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Results for “VERNIX CASEOSA”

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PubMed1983

Rapid diagnosis of amniotic fluid embolism.

Acute respiratory failure developed in a 19-year-old primigravida 7 hours after undergoing cesarean section. The diagnosis of amniotic fluid embolism was established by viewing fragments of vernix caseosa in a pulmonary artery blood sample. Forty-eight hours after the cytologic diagnosis had been made, amniotic fluid material was no longer present in pulmonary arterial blood. The patient underwent supportive care in an intensive care setting and recovered completely.

Adolescent↗

PubMedDate not supplied

[Fetal lung maturity and skin maturity: 2 distinct concepts and the clinical significance of their differences].

The maturation of the fetal lungs, that is to say the adequate production of surfactant in the fetal alveoli, as it is well known reaches to its end about the 35.-36th week of gestation. Even more closely to the date of delivery, about the 37.-38th week of gestation, the maturation of the fetal skin takes place, so to say the detachment of the Vernix caseosa from the fetal skin into the amniotic fluid. The above mentioned means that the children with "mature skin" should have mature lungs too, so that those children have about nothing to fear from the RDS. That can be proved by the comparison of the values which were measured in 38 cases of the L/S Ratio (as a criterion of the lung-maturity), to those of the turbidity of the amniotic fluid and average quantities of the keratinocytes of the amniotic fluid cell population (as a criterion of the skin-maturity); that observation becomes stronger with the comparison of all those values to a Vernix-Score, which can be completed after delivery.

Amniotic Fluid↗

PubMed1992

Keloids: a study of the immune reaction to sebum.

A controlled study of the "immune reaction to sebum" pathogenesis of keloids was carried out at the University College Hospital, Ibadan, Nigeria; on 22 humans using a homogenate solution of liquid paraffin and vernix caseosa from neonates. The 22 human volunteers comprised two groups, 11 of which were keloid formers and 11 non keloid formers. 0.1cc of sterile liquid paraffin was injected intradermally into the anterior aspect of the left forearm. The mean reaction in keloid formers was 11.55mm while in non keloid formers, it was 8.18mm. Although a higher reaction was demonstrated in this study, in keloid formers, this was found not to be significant (p less than 0.05), thus suggesting that sebum may not be an important factor in the pathogenesis of keloid.

Adolescent↗

PubMed1976

Analysis of fatty acid and alcoholic components of sebaceous lipid types.

Lipids were extracted from hair, scalp wipings, ovarian dermoid cysts, and vernix caseosa and submitted to alkaline hydrolysis. Alumina chromatography applied to the unsaponifiable portions allowed for the separation of hydrocarbons, alcohols, and sterols. The fatty acids from the saponifiable mixtures were converted to the methyl esters and analyzed by gas chromatography in conjunction with mass spectrometry. This technique permitted the identification of the even, odd, iso, and anteiso fatty acid levels of the various pools. Analysis of the alcohols was afforded by gas chromatography of the acetates. Ratios were determined among the acidic and alcoholic components of each lipid class and the alcoholic constituents of each pool appeared to be increased by two C2-fragments over the average carbon number of the corresponding acid fraction. Branched components ranged higher in all alcohol mixtures as compared to the respective acids and thus, indicative of a specificity for the synthesis of a specificity for the synthesis of alcohols.

Chromatography, Gas↗

PubMed2005

Cutaneous bacterial infections in the newborn.

PURPOSE OF REVIEW: This review examines neonatal bacterial skin infections with respect to host immunity, bacterial pathogens, patterns of infection, and new therapeutic approaches. RECENT FINDINGS: Advances have been made in our understanding of innate host defense and the emerging role of cutaneous antimicrobial peptides of the cathelicidin and defensin families. Toll-like receptors are being investigated with respect to their interactions with bacteria and other components of the innate immune defense, such as the antimicrobial peptides. The epidermal barrier remains an active area of research. Studies confirm that maintaining an intact epidermal barrier by minimizing exposure to soap and by not removing vernix caseosa are simple measures to improve skin barrier function. Active barrier-enhancing measures such as the application of topical emollients have shown mixed results in the prevention of nosocomial infection. A meta-analysis of studies performed in developed countries showed a trend of increasing risk for coagulase-negative staphylococcal infection. By contrast, a randomized controlled trial showed that infants treated with sunflower oil are less likely to experience nosocomial infections than are control infants. Infants with bacteremia and no known source of infection should be carefully examined because cutaneous abscesses have been shown to be an important nidus of infection. Methicillin-resistant Staphylococcus aureus is reaching epidemic proportions, making surface cultures an essential part of the evaluation of cutaneous bacterial infection. SUMMARY: New insights have been gained regarding the basic science of neonatal host defense and these advances may produce new ways of approaching the prevention and treatment of bacterial skin infections in the newborn period.

