Summary: Labeled choline incorporation into adult rat lung type II alveolar epithelial cells and adult rat lung fibroblasts in monolayer culture was dgtennined after incubation with insulin (Ins) 10 μg/ml. Dexamethasone (Dex) 10-6 M, or no drug (ND). Incubation periods were 1. 3. 4, and 5 hours. The lecithin (phosphatidyl choline - PC) recovered was separated into disaturated phosphatidyl choline (DSPC) and unsaturated phasphatidyl choline (USPC). Results expressed as specific activity per hour (see Table) indicate that the incorporatian of choline into PC and USPC was greater in fibroblasts (F) than in epithelial cells (E) whether ND, Dex or Ins was present. For incorporation into DSPC, there was no difference between E and F whether ND, Dex or Ins was present. There was significant increase in choline incorporation into PC or USPC for both cell types when Ins was present, whereas there was no difference for either cell type when Dex was present. Insulin significantly increased choline incorporation into DSPC in E cells only. Dex was no different from ND in DSPC incorporation in either cell type. We attribute the greater lecithin synthesis of the F cells to a more rapid increase in cellular strucrural lipids in the fibroblast cell. Dex had no effect an either cell type from the short-term exposure or possibly because the effect of dexamethasone on alveolar epithelial cells is mediated by product(s) from other lung cells. and thus requires a mixed cell culture to have its effect. We suggest that further study of isolated homogeneous cell lines vill not be fruitful in the evaluation of mechanisms of acceleration of lung maturation. Speculation: Isolated alveolar epithelial cells shw a relatively greater increase in DSPC synthesis than do isolated fibroblasts in response to insulin. while neither cell type responds to short term glucocarticoid treatment. Since other investigators using mixed lung cell cultures have sham increased DSPC in response to insulin end even greater response with glucocarticoid treatment, it is likely that the presence of fibroblasts or other pulmonary cells is required for the alveolar epithelial cell to increase DSPC production in response to glucocorticoids.

Education of health professionals has an important role in improving health care. A media-based, self-instructional, perinatal education program was developed and field tested in rural and urban regions of Michigan. Cognitive tests, chart audits, and consultation/referral times were used to measure the impact on education and patient care. The program effectively increased knowledge and improved patient care practices by physicians and nurses. This study presents evidence that a targeted educational program in a media-based format can significantly improve perinatal care.

Clonally isolated and continuously cultured type II alveolar epithelial cells from adult rat lung (L-2) were compared to clonally cultured rat lung fibroblasts with respect to composition and biochemical function. There was no difference in phospholipid composition betweem those 2 cell types. After incubation with tritiated choline, the specific activity (cpm/nmol of lipid phosphorus) of disaturated phosphatidylcholine (PC) was lower than that of total PC in both cell types. Our findings suggest that, in our cell cultures, disaturated PC is not synthesized as a specific component of pulmonary surfactant, but more likely as a component of cell membranes. The increased DNA content of the L-2 cells indicates transformation and may be associated with the inability to synthesize surfactant. Under the described conditions, we are hesitant to use the clonally derived L-2 cell line as a model system for the study of pulmonary surfactant synthesis and secretion.

A modular, self-paced instructional program in neonatal respiratory distress was provided to all levels of health professionals and evaluated for its ability to cause cognitive change. The program consisted of 30 media packages (video-tape and slide-tape) and a study guide. Local hospital personnel in 3 communities were responsible for dissemination of the program to 187 potential participants. 63% of the MD's, 73% of the RN's and 64% of the LPN's completed eight or more of the packages. Cognitive change was assessed by written tests administered before and following presentation of the study materials in the community hospitals. All professional groups demonstrated a gain in cognitive level Score differences between pediatricians and obstetricians on pediatric care and obstetric care were significant (p<.05) in the pretest but no differences were found in the post-test. This community-based educational program was effective in increasing the cognitive level of learners representing wide differences in professional background. Changes in care were documented in the hospitals as a result of this program.

Chest radiographs of 29 patients with the clinical and radiographic diagnosis of RDS during the 5 days of the illness were graded according to a modification of the classification of Bomsel. There was no significant difference between the radiographs of surviving neonates and those who died of RDS. Mean L/S ratios were also collected from 26 of the 29 patients. Those who survived had significantly more mean L/S ratios greater than 2.5 than did the nonsurvivors (p less than 0.01). This difference did not correlate with the staging of the chest radiographs. The mean L/S ratio is a better predictor of survival than chest radiographs during the first 5 days of RDS.

An in vitro system for evaluating the toxicity of serum from cystic fibrosis (CF) patients is reported. Rat lung epithelial cells were incubated for 18 hours in medium containing varying concentrations of human serum (HS) from CF patients and patients without cystic fibrosis (non-CF). Twenty-four assays were performed for 4 concentrations of each HS. Attachment efficiency (AE), defined as the number of cells attached to the culture surface divided by the number of cells dispensed per culture, was determined for each concentration of HS. Attachment efficiency was always greater when no human serum was present. As the percentage of serum increased, the AE decreased in all cases.Because the AE varied from day to day, the ratio (RAE) of the AE for 0% HS to the AE for 2% HS was calculated for each serum sample. The RAE value was reproducible within 0.07 over a four-week interval for individual serum samples. The higher the RAE value, the more toxic the serum.There is a significant difference (p < 0.05) in the two populations of patients. The serum from the CF patients was more toxic to rat lung epithelial cells than serum from non-CF patients.

