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Pregnant rats received 0.10 or 0.20 mg/kg body weight betamethasone, or 100 mg/kg body weight L-carnitine, or L-carnitine 100 mg/kg plus betamethasone 0.05 or 0.10 mg/kg body weight, or saline (controls) for three days before delivery of foetuses at day 19 of gestation. Dose-related effects on the dipalmitoyl phosphatidylcholine content and the phosphatidylcholine species composition of foetal and maternal lungs were determined. Betamethasone (0.10 and 0.20 mg/kg) or L-carnitine (100 mg/kg) significantly increased (p < 0.05) the dipalmitoyl phosphatidylcholine content in the foetal lungs, while only small changes were found in relative terms. Combinations of betamethasone (0.05 or 0.10 mg/kg) with L-carnitine (100 mg/kg) also significantly increased the dipalmitoyl phosphatidylcholine content of the foetal lungs above control values (p < 0.01) and above the values achieved with betamethasone alone (p < 0.05). In the maternal lungs a significant increase of the dipalmitoyl phosphatidylcholine content above the control values was only found after treatment with betamethasone-carnitine combinations, whereas compared with the foetal lung the relative increase of dipalmitoyl phosphatidylcholine as a fraction of total phosphatidylcholine was more pronounced after betamethasone treatment. The gas chromatographic method used separates two monoenoic phosphatidylcholine species with 32 carbon atoms in the acyl residues. These two phosphatidylcholine species showed striking differences between adult and foetal lungs. Palmitoleyl palmitoyl phosphatidylcholine predominates in the maternal lung, whereas palmitoyl palmitoleyl phosphatidylcholine is the major monoenoic phosphatidylcholine species with 32 carbon atoms in the foetal lung. These two species were not affected in maternal or foetal lung by betamethasone or L-carnitine treatment. In contrast, after treatment with betamethasone-carnitine combinations, a significant increase of the fraction of palmitoyl palmitoleyl phosphatidylcholine was found in foetal but not in the maternal lung. The results of the present study demonstrate that maternal glucocorticoid and carnitine treatment affects the maternal as well as the foetal lung but with different effects on the dipalmitoyl phosphatidylcholine content and phosphatidylcholine species composition.

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The aim of the present study was to examine the effects of maternal carnitine treatment combined with thyroxine, a hormone influencing both lung maturation and carnitine metabolism. Administration of a carnitine-thyroxine combination to pregnant rats resulted in a significant increase of DPPC content in fetal rat lungs to 8.8 +/- 1.8 mg/g dry weight (mean +/- SD), compared with the control group, the carnitine-treated group, and the thyroxine-treated group [5.4 +/- 1.8 (p less than 0.01), 5.6 +/- 1.5 (p less than 0.01), and 6.6 +/- 1.0 mg/g dry weight, respectively]. The portion of DPPC in the PC species increased significantly from 20.9 +/- 2.1% in the control group and to 27.2 +/- 3.5% (p less than 0.01) in the carnitine-thyroxine combination group. A significant (p less than 0.01) diminution of the palmitoyl-palmitoleyl PC (16:0/16:1-PC) portion in the PC species was found. Maternal carnitine administration resulted in an elevation of the carnitine levels in the fetal lungs to approximately twice those of the controls (p less than 0.01). The combined administration of carnitine and thyroxine resulted in no increase in the total carnitine content but in a significant (p less than 0.01) increase of the short chain acylcarnitine content. The present results demonstrate that carnitine potentiates the effects of thyroxine on DPPC content and support the concept of an interrelationship between carnitine and thyroxine metabolism.

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Advances in the understanding of the neonatal respiratory distress syndrome have led to a proliferation of amniotic fluid tests. Measurement of pulmonary surfactant production is the most direct means of assessing pulmonary maturity. Assays of surfactant are subjected to certain pre-analysis sources of variation, such as variability in amniotic fluid volume, sample collection site, centrifugation speed and time, and contamination with blood and/or meconium. Amniotic fluid surfactant assays can be divided into biochemical and functional tests. When properly performed, both approaches yield results that correlate well with clinical findings. However, no single method has achieved the distinction of total reliability and universal applicability. In most tests the value for mature lungs is almost 99% accurate. On the other hand, immature values have very low accuracy. Therefore, it is advisable to perform an additional test or to repeat the determination. The determination of the lecithin/sphingomyelin ratio is characterized by sufficient accuracy for routine analyses. For scientific studies we recommend the use of a capillary gas-chromatographic method allowing an accurate assessment of dipalmitoylphosphatidylcholine, the most important surfactant constituent.

