Transcript

Stabilization of these extreme limits of cerebral blood flow that still allowsnormal functioning of the CNS may be a basis of further observation ofvariations in pathological conditions.

doi:10.1016/j.earlhumdev.2008.09.220

Abstract UENPS.205The role of cranial ultrasound in infants greater than 32 weeksgestation — Our experience

Isabel Loureiro⁎, Andreia Lopes, Edite Gonçalves, Ana Vilan, Gustavo Rocha,Anabela Braga, Conceição Guerra, Hercília GuimarãesHospital S. João, Porto, Portugal

Background and aim

The cranial ultrasound (US) is a useful exam in the detection of neurologicabnormalities in the preterm infant. Our aim is evaluate the need to performcranial US to all infants with or above 32weeks gestation andminor risk factors.

Materials and methods

Retrospective study of 296 infants with or above 32 weeks gestation andbirth weight above 1500 g, admitted at our NICU between January 2005 andDecember 2007. Infants with major malformations, TORCH infections,neurologic events, metabolic disorders, prenatal diagnoses of brain mal-formation and hypoxic encephalopathy were excluded.

Results

59% (n=175) of infants were preterm, 55.4% (n=97) of themwith risk factorsfor neurological disabilities. Preterm infants without risk factors (n=78) hadabnormalities in 35% cranial US, including intraventricular hemorrhage grade Iand II (6.4%), cystic lesions (1.3%), hyperechogenicity (24.4%) and ventricular sizeabnormalities (5.1%). In term infants (n=121), 9.9% of them had associated riskfactors and cranial US findings. From thosewithout risk factors (64.5%, 78),12.8%had pathological findings in the US, including intraventricular hemorrhagegrade I (1.3%), calcifications (3.8%) and cystic lesions (3.8%). All infants withabnormal findings (n=81) in the US that presented latter with developmentaldelay (n=4, 3 preterm and 1 term infant) had associated pathology.

Conclusions

Our study revealed abnormal cranial US findings in 19.9% of our NICUinfants without risk factors and no apparent limitation in the outcome. So,these results support the recommendation of our National Guidelines thatscreening US can be limited to infants less than 32 weeks gestation or greaterthan 32 weeks with risk factors.

doi:10.1016/j.earlhumdev.2008.09.221

Abstract UENPS.206Intra-alveolar mRNA expression pattern of tissue factor (TF) andconnective tissue growth factor (CTGF) in neonatal respiratorydistress syndrome

Kampas Konstantinos, Skordala-Riti Marianna⁎, Mitroulis Ioannis,Kourtzelis Ioannis, Rafail Stavros, Sigalas Ioannis, Ritis KonstantinosUniversity District Hospital, Alexandroupolis, Greece

Background and aim

Neonatal respiratory distress syndrome (RDS) can potentially lead tobronchopulmonary dysplasia (BPD). RDS is characterized by migration ofcells to the alveolar space and the presence of thrombin, a product of TF/FVIIainteraction, resulting in the formation of hyaline membranes. Prompted by a)our recent study, indicating that the expression of TF in BALF cells of patientswith acute respiratory distress syndrome (ARDS) is mainly attributed to the

migrating cells (Kambas K. et al., 2008, J Immunol. 180:7368–75), and b)studies on animal models, indicating that thrombin induced the expressionof CTGF, a protein involved in the pathogenesis of fibrosis, we explored themRNA expression pattern of TF and CTGF in BALF cells from RDS infants.

Materials and methods

During the third day of mechanical ventilation BALF cells, peripheralneutrophils and mononuclear cells from 12 RDS infants were analysed. In allinfants surfactant had been administered. Six of them had fibrotic model anddeveloped BPD (severe RDS group), whereas the other 6 (mild/moderate RDSgroup) did not. Real-time RT-PCR was performed and results were analysedusing the 2-DDCT method, in order to quantify the relative expression of TFand CTGF genes.

Results

BALF cells of the two infant populations were comprised by neutrophils,alveolar macrophages and other pulmonary cells. In the severe RDS group, BALFcontained higher percentage of neutrophils (80.37±7.50) compared to the mild/moderate RDS group (48.38±6.32). Relative expression based on average ?CTvalues of TF or CTGF (target genes) and GAPDH (reference gene), illustrated thatBALF cells from infants which developed BPD had a 33.13 fold increase in TFexpression compared to their peripheral neutrophils (BALF TF ?CT: 3.529±0.87 vs8.327±0.9 of peripheral neutrophils. p<0.05). In parallel a 9.30 fold increase inBALF CTGF was observed compared to peripheral neutrophils (BALF CTGF ?CT6.725±0.63 vs 9.850±0.87 of peripheral neutrophils, p<0.05). RNA expressionalterations inmild/moderateRDSgroup inbothTFandCTGFwerenon-significant.

Conclusions

These findings, as in ARDS, indicate that migrating intra-alveolar cellsconstitute a significant source of TF in RDS BALF. This local TF expression iscorrelated with intra-alveolar CTGF over-expression and fibrotic findingsthus suggesting a possible link between coagulation and fibrosis.

doi:10.1016/j.earlhumdev.2008.09.222

Abstract UENPS.207Peptidomics of bronchoalveolar lavage fluid (BALF) from preterm infantswith bronchopulmonary dysplasia: Role of matrixmetalloproteinase-3 (MMP-3)

Tirone Chiara⁎,a, Inzitari Rosannaa, Capoluongo Ettorea, Ameglio Francoa,Lulli Paolaa, Vendettuoli Valentinaa, Tana Milenaa, Lozzi Simonab,Romagnoli Costantinoa, Mosca Fabioc, Matassa Pieroc, Messana Irened,Castagnola Massimoa, Vento GiovanniaaPoliclinico A. Gemelli, Università Cattolica del S. Cuore, Rome, ItalybOspedale Bambino Gesù, Rome, ItalycFondazione IRCCS “Ospedale Maggiore Policlinico, Mangiagalli and ReginaElena”, University of Milan, Milan, ItalydUniverità di Cagliari, Cagliari, Italy

Background and aim

Proteomic approaches have not yet been reported in the study of acute lunginjuryof premature neonates suffering from respiratory distress syndrome,withsubsequent development of bronchopulmonary dysplasia (BPD), which remainsthe most prevalent chronic morbidity afflicting the prematurely born infants.

The aim of the study is to assess and compare the peptidomic profiles ofbronchoalveolar lavage fluid from premature neonates with and withoutbronchopulmonary dysplasia.

Materials and methods

BALF samples were obtained on the third day of life (DOL) from 34neonates with gestational age=32 weeks. Two pools of samples frompatients with and without bronchopulmonary dysplasia (BPD, O2-depen-dency at 28 DOL), were analysed by reverse-phase high performance liquid

AbstractsS86

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