The diagnosis of fetal lung maturity by analysis of the amniotic fluid still constitutes a present-day problem. In this study the results of measuring the dynamic surface tension by the Wilhelmy-balance were compared with the DPPC (Dipalmitoyl-Phosphatidyl-Choline) and lecithin species-analysis by the quantitative capillary gas chromatography. The first possibility is a "bed-side"-method, which evaluates the effect of the surfactant in the amniotic fluid in its entirety, whereas the second method represents a highly specialized laboratory procedure analysing the most important part of surfactant contact. The surface tension of amniotic fluid is expressed by its value at 20% of the extension of the surface (gamma-min) as well as the hysteresis area. We were able to show a better correlation between the hysteresis area and the DPPC (r = 0.422, p less than 0.012) than between the gamma min and the DPPC (r = 0.370, p less than 0.031). The correlation between the hysteresis area respectively between the gamma-min, and the second gas chromatographically detectable component of the surfactant, PC 30 was not so distinct (r = 0.068, p less than 0.744; R = -0.355, p less than 0.075). Obviously this component of the surfactant is not as active on the surface and therefore not as important. Further we could show, a negative correlation to the lecithin species PC 34; with increasing surface activity and increasing lung maturity this lecithin species quantitatively recedes into the background.
Article Pregnancy-related changes of carnitine and acylcarnitine concentrations of plasma and erythrocytes was published on January 1, 1995 in the journal Journal of Perinatal Medicine (volume 23, issue 6).
Lungs of foetal rats between the 16th and 20th gestational day (total gestation lasting 22 days) were examined. There was a striking increase of both total phosphatidylcholine and dipalmitoyl phosphatidylcholine from day 19 to 20 of gestation. The carnitine content increased continuously from day 17 both in the foetal lungs and livers. In both organs, the increase in short-chain acylcarnitine was more pronounced than the increase in free carnitine. Compared with an untreated control group, treatment of the mother with L-carnitine (from day 16 to 18 of gestation, with 60, 80, and 100 mg/kg.d L-carnitine, respectively) resulted in significant increases in both total phospholipid (p less than 0.05 in all treated groups) and dipalmitoyl phosphatidylcholine (p less than 0.05, p less than 0.01, p less than 0.001, corresponding to maternal treatment with 60, 80, 100 mg/kg.d, respectively) on the 19th gestational day. The results are in accordance with morphological evaluations: with increasing carnitine-dosage, increasing numbers of lamellar bodies in type II cell progenitors were found. The enhanced dipalmitoyl phosphatidylcholine content is a consequence of enhanced phospholipid synthesis in remarkably undifferentiated type II cells largely lacking membrane structures and cell organelles capable of phospholipid synthesis. Thus, in general, carnitine treatment seems to stimulate foetal lung phospholipid synthesis, thereby enhancing the dipalmitoyl phosphatidylcholine content.
Changes in the fatty acid pattern of plasma lipid in four different groups of polytraumatized patients were investigated. All of the patients received amino acid solutions containing 0.24 gN/day/kg body weight and 30 kal/day/kg body weight (BW). In group 1, all calories were administered as carbohydrates (glucose and fructose). In group 2, 30 to 40% of the calories were provided as a fat emulsion. When compared to the control group, a reduction in the essential fatty acid concentration in the phospholipid fraction was detected in both groups during the early post-traumatic period. In group 1, a continuous decline was observed during the remainder of the trial period. In group 2, however, the concentration of essential fatty acids remained constant after the initial decline and increased slightly from the 7th day on. In the second part of the investigation, the effect of human growth hormone (HGH) administration on the fatty acid pattern was evaluated. Group 3 and 4 received intravenous feedings identical to the patients in group 2; in group 4, however, 10 mg of HGH per day were added to the infusion. The results of this study confirm the hypothesis that supplemental infusion of a fat emulsion prevents a continuous reduction of essential fatty acids in plasma lipids. An effect of 10 mg/day of HGH on essential fatty acid concentration or composition, however, could not be observed. There were no detectable differences in the percentage of essential fatty acids between those patients receiving and those not receiving HGH.
