infants were significantly lower than those of term newborns. The in vitro effect of theophylline on the mitogenic response of PBMC from adults, term and preterm infants was also compared. It was found that PBMC from adults were significantly more sensitive to the inhibitory effect of theophylline on Con A-induced proliferation than were PBMC from either term or preterm infants, whereas the effect of the drug on the mitogenic response to PHA was similar in the three groups. These data suggest differences either in the sensitivity to increased cAMP concentration between PBMC from adults and newborns or in their lymphocyte subpopulations.

Thrombopoietic activity in preterm newborns and infants.

Platelet count and thrombopoietic activity were investigated in preterm infants at birth and during their first four months of life. Thrombopoiesis stimulating factor activity in cord serum was significantly lower than that of adults and of the respective mothers. No difference was noted between thrombopoietic activity in cord serum in the various gestational ages studied--that is, 24 through 39 weeks. Preterm infants followed during their first four months of life showed a mean platelet count significantly higher than that observed in term infants at the respective age. Furthermore, thrombocytosis was found in premature thriving infants at the age of 1 and 2 months. It is suggested that this thrombocytosis is responsible for the low thrombopoietic activity observed in these infants during their first four months of life.

Thrombopoietic activity in newborn infants.

Platelet count and thrombopoietic activity were investigated in newborns and in infants during their first 4 months of life. Four-day-old newborns, although not thrombocytopenic, showed a significantly reduced platelet count as compared to that of control adults. Furthermore, a significantly lower thrombopoietic activity was found in the sera of newborns compared to that in the sera of adults. In addition, the thrombopoiesis-stimulating factor (TSF) activity in cord serum was significantly lower than that in the mothers' sera. Since 7 of 37 newborns examined in the present study showed a very low TSF activity, lower than that found in the saline controls, the possibility that an inhibitor for thrombopoiesis exists in the newborns is suggested and discussed. The follow-up study revealed a low TSF activity in the sera of 1-month-old infants followed by a gradually increased activity, reaching in the 4th month levels similar to those of adults. Concomitantly with the rise in TSF activity in the serum, an increased platelet count was observed.

IL-1 beta and IL-3-like activity in preterm infants.

The capacity of peripheral blood mononuclear cells (PBMC) of preterm neonates to release IL-1 beta and IL-3-like activity (IL-3-LA) has been investigated. In the present study it was found that this capacity is significantly lower than that of their mothers and of control adults. In addition, the results showed that preterm serum has a lower stimulatory effect on IL-1 beta production and an inhibitory effect on IL-3-LA secretion by PBMC of adult controls, in comparison with maternal and adult sera. These findings suggest an additional feedback mechanism for control of haematopoiesis in premature neonates. It is possible that the lower production of IL-1 beta and IL-3-LA may be involved in the increased susceptibility to infections of preterm newborns.