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Administration of L-carnitine or betamethasone to pregnant rats failed to increase either the total phospholipid or dipalmitoylphosphatidylcholine (DPPC) contents in foetal rat lungs on the 20th day of gestation, compared to controls. The combined administration of betamethasone (0.3 mg/kg) and L-carnitine (80 mg/kg) resulted in a pronounced increase of dipalmitoylphosphatidylcholine (7.8 +/- 2.5 mg/g dry weight) compared with the control group (5.4 +/- 1.8 mg/g dry weight), and compared with the groups receiving betamethasone (5.9 +/- 1.9 mg/g dry weight) or L-carnitine (5.6 +/- 1.5 mg/g dry weight) alone. The proportion of dipalmitoylphosphatidylcholine in the phosphatidylcholine species increased from 20.9 +/- 2.1% in the foetal lungs of the control group to 22.6 +/- 5.0% in the L-carnitine group, to 24.3 +/- 3.3% (p less than 0.01) in the betamethasone-L-carnitine (20 mg/kg) group, to 25.2 +/- 3.5% (p less than 0.01) in the betamethasone group, to 27.1 +/- 2.6% (p less than 0.01) in the betamethasone-L-carnitine (40 mg/kg) group, and to 28.4 +/- 3.7% (p less than 0.01) in the betamethasone-L-carnitine (80 mg/kg) group, while the palmitic acid portion in the phosphatidylcholine fatty acids was nearly unchanged. A pronounced increase of palmitoyl-myristoyl phosphatidylcholine (PC-30), the second disaturated phosphatidylcholine species present in lungs in significant amounts beside dipalmitoylphosphatidylcholine, was noted only in betamethasone treated animals. Furthermore, after betamethasone and betamethasone-L-carnitine treatment, a significant diminution (p less than 0.01) of the proportion of palmitoyl-palmitoleyl phosphatidylcholine (16 : 0/16 : 1-PC) in the phosphatidylcholine species was demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

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.he Prevical curette is a new instrument for an early diagnosis of carcinoma of the endometrium. The good acceptance of this method, which can be practised on an outpatient basis without anaesthesia, has been described by other groups of researchers. To check its reliability, we analysed endometrium specimens of 105 patients both cytologically and histologically. The collection of the material by the cytological method was successful in 99% of the cases, whereas clinical interpretation was possible in 94%. With nine carcinomas of the endometrium in the examined women, no false negative result was obtained. Hence, the use of this curette seems to be useful in patients with special risk factors and patients who cannot be anaesthetised. It should, always be kept in mind that the Prevical curette is conceived as a screening method which cannot replace histological clarification.

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Conventional and recently developed hysterectomy clamps were examined with respect to sure, nonslip grip and minimum resulting tissue trauma. Slippage was appraised by means of the tenacity testing device, tissue damage on the basis of macroscopic, histologic, and scanning-electron-microscope findings. The new clamp (Zeppelin) comes closest to meeting the demands set for sure grip and gentleness to tissue as compared to the conventional clamps (Wertheim, Rogers, Masterson) and best satisfies requirements for the use in hysterectomies today.

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Colloidosmotic pressure (COP), osmotic and hydrostatic pressures are important parameters in passive maternofetal fluid exchange. Using a new method (Hansen-/Knauer-Osmometer), COP-measurements were carried out on maternal blood plasma (COP 355 +/- 55 mmH2O), fetal plasma (COP 290 +/- 51 mmH2O) and amniotic fluid COP 12.6 +/- 5.8 mmH2O) obtained of 30 pregnant women during delivery at term. The interpretation of the resulting pressure gradients must consider physiochemical properties of protein solutions and the "selectivity" of biologic and artificial membranes. Membrane osmometry registers pregnancy-specific protein alterations, yields additional information concerning the physiology and pathology of fluid exchange, and may continue advanced development of kybernetic model conceptions.

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44 specimens of amniotic fluid from the 25 week's gestation onwards were tested in a modified Wilhelmy-Langmuir surface balance. In addition percentage of lecithin in total phospholipids, total phospholipd phosphorus concentration and fatty acid composition of lecithin was determined. Lecithin, total phospholipid-phosphorus and palmitic acid show significant rises in concentration with gestational progress. The results of the surface tension measurements are significantly correlated with the biochemical analysis. Therefore, fetal lung maturity seems to be well estimated by the biomechanical method.

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