Antimicrobial Cationic Peptides↗

PubMed1993

External and middle ear status related to evoked otoacoustic emission in neonates.

OBJECTIVE: Screening auditory status prior to neonatal hospital discharge to identify newborns with severe hearing impairment is an important pediatric care priority. Evoked otoacoustic emission (OAE) testing is a quick noninvasive method. The purpose of this study was to determine the relationship between external auditory canal and middle ear status with click-evoked OAE. It was hypothesized that vernix caseosa, debris in the ear canal, and middle ear fluid contribute to the OAE fail rate. DESIGN: All neonates had an initial OAE examination. A second investigator, "blinded" to the results, examined all ears otoscopically, cleaned any obstructing debris, and repeated with a second OAE test. SETTING: All neonates were tested in a designated nursery at a mean age of 43 +/- 21 hours. PATIENTS: Forty-one full-term neonates were prospectively enrolled. INTERVENTION: The ear canals with debris were cleaned under direct vision with a pediatric swab dampened by an alcohol wipe. OUTCOME MEASURE: The primary outcome measure was the postcleaning OAE pass rate. RESULTS: The preotoscopic examination pass rate of 82 ears was 76%. The OAE pass rate improved to 91% after debris removal. CONCLUSIONS: The results indicate that the examination and cleaning of the external ear canal are important components of the neonatal screening process.

Acoustic Stimulation↗

PubMed1989

Identification of long-chain fatty acids and alcohols from human cerumen by the use of picolinyl and nicotinate esters.

Human cerumen was hydrolysed with base and the constituents were examined as trimethylsilyl (TMS), methyl ester/TMS, picolinyl/TMS and nicotinate/TMS derivatives by gas chromatography and gas chromatography/mass spectrometry. A sample was also reacted with osmium tetroxide for double bond location. The major constituents were cholesterol, squalene and several series of long-chain fatty acids and alcohols. These latter compounds had chain lengths of 12-26 carbon atoms and were predominantly either straight-chain saturated or straight-chain unsaturated compounds. Saturated branched-chain acids with methyl groups predominantly on even-numbered carbon atoms were present but were less abundant. Unsaturated, branched-chain acids were also present. The major unsaturated acids contained unsaturation at the delta-6-position or were derived from these acids by chain elongation. The compounds were similar to those found in vernix caseosa. The mass spectra of picolinyl esters were, for the first time, shown to be capable of determining both the position of unsaturation and methyl branching in the same molecule.

Adult↗

PubMed2005

Prenatal diagnosis of a long QT syndrome by fetal magnetocardiography in an unshielded bedside environment.

OBJECTIVE: The potentially life threatening long QT syndrome should be diagnosed during pregnancy to improve perinatal care. METHODS: A patient with a family history for a hereditary long QT syndrome presented at 30 weeks of her first pregnancy with fetal bradycardia and a narrow oscillation bandwidth on cardiotocography without structural abnormalities of the fetal heart. Fetal magnetocardiography was performed with a prototype biomagnetometer/gradiometer device in a magnetically unshielded environment. The cardiac time intervals were determined in the averaged PQRST complex. RESULTS: The QT time and the frequency-corrected QTc showed a marked prolongation to 380 ms and 0.52 s, respectively. The findings were confirmed in the postnatal electrocardiogram after spontaneous term delivery in a perinatal center. The causative mutation on chromosome 11 had been passed on to the newborn from his mother. CONCLUSION: Bedside fetal magnetocardiography revealed the exact diagnosis of the long QT syndrome in a period of the gestation when the fetus was electrically isolated by the vernix caseosa that hinders electrocardiography. To patients at risk of fetal cardiac abnormalities, magnetocardiography can be offered as a non-invasive diagnostic bedside procedure. The diagnosis should trigger closer surveillance and delivery in a perinatal center.

Adult↗

PubMed1992

Pregnancy and breast cancer: a possible explanation for the negative association.

