Disrupted pulmonary vasculature and decreased vascular endothelial growth factor, Flt-1, and TIE-2 in human infants dying with bronchopulmonary dysplasia.

An abnormal pulmonary vasculature may be an important component of bronchopulmonary dysplasia (BPD). We examined human infant lung for the endothelial cell marker PECAM-1 and for angiogenic factors and their receptors. Lung specimens were collected prospectively at approximately 6 h after death.

Do urinary levels of vascular endothelial growth factor predict proliferative retinopathy?

Purpose: Vascular endothelial growth factor (VEGF) is elevated in the vitreous of patients with proliferative retinopathies (PR). Angiogenic factors like VEGF are elevated in the urine of subjects with cancers, including those distant from the genitourinary tract. We hypothesized that local increases in VEGF in the vitreous would be reflected in the urine of subjects with PR.

Improving adolescent preventive care in community health centers.

Objective: To evaluate implementation of the Guidelines for Adolescent Preventive Services (GAPS) in Community and Migrant Health Centers (CMHCs).

Design: Before and after comparison of health center policy, clinician and adolescent self-report, and chart reviews in 5 CMHCs.

Participants: Eighty-one preintervention and 80 one-year postintervention providers and 318 preintervention and 331 postintervention 14- to 19- year-old adolescent patients being seen for well visits at 5 CMHCs.

Oxygen regulation of gene expression: a study in opposites.

Oxygen is crucial to aerobic metabolism, but excesses of oxygen or reactive oxygen species (ROS) can injure cells. This minireview addresses two transcription factors that regulate several cellular responses to oxygen tension. Hypoxia inducible factor-1 (HIF-1) is a heterodimeric protein activated by hypoxia.

Risk factors for pediatric asthma. Contributions of poverty, race, and urban residence.

The Child Health Supplement to the 1988 National Health Interview Survey was used to examine parent-reported current asthma among a nationally representative sample of 17,110 children zero to 17 yr of age. Numerous demographic variables were analyzed for independent associations with asthma using modified stepwise logistic regression, with models including specific combinations of risk factors. Black children had higher rates of asthma than did white children in unadjusted analyses, but after controlling for multiple factors, black race was not a significant correlate of asthma (adjusted odds ratio = 0.

Lumped parameter estimation for the embryonic chick vascular system: a time-domain approach using MLAB.

We have evaluated several lumped parameter analog models for the early chick embryonic vascular system that may be used to infer loading characteristics of the developing heart. We measured dorsal aortic pressure and flow simultaneously with a servo-null pressure system and a pulsed Doppler velocimeter. Four different analog circuit models were chosen for comparisons.

Neurodevelopmental and health outcomes in term infants treated with surfactant for severe respiratory failure.

Objective: Analysis of health, neurodevelopmental, and school performance outcomes in a pilot study of term and near-term infants with respiratory failure due to pneumonia or meconium aspiration treated with surfactant.

Study Design: Retrospective review of medical records, neurodevelopmental and psychosocial evaluations, and parent and teacher surveys.

Results: Of the 14 patients enrolled, only one was rehospitalized, for pneumonia.

Multiple esophageal rings: an association with eosinophilic esophagitis: case report and review of the literature.

Esophagitis may present endoscopically with erythema, edema, loss of vascular pattern, friability, and ulceration of the esophageal mucosa. Left untreated, chronic esophagitis may result in stricture formation. The presence of multiple concentric rings involving the entire esophagus has been cited as a chronic form of esophagitis.

Expression of vascular endothelial growth factor and Flk-1 in developing and glucocorticoid-treated mouse lung.

Although the endothelial cell is the most abundant cell type in the differentiated lung, little is known about regulation of lung developmental vasculogenesis. Vascular endothelial growth factor (VEGF) is an endothelial cell mitogen and angiogenic factor that has putative roles in vascular development. Mitogenic actions of VEGF are mediated by the tyrosine kinase receptor KDR/murine homologue fetal liver kinase Flk-1.

Ablation of tumor necrosis factor receptor type I (p55) alters oxygen-induced lung injury.

Hyperoxic lung injury, believed to be mediated by reactive oxygen species, inflammatory cell activation, and release of cytotoxic cytokines, complicates the care of many critically ill patients. The cytokine tumor necrosis factor (TNF)-alpha is induced in lungs exposed to high concentrations of oxygen; however, its contribution to hyperoxia-induced lung injury remains unclear. Both TNF-alpha treatment and blockade with anti-TNF antibodies increased survival in mice exposed to hyperoxia.

Vascular endothelial growth factor in pulmonary lavage fluid from premature infants: effects of age and postnatal dexamethasone.

Corticosteroids are used to ameliorate bronchopulmonary dysplasia (BPD). They also affect normal development, including the expression of growth factors such as vascular endothelial growth factor (VEGF). Deep pulmonary lavage specimens were collected on days 1, 3, 7 and 28 of life in 40 infants of <34 weeks of gestation at birth during a randomized controlled trial of two doses of dexamethasone (DEX) at 12 and 24 h of age for BPD prophylaxis.

Discordant pulmonary proinflammatory cytokine expression during acute hyperoxia in the newborn rabbit.

Newborn animals are resistant to oxygen toxicity. To investigate this phenomenon, the proinflammatory cytokines interleukin (IL)-1 beta, IL-8, and monocyte chemoattractant protein-1 (MCP-1) were measured during newborn rabbit hyperoxic lung injury. Pups were exposed to > 95% O2 for 8-9 days, followed by 60% O2 until 36 days of age.

