[Pharmacokinetics of injectable phenobarbital in the premature infant. Study of a new lyophilized form]. / Pharmacocinétique du phénobarbital injectable chez le prématuré. Etude à partir d'une nouvelle forme lyophilisée.

A lyophilized preparation of phenobarbital was studied in newborns without cerebral palsy. Plasma levels were determined using gas chromatograph fitted with thermo ionic probe after either an intra-muscular (IM) injection in premature infants or an intravenous (IV) injection over single dose of phenobarbital 10 mg/kg within 6 hours after birth. Five term babies were included in the study as controls and received an IM injection. The results showed rapid increase in plasma concentration after IM injection in 10 of 13 subjects with a peak concentration reached 60 minutes after injection. The mean ratio (maximal concentration/dose) was 1.25 and 1.10 for term infants and preterm infants respectively. In all cases, the drug was well tolerated. In 15 preterm infants (n: 7 IM and n: 8 IV) the plasma concentrations were followed over a period of 15 days. The disappearance curve was biphasic; it varied the first 7 days, then remained constant for the following week (apparent half life 106 hours).

Steroid metabolism by human chorion laeve from dichorionic twin pregnancies.

Certain steroid metabolic properties of chorion laeve from dichorionic twin pregnancies were examined to determine whether they were present in chorion not contaminated by decidua or serum. In the chorion situated between the two amniotic sacs and not in contact with decidua, aryl sulfatase, 3 beta-hydroxysteroid dehydrogenase, and aromatase activities were found. This indicates that these reactions are present in chorion laeve and were not previously ascribed to this tissue because of decidual contamination. Specific cortisol binding was also present in this area of chorion laeve, which excludes serum contamination. It is suggested that the specific steroid-binding protein in the membranes may be derived from the transcortin-like protein present in amniotic fluid.

[The 49,XYYYY syndrome: apropos of a case detected at birth and followed for 2 1/2 years]. / Le syndrome 49,XYYYY: à propos d'un cas dépisté à la naissance et suivi depuis deux ans et demi.

A male child, mentally and physically retarded shows a facial dysmorphy, fingers' abnormalities and a radio-ulnar synostosis. These features are common in the 49,XYYYY syndrom, in which external genitalia, normal at birth, remain undevelopped at the time of puberty. Four others publications through the literature report tetrasomic cells for Y chromosome, but only two of them are real 49,XYYYY (with 88% to 100% of affected cells). Our case has 96,7% tetrasomic cells.

[2 cases of congenital sternal cleft]. / A propos de deux cas de fissure sternale congénitale.

Two cases of upper sternal cleft are reported, the first operated on twenty nine months, the second on six weeks. The authors present a revision of the surgical technics proposed for correction of this rare malformation. The result is better and surgery easier when performed shortly after birth. There two cases had a facial angiomatosis associated.

Characterization of specific steroid binding in human amnion at term.

In human fetal membranes (amnion and chorion) the appearance, during the last few weeks of pregnancy, of a protein which binds progesterone has been suggested as playing an important role in the inset of labor. The purpose of the present study was to quantitatively characterize specific binding in fetal membranes. Amnion, rather than chorion, was studied because it could be obtained free from contamination by other tissues. The cytosol (105,000 X g supernatant) was used after being extracted for 1 h with dextran-coated charcoal. The specific binding of cortisol in the cytosol, determined with a charcoal assay, was stable after storage at -20 degrees C or -60 degrees C and after heating for 1 h at 37 degrees C. It was reversible, and showed high-affinity, KD = 1 +/- 0.5 nM (mean +/- SEM, n = 6) and a large number of sites were found, 1497 +/- 666 fmoles/mg protein (mean +/- SEM, n = 6). In contrast, progesterone binding in the cytosol had a 10-fold lower affinity, KD = 12 +/- 5 nM (mean +/- SEM, n = 5) with 802 +/- 246 fmol bound/mg protein (mean +/- SEM, n = 5). A number of steroids were examined for their ability to compete with cortisol binding. The following were found to express affinities relative to cortisol which was considered to be 100: corticosterone (100), progesterone (10), cortisone (8), 5 alpha-pregnane-3, 20-dione (2), and 20 alpha-hydroxy-4-pregnen-3-one (less than 1). No competition was found for dexamethasone, betamethasone, triamcinolone, triamcinolone acetonide, R5020, medroxyprogesterone acetate, estrone or estradiol. These studies indicate that the steroid binding protein associated with human amnion at term exhibits a higher affinity for a cortisol and corticosterone than progesterone. Thus it is perhaps involved in the metabolism of glucocorticoids by the membranes, rather than in the local withdrawal of progesterone, as proposed by previous investigators.

Subsequent pregnancy following the loss of an early preterm newborn infant weighing less than 1000 grams.

During a 5-year period (1974 to 1978), 84 mothers with an average age of 26.3 +/- 4.5 years delivered 89 newborn infants who subsequently died. Each infant weighed less than 1000 g. These infants had a mean birth weight of 790 +/- 170 g and a mean gestational age of 26.3 +/- 1.9 weeks. Thirty-six (90%) of 40 mothers who subsequently became pregnant gave birth to a surviving newborn. The mean gestation age and birth weight were 37.6 +/- 3 weeks and 2754 +/- 754 g, respectively. Similar data were obtained from a control group of 565 mothers who delivered normal infants at term during a 2-month interval within the study period. In the control group 170 mothers subsequently became pregnant and 163 (96%) gave birth to normal infants at term. Mean gestational age was 39.09 +/- 2 weeks (P less than .001) and birth weight was 3304 +/- 566 g (p less than .001).