We propose that pregnancy protects against breast cancer, in part, because it results in excretion of lipophilic carcinogens by the mother through the fetal fat and vernix caseosa. We review several lines of epidemiologic and toxicologic evidence in support of this idea, including concordances between known or suspected risk factors for cancer of the female breast and known or suspected risk factors for increased body burdens of lipophilic carcinogens.

Breast Neoplasms↗

PubMedDate not supplied

Bathing or washing babies after birth?

One group of healthy full-term newborn babies was washed after birth and another was bathed to remove vernix caseosa and clean the skin. Few infections, none of them serious, occurred in either group. Bacterial colonisation of the umbilical cord on the third day of life was similar in both groups. The rectal temperature fell further and more infants cried during washing than during bathing. Thus bathing the baby after birth makes it calmer, quieter, and more comfortable than washing and causes less heat-loss. Clinical signs of infection and bacterial colonisation rates are no higher after bathing than after washing.

Baths↗

PubMed2003

Review of electromagnetic source investigations of the fetal heart.

There is at present no reliable clinical technique for the assessment of cardiac electrophysiological activity in the fetus. There are two primary requirements of this type of monitoring: (i) sequential assessment of morphological and temporal parameters of cardiac electrical activity during advancing gestation, and (ii) description of the cardiac electrical activity in terms of an electrophysiologically realistic model. Fetal electrocardiography may be performed using maternal abdominal electrodes but this is only reliable prior to the 27th week of gestation. This is primarily because of the electrically insulating effects of the vernix caseosa and the existence of preferred conduction pathways between the fetal heart and maternal abdomen after this time. Fetal magnetocardiography is largely unaffected by these factors and so enables a reliable assessment of fetal electrocardiological activity throughout the second and third trimesters of pregnancy. This method can also be used to model fetal electrophysiological activity in terms of a current dipole or magnetic dipole. The vectorcardiogram is a plot of the dynamic change in dipole parameters during the cardiac cycle, allowing the study of growth-related or pathology-related electromagnetic changes in the heart. Fetal magnetocardiography and the fetal vectorcardiogram may thus provide important additions to current methods of antenatal monitoring.

Electrocardiography↗

PubMed2004

First line of defense in early human life.

Innate antimicrobial peptides are considered to play an important role in host defense against microbial invasion. They are expressed in a wide variety of organisms. In the case of human beings, defensins and the cathelicidin LL-37 appear to be the major microbicidal peptides. With respect to human neonates, only few investigations have been performed in this context, revealing the presence of alpha-defensins and LL-37 in neutrophils and vernix caseosa. In addition, beta-defensins are present in tracheal aspirates and breast milk, whereas LL-37 has been detected in the skin of the newborn baby. During recent years, immunomodulatory activities such as chemotaxis have emerged as important functions of antimicrobial peptides. Thus, these innate effectors may work synergistically to provide a first line of defense against infection, as well as to promote interactions between the innate and adaptive immunity in newborn infants.

Antimicrobial Cationic Peptides↗

PubMedDate not supplied

[Surfactant proteins A and D: major factors of the immune response of the lung].

Surfactant proteins (SP) A and D play a key role in pulmonary host defense of preterm and term newborns. SP-A and SP-D have structural elements of both collagens and lectins, for which they are called "collectins". SP-A and SP-D coordinate the innate and adaptive immune response in the lung and convey protection against infection in amniotic fluid and vernix caseosa. They are pattern-recognizing molecules of the innate immune system that are involved in binding, agglutination of pathogens, chemotaxis of neutrophils, phagocytosis of pathogens, and production of reactive oxygen species. In addition, SP-A and SP-D interact with the adaptive immune system by reducing interleukin-2 production and T lymphocyte proliferation.

Chemotaxis, Leukocyte↗

PubMed1995

[Magnetocardiography for assessment of fetal heart actions].

Magnetocardiography provides a new, alternative method for fetal surveillance. This method allows the registration of changes in the magnetic field produced by the fetal cardiac system. In comparison to fetal ECG, the fetal magnetocardiogram (fMCG) is not affected by intermediate tissue, in particular by the insulating effect of the vernix caseosa. Furthermore fMCG's with a good signal noise ratio can be obtained in the second trimester. A multichannel biomagnetometer allows the non-invasive measurement of the magnetic signals produced by the fetus. Examples of dta and evaluation techniques are given. Signal processing software allows the identification of all fetal beats in a data set, permitting the calculation of an averaged beat and the evaluation of signal morphology and cardiac time intervals. Furthermore it is possible to produce a beat to beat time series with high temporal resolution, making the evaluation of heart rate variability with measures from the time, frequency, and phase domain accessible. Particularly the latter are of interest in investigating changes in temporal complexity of the fetal cardiac system. Magnetocardiography thus holds the promise of improved antenatal surveillance as of the second trimester.

