Adverse respiratory patterns in near-term spontaneously breathing newborn lambs with elevated airway liquid volumes at birth.

Introduction: Recent evidence indicates that respiratory distress (RD) in near-term infants is caused by elevated airway liquid (EL) volume at the beginning of air-breathing after birth. While the adverse effects EL volumes on newborn lung function are known, the effects on respiratory control and breathing patterns shortly after birth (<4 h) are unknown. We investigated the effects of EL volumes on cardiorespiratory function and breathing patterns in spontaneously breathing near-term newborn lambs in the first hours after birth. Methods: At 137-8 days gestation (2-3 days prior to delivery; term ∼147 days), sterile surgery was performed on fetal sheep (n = 17) to implant catheters and blood flow probes. At 140 days, lambs were delivered via caesarean section under spinal anaesthesia. Airway liquid volumes were adjusted to mimic the level expected following vaginal delivery (∼10 ml/kg; Controls; n = 7), or elective caesarean section (∼30 ml/kg; elevated airway liquid group; EL; n = 10). Spontaneous breathing and cardiorespiratory parameters were recorded over four hours after birth. Non-invasive respiratory support with supplemental oxygen was provided if required. Results: EL lambs required higher inspired oxygen levels (p = 0.0002), were less active (p = 0.026), fed less (p = 0.008) and had higher respiratory morbidity scores than Controls (p < 0.0001). EL lambs also displayed higher rates of breathing patterns associated with RD, such as expiratory braking and tachypnoea. These patterns were particularly evident in male EL lambs who displayed higher levels of severe respiratory morbidity (e.g., expiratory braking) than female EL lambs. Conclusion: The study demonstrates that EL volumes at birth trigger respiratory behaviour and breathing patterns that resemble clinically recognised features of RD in term infants.

Respiratory patterns in spontaneously breathing near-term lambs delivered by caesarean section under spinal anaesthesia.

Introduction: The transition to newborn life has typically been studied in intubated and mechanically ventilated newborn lambs delivered via caesarean section (CS) under general anaesthesia. As a result, little is known of the spontaneous breathing patterns in lambs at birth, particularly those at risk of developing respiratory distress (RD). We have developed a method for delivering spontaneously breathing near-term lambs to characterise their breathing patterns in the immediate newborn period. Methods: At 137-8 days gestation (2-3 days prior to delivery; term ∼147 days), fetal lambs (n = 7) were partially exteriorised for instrumentation (insertion of catheters and flow probes) before they were returned to the uterus. At 140 days, lambs were delivered via CS under light maternal sedation and spinal anaesthesia. Lambs were physically stimulated and when continuous breathing was established, the umbilical cord was clamped. Breathing patterns were assessed by measuring intrapleural and upper-tracheal pressures during the first four hours after birth. Results: Newborn lambs display significant heterogeneity in respiratory patterns in the immediate newborn period that change with time after birth. Seven distinct breathing patterns were identified including: (i) quiet (tidal) breathing, (ii) breathing during active periods, (iii) breathing during oral feeding, (iv) tachypnoea, (v) expiratory braking manoeuvres, (vi) expiratory pauses or holding, and (vii) step changes in ventilation. Conclusions: We have described normal respiratory behaviour in newborn lambs, in order to identify respiratory behaviours that are indicative of RD in term newborn infants.

Does growth restriction increase the vulnerability to acute ventilation-induced brain injury in newborn lambs? Implications for future health and disease.

Fetal growth restriction (FGR) and preterm birth are frequent co-morbidities, both are independent risks for brain injury. However, few studies have examined the mechanisms by which preterm FGR increases the risk of adverse neurological outcomes. We aimed to determine the effects of prematurity and mechanical ventilation (VENT) on the brain of FGR and appropriately grown (AG, control) lambs. We hypothesized that FGR preterm lambs are more vulnerable to ventilation-induced acute brain injury. FGR was surgically induced in fetal sheep (0.7 gestation) by ligation of a single umbilical artery. After 4 weeks, preterm lambs were euthanized at delivery or delivered and ventilated for 2 h before euthanasia. Brains and cerebrospinal fluid (CSF) were collected for analysis of molecular and structural indices of early brain injury. FGRVENT lambs had increased oxidative cell damage and brain injury marker S100B levels compared with all other groups. Mechanical ventilation increased inflammatory marker IL-8 within the brain of FGRVENT and AGVENT lambs. Abnormalities in the neurovascular unit and increased blood-brain barrier permeability were observed in FGRVENT lambs, as well as an altered density of vascular tight junctions markers. FGR and AG preterm lambs have different responses to acute injurious mechanical ventilation, changes which appear to have been developmentally programmed in utero.

Redistribution of fractions of zinc, cadmium, nickel, copper, and lead in contaminated calcareous soils treated with EDTA.

