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Purpose of Study Prenatal exposure to inflammation increases the risk of bronchopulmonary dysplasia (BPD) in preterm infants. In a fetal mouse lung model, lipopolysaccharide (LPS) decreased distal airway branching, which may contribute to BPD pathology. In a candidate gene approach, we tested if LPS decreased expression of FGF-10, a master regulator of branching morphogenesis. We hypothesized that decreased FGF-10 expression could lead to defective distal airway branching. Methods E16 fetal mouse lung explants were cultured for up to 72 hours. Distal airway branching was measured by counting the number of distal airways per explant area. Fetal mouse lung mesenchymal cells were also isolated and cultured. Gene expression was measured by real time PCR. Results We measured decreased FGF-10 gene expression in LPS-treated fetal lung explants (55% of control, p Conclusion LPS decreased FGF-10 expression and altered gene expression along the FGF-10 signaling pathway. Decreased FGF-10 expression may identify a mechanism by which innate immunity can contribute to BPD.

Introduction Severe congenital cardiovascular malformation (CCVM) occurs in 1 to 2 per 1000 live births. The outlook for newborns with CCVM has improved considerably, but these malformations still contribute morbidity and mortality in this age group particularly with delays in recognition and treatment. Aim To determine the prevalence of late referral for infants with serious congenital cardiac anomalies. Methods All neonates with CCVM admitted to Alabama9s regional cardiovascular referral center from January 1, 1989 to June 30, 2004 were eligible for study. Demographic data and time of referral for cardiovascular evaluation were collected prospectively and maintained in a database. Medical records of a subset of these infants, admitted from January 1 to August 20, 2004, were reviewed retrospectively. Information on type of cardiac lesion, time of diagnosis, and various demographic variables was obtained. Infants with patent ductus arteriosus or ventricular septal defect as the only cardiac diagnosis were not included. Referral was considered late if it occurred after 2 days of age. Results During the 15-year study period, 2390 infants were admitted with CCVM. 726 (30%) were referred for care after 2 days of age. During the study year, 2004, 59 infants were referred with CCVM. Overall, 19 infants (32%) were diagnosed after postnatal day 2. The figure shows the proportion of early and late referrals in study year 2004 for each cardiac diagnosis. Conclusion More than 30% of infants with serious CCVM were referred for diagnosis and treatment after the second postnatal day. The high proportion of infants in whom diagnosis of CCVM is delayed underscores the need for earlier detection and referral.

Free erythrocyte protoporphyrin (FEP) and hemoglobin concentrations in 788 children were investigated during routine check-ups in a private pediatric practice. FEPs > 3.0 ZPP/gm hemoglobin were found in 29.8 percent of 9-month-olds and in 9.6 percent of the total group tested. Correlations between FEP levels and hemoglobin concentrations are presented.