Adult↗

PubMed1990

Unusual cholesterol esters in the sebum of young children.

Cholesterol esters (CE) having fatty acids of more than 18 carbons are a prominent feature of fetal skin surface lipid (vernix caseosa), but are a minor component of adult lipid. The difference may be related to the fact that fetal sebaceous glands generally synthesize little lipid. If so, it would be expected that prepuberal children, who also have very inactive glands, would secrete CE with a large proportion of very-long-chain fatty acids. To test this conjecture, skin surface CE from young children were isolated and analyzed. Sebum was extracted from the hair of 38 children, aged six to nine. To obtain a measure of sebaceous lipogenesis, the class composition of the lipid was determined by quantitative thin-layer chromatography and the ratio of wax esters/[cholesterol + cholesterol esters] (WE/[CH + CE]) was calculated. CE were then isolated from the lipid and hydrolyzed. The freed fatty acids were converted to fatty acid methyl esters (FAME) and analyzed by capillary gas chromatography to determine the proportion with more than 18 carbons. FAME from five of the subjects were then separated into saturated and monounsaturated fractions and analyzed again by gas chromatography to identify chain types. Ratios of WE/[CH + CE] ranged from 0.08 to 2.8 in the subjects. The proportion of CE FAME with more than 18 carbons ranged from 15 to 72%, with the highest proportion being found in the children with the lowest WE/[CH + CE]. The saturated FAME were mostly iso- or anteiso-branched, whereas the monounsaturated FAME were mostly straight-chain extension products of 16: 1 delta 9 or 18: 1 delta 9.

Child↗

PubMed1995

Ceroid granulomas in the female genital system.

Three cases of ceroid granulomas of the female genital system are presented, involving the cervix in two and lesions in the ovaries and bowel serosa in the other. Ceroid granulomas are unusual and interesting lesions formed when suitable substrates accumulate within macrophages to such an extent that a relative lack of biological antioxidants results and auto-oxidation and conversion to ceroid is favoured. This may occur in the setting of haemorrhage and necrosis, whether from tumour necrosis or associated with endometriosis. Other sources of lipids and lipoproteins include bile, meconium and vernix caseosa.

Aged↗

PubMed2002

[Clinical significance of echogenic amniotic fluid at term pregnancy].

PURPOSE: This study is aimed to determine the clinical significance of echogenic amniotic fluid. MATERIAL AND METHODS: I surveyed 9 at term pregnancies in which the amniotic fluid was echogenic. Morphologic characteristics of amniotic fluid were assessed from samples taken at amniocentesis or upon delivery within one day after last sonographic examination. RESULTS: In pregnancies with echogenic amniotic fluid, assessment revealed clear fluid in 4 cases (44.5%), vernix caseosa in 4 (44.5%), and meconium in 1 (11.0%). CONCLUSIONS: Echogenic amniotic fluid on prenatal sonography is not predictive of fetal distress.

Adult↗

PubMed2004

Cleaning fetal MEG using a beamformer search for the optimal forward model.

We present a new method for improving the signal-to-noise ratio (SNR) of event-related fetal MEG signals based upon the SAM minimum-variance beamformer. SAM could separate the evoked response source activity from the remaining fMEG signal and interference if the evoked response source coordinates and forward model were know. However, this requires knowledge of both the coordinate of the evoked response source and its forward model. In late gestation, the vernix caseosa effectively insulates the fetus from the amniotic fluid. Hence, the forward model could be approximated by an equivalent current dipole in a homogeneously conducting sphere with its origin at the center of the fetal head. In the absence of accurate anatomical data, a beamformer could be used to evaluate all feasible source-origin combinations--selecting the combination giving the best SNR for the evoked response. Application of this approach to measured fMEG data reveals that the optimal model sphere location is described not by a single local sphere origin, but rather by all origins lying within an extended region. This result is explained by model predictions showing the same region of ambiguity [Vrba, 2004]. Although the model search does not localize the sources of the fetal evoked response, it does significantly improve SNR. This was demonstrated by analysis of fetal auditory evoked response data.

Cardiotocography↗