Effect of ethylene diamine tetraacetic acid (EDTA) on the fractionation of zinc (Zn), cadmium (Cd), nickel (Ni), copper (Cu), and lead (Pb) in contaminated calcareous soils was investigated. Soil samples containing variable levels of contamination, from 105.9 to 5803 mg/kg Zn, from 2.2 to 1361 mg/kg Cd, from 31 to 64.0 mg/kg Ni, from 24 to 84 mg/kg Cu, and from 109 to 24,850 mg/kg Pb, were subjected to EDTA treatment at different dosages of 0, 1.0, and 2.0 g/kg. Metals in the incubated soils were fractionated after 5 months by a sequential extraction procedure, in which the metal fractions were experimentally defined as exchangeable (EXCH), carbonate (CARB), Mn oxide (MNO), Fe oxide (FEO), organic matter (OM), and residual (RES) fractions. In contaminated soils without EDTA addition, Zn, Ni, Cu, and Pb were predominately present in the RES fraction, up to 60.0%, 32.3%, 41.1%, and 36.8%, respectively. In general, with the EDTA addition, the EXCH and CARB fractions of these metals increased dramatically while the OM fraction decreased. The Zn, Ni, Cu, and Pb were distributed mostly in RES, OM, FEO, and CARB fractions in contaminated soils, but Cd was found predominately in the CARB, MNO, and RES fractions. The OM fraction decreased with increasing amounts of EDTA. In the contaminated soils, EDTA removed some Pb, Zn, Cu, and Ni from MNO, FEO, and OM fractions and redistributed them into CARB and EXCH fractions. Based on the relative percent in the EXCH and CARB fractions, the order of solubility was Cd > Pb > Ni > Cu > Zn for contaminated soils, before adding of EDTA, and after adding of EDTA, the order of solubility was Pb > Cd > Zn > Ni > Cu. The risk of groundwater contamination will increase after applying EDTA and it needed to be used very carefully.

VDUP1: a potential mediator of expansion-induced lung growth and epithelial cell differentiation in the ovine fetus.

The degree of fetal lung expansion is a critical determinant of fetal lung growth and alveolar epithelial cell (AEC) differentiation, although the mechanisms involved are unknown. As VDUP1 (vitamin D3-upregulated protein 1) can modulate cell proliferation, can induce cell differentiation, and is highly expressed in the lung, we have investigated the effects of fetal lung expansion on VDUP1 expression and its relationship to expansion-induced fetal lung growth and AEC differentiation in fetal sheep. Alterations in fetal lung expansion caused profound changes in VDUP1 mRNA levels in lung tissue. Increased fetal lung expansion significantly reduced VDUP1 mRNA levels from 100+/-8% in control fetuses to 37+/-4, 46+/-4, and 45+/-9% of control values at 2, 4, and 10 days of increased fetal lung expansion, respectively. Reduced fetal lung expansion increased VDUP1 mRNA levels from 100+/-16% in control fetuses to 162+/-16% of control values after 7 days. VDUP1 was localized to airway epithelium in small bronchioles, AECs, and some mesenchymal cells. Its expression was inversely correlated with cell proliferation during normal lung development (R2=0.972, P<0.002) as well as in response to alterations in fetal lung expansion (R2=0.956, P<0.001) and was positively correlated with SP-B expression during normal lung development (R2=0.803, P<0.0001) and following altered lung expansion (R2=0.817, P<0.001). We suggest that VDUP1 may be an important mediator of expansion-induced lung cell proliferation and AEC differentiation in the developing lung.

Effect of photopolymerization variables on composite hardness.

STATEMENT OF PROBLEM: Variations in light-polymerizing parameters, such as light intensity and light-to-material distance, may affect the physical characteristics of polymerized resin. PURPOSE: The purpose of this study was to characterize the relation between total light energy and the final hardness of 4 composites polymerized under varying conditions. MATERIAL AND METHODS: Four commercial composite restorative resins (Z100, Filtek A110, Tetric Ceram, and Tetric Flow) were used to prepare 4 disk-shaped specimens (6 x 2 mm) for each experimental condition. Photoactivation was carried out with a light device and energy of 22.6, 15.7, 9.0, or 6.7 J/cm(2). Either the light-to-material distance (0, 5, 10, 15 mm) or activation time (40, 28, 16, 12 seconds) was varied. Immediately after polymerization, Barcol hardness was determined on the specimen surface that had been exposed to the light. Analysis of variance (P<.05) and regression analysis were used to examine the data. RESULTS: No significance (P>.05) was found for the overall effect of the experimental variables (polymerization time and distance), but significant differences (P<.01) were found among materials and energy levels. Regression equations for each product and polymerization condition were calculated for hardness as a function of energy. No significant differences were found for slopes within each material. Hardness values were 3.0 to 3.5 for Tetric Ceram, Tetric Flow, and Filtek A110 and approximately 4.9 for Z100. CONCLUSION: The hardness of the products analyzed was related to the total energy used for activation. The effect was independent of the manner in which the amount of energy was modified (light-to-material distance or activation time).