Transillumination of the chests of neonates1 has been used in our neonatal intensive care unit now on approximately 200 neonates with pneumothorax (PT) or pneumomediastinum (PM) using the Minilight illuminator* without any deleterious effects. Even though the fiberoptic probe tip remains cool when exposed to air indefinitely, we still wished to test for the build-up of heat beneath the rubber-sheathed probe tip of the Minilight and the Chun Gun† when these were held tightly against the skin.

In thirty infants with severe respiratory distress syndrome who required endotracheal intubation, serial tracheal aspirate lecithin/sphingomyelin ratios were determined. There was 19 survivors and 11 nonsurvivors. The L/S ratios were plotted as a function of postnatal age; the ratios of the survivors demonstrated a significant increase between 24 and 96 hours. Nonsurvivors did not show this change. There was a significant difference on Days 3, 4, and 5 between survivors and nonsurvivors in the percentage of L/S ratios greater than 2.5. Daily mean L/S ratios correctly identified the outcome of 23 of 24 infants alive on Days 4 and/or 5 and were a more accurate prediction of survival than a single L/S ratio. The changes in the L/S ratios of the tracheal aspirates were not related to gestational age.

Transillumination of the neonatal chest is described as an aid in the diagnosis of pneumothorax or pneumomediastinum. Sudden severe tension pneumothorax or pneumomediastinum can be localized for immediate treatment and the success of therapy can be immediately assessed using transillumination.

HomeRadiologyVol. 112, No. 1 PreviousNext Technical NotesAdaptation of Infant Warmer for Magnification RadiographyAndrew K. Poznanski, Robert C. Borer, Dietrich W. RoloffAndrew K. Poznanski, Robert C. Borer, Dietrich W. RoloffAndrew K. PoznanskiRobert C. BorerDietrich W. RoloffPublished Online:Jul 1 1974https://doi.org/10.1148/112.1.219MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractA simple modification of a commercially available infant warmer allows magnification radiography of infants in an intensive-care nursery.Article HistoryAccepted: Jan 1974Published in print: July 1974 FiguresReferencesRelatedDetailsCited ByDiagnostic Radiography and Ultrasound in the Perinatal Intensive Care UnitRonald C.Ablow, Kenneth J.W.Taylor, John C.Hobbins1976 | Clinics in Perinatology, Vol. 3, No. 2Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 112, No. 1 Metrics Altmetric Score PDF download

Radiation dose to personnel in a neonatal nursery from scattered irradiation from mobile radiographs can be kept at a level below background if certain simple precautions are observed. These consist of staying one foot or more away from the baby that is being radiographed and avoiding the direct beam when lateral cross table films are obtained.

Description of procedures for determining the leci-thin/sphingomyelin ratio, and its interpretation as an estimation of fetal lung maturity.

The significance of the lecithin/sphingomyelin (L/S) ratio is well established. However, numerous variations in techniques are appearing, and certain issues about techniques have emerged; among these, acetone precipitation, phosphorus determination rather than densitometry or area measurement, measurement of total phospholipids rather than the L/S ratio, and determination of lecithin concentration rather than the L/S ratio are discussed. Acetone precipitation allows examination of the physiologic (surface-active) fraction of lecithin; this fraction also helps to evaluate the rapidly maturing lung and possibly prevent false predictions. Maturational acceleration of the L/S ratio may be secondary to chronic stress or to acute stress such as acute placental infarction or ruptured membranes. Further evidence is presented that there is continuity between the fetal lungs and amniotic fluid. General principles are presented as a guide in clinical interpretation of the L/S ratio.

Serial postmortem radiographs were taken of 22 infants with the idiopathic respiratory distress syndrome. All had umbilical artery catheters and had received intermittent positive pressure ventilation prior to death. Four of the 22 gave evidence of spontaneous gas accumulation within intravascular, intraperitoneal, and cerebrospinal fluid spaces. In three, gas accumulation was demonstrated within 25 minutes after death and progressively increased even though their umbilical catheters were removed immediately after death. Since physiologic gas accumulation can occur rapidly, the significance of postmortem intravascular gas can be interpreted only if the interval between death and the radiographic exposure is known.

Previously we have demonstrated that changing TA L/S were associated with survival from RDS. In this current report L/S of serial TA obtained during the first 120 hrs. of life were examined in 30 infants with severe RDS requiring endotracheal intubation. The infants were divided into two groups by survival: survivors (S), n=19; non-survivors (NS), n=ll. The means of all L/S values per day in infants with at least three samples per 24 hr. period were calculated. In S 10/14 (71%), 10/12 (83%) and 9/9 (100%) infants had mean L/S > 2.5 on days 3, 4 and 5 respectively. In NS 1/5 (20%), 1/6 (17%) and 1/7 (14%) infants had mean L/S > 2.5 on days 3, 4 and 5 respectively. This difference was significant by day 4 (p < 0.05). Both S and NS were similar in their requirement for ventilatory support at 48 and 72 hrs. of life. At 96 and 120 hrs. there were significantly fewer S requiring mechanical ventilation. Thus, the attainment of a TA L/S > 2.5 by day 4 appears to be a chemical predictor of survival in infants with severe RDS. A significant observation in this study was that the attainment of a TA L/S > 2.5 on day 4 was independent of gestational age. This observation suggests that TA L/S is related to postnatal factors.