Differential expression of VEGF mRNA splice variants in newborn and adult hyperoxic lung injury.

Lung development and repair of hyperoxic injury require closely regulated growth and regeneration of alveolar capillaries. Vascular endothelial growth factor (VEGF), a mitogen for endothelial cells, is expressed by alveolar epithelial cells. Alternative splicing of VEGF mRNA results in isoforms of varying mitogenicity and solubility.

Varicella immunization practices and the factors that influence them.

Objectives: To evaluate the varicella immunization practices of physicians in Rochester, NY, and to identify factors that predict whether physicians administer varicella vaccine to children.

Design: Evaluation of a 40-item survey addressing varicella immunization practices and opinions about varicella immunization that was sent to 241 pediatricians and family physicians.

Results: A total of 172 physicians (71.

Prognostic significance of early response to a single dose of asparaginase in childhood acute lymphoblastic leukemia.

Purpose: The in vitro and in vivo efficacy of a single dose of asparaginase in children with newly diagnosed acute lymphoblastic leukemia and the correlation between in vitro and in vivo antileukemic response and long-term outcome were prospectively evaluated.

Patients And Methods: Two hundred fifty-one patients were randomized to receive 1 of 3 asparaginase preparations (Escherichia coli, Erwinia chrysanthemi [Erwinia], or pegaspargase). In vitro assessment of efficacy was expressed as the percent total cell kill (TCK), based on the number of viable cells found after 5 days of culture in the presence of asparaginase.

Hyperoxia increases keratinocyte growth factor mRNA expression in neonatal rabbit lung.

Acute hyperoxic lung injury remains a major factor in the development of chronic lung disease in neonates. A critical step in the repair of acute lung injury is the proliferation of type II alveolar epithelial cells. Type II cell proliferation is stimulated by keratinocyte growth factor (KGF), an epithelial cell-specific mitogen.

Chemokine mRNA alterations in newborn and adult mouse lung during acute hyperoxia.

Chemokines play a major role in the recruitment of inflammatory cells during acute lung injury. Adult and newborn C57BL/6 mice were exposed to > 95% oxygen for up to 72 hours and 7 days, respectively. Chemokine mRNA abundance was evaluated in whole lung RNA by ribonuclease protection assay and in tissue sections by in situ hybridization.

Epidemiology of anthracycline cardiotoxicity in children and adults.

Anthracyclines, potent cytotoxic agents used to treat a broad spectrum of malignancies, are limited in their use by an attendant risk of cardiotoxicity. Malignancies affect all age ranges, and anthracyclines are used in all age ranges, thereby exposing a broad population of patients to the development of heart disease. For some treated patients, anthracyclines affect cardiac muscle, resulting in cardiomyopathy.

Adolescents' access to care: teenagers' self-reported use of services and perceived access to confidential care.

Background: Most surveys on adolescents' use of health services rely on parental report, and this may underestimate adolescents' use of confidential services.

Objective: To investigate adolescents' report of their own use of health services, access to care, and knowledge and use of confidential services.

Method: A random digit-dialed survey of 14- to 19-year-old adolescents was conducted in Monroe County, New York.

Cell-specific expression of fibronectin and EIIIA and EIIIB splice variants after oxygen injury.

Cellular fibronectin (cFN) expression is characteristic of injured tissues. Unlike plasma FN, cFN mRNA often contains the EIIIA or EIIIB domains. We examined the lung cell-specific expression of total cFN mRNA and the EIIIA and EIIIB splice variants in rabbits after acute oxygen injury.

Inflammatory and epithelial responses in mouse strains that differ in sensitivity to hyperoxic injury.

The pulmonary response to various toxicants including bleomycin, ozone, ionizing radiation, and hyperoxia is highly variable among mouse strains. The current study tests the hypothesis that at a similar stage of injury, regardless of strain, expression of inflammatory cytokine and epithelial marker genes would be similar, indicating a common pathway of injury progression. Three strains of mice, C57B1/6J, 129/J, and C3H/HeJ, ranging from sensitive to resistant, were exposed to > 95% O2 for varying times.

Three-year follow-up of vaccine response in extremely preterm infants.

Objective: To assess whether the adequate antibody response observed in former extremely premature infants after the primary series of immunizations is sustained after the first booster vaccines.

Subjects And Methods: Sixteen former extremely premature (<29 weeks, <1000 g at birth) and 17 former full-term (>37 weeks) infants had sera obtained for antibody titer measurement at 3 to 4 years of age. All had received the primary series and first booster vaccines for diphtheria, pertussis, tetanus, polio, and Haemophilus influenzae type b.

Fibromyalgia syndrome in children and adolescents: clinical features at presentation and status at follow-up.

Objectives: To 1) describe the characteristic features of fibromyalgia syndrome (FS) in a pediatric population, 2) note similarities and differences with FS in adults, and 3) determine outcome after treatment.

Setting And Design: The Pediatric Rheumatology Clinic at the University of Rochester Medical Center is staffed by two pediatric rheumatologists and serves as a regional subspecialty referral service with approximately 450 annual patient visits, of which approximately 120 are initial evaluations. A retrospective medical record review from 1989 to 1995 was used to identify and describe the study population, and a structured telephone interview served to determine current status and response to treatment.