OBJECTIVES: This study determined the initial otoacoustic (OAE) hearing screening results of newborns with collapsed ear canals and vernix caseosa in the ear canal and compared these to ears that were patent.
METHODS: Two hundred term newborns (400 ears) with normal APGAR scores, birth weight, maternal and gestational history, who were born between August 2013 to October 2013 and who had OAE hearing screening test done by trained midwives were included in this study. All of them underwent otoscopy after the OAE hearing screening test was done to determine patency of the ear canal and presence of vernix caseosa. The examining physician was blinded to the OAE results. Comparison between the OAE results and the otoscopic findings were done.
RESULTS: Four hundred ears were included in the study. Two hundred and fifty one ears (62.8%) had vernix caseosa and 42 ears (10.5%) had collapsed ear canal. The overall initial OAE hearing screening test pass rate of the newborns tested was 69.5%. The initial OAE hearing screening test pass rate of newborns those with ear canal vernix caseosa or collapsed ear canal, were 72.1% and 47.6%, respectively. Patent ears were found in 107 (26.7%) with a pass rate of 71.9%.
CONCLUSION:The pass rates of ears with vernix caseosa and collapsed ear canal were 72.1% and 47.6%, respectively. There was no significant difference between the OAE hearing screening test pass rates of ears with patent canal and ears that were collapsed and/ or had vernix caseosa. However, there was a statistically significant difference in pass rates between patent ear canals and collapsed ear canal

Otoscopy ; Infant, Newborn ; Vernix Caseosa

OBJECTIVETo explore the preliminary methods of in vitro isolation, culture and identification of sebocytes and eccrine sweat gland cells from human fetal skin.

METHODSHuman fetal skin was digested with dispase or type II collagenase, and then by micro - sieving to isolate human sebaceous gland and eccrine sweat gland cells. DMEM/F12 (1: 1) was used as the basic culture medium, supplemented with fetal bovine serum, recombinant human epidermal growth factor, L-glutamine, Hydrocortisone, choleratoxin, penicillin and streptomycin as the medium for sebocytes, or fetal bovine serum, recombinant human epidermal growth factor, triiodothyronine, hydrocortisone, insulin, transferrin, sodium selenite to the medium for eccrine sweat gland duct cells. Primary cultures and subcultures were incubated at 37 degrees C in humidified atmosphere of 5% CO2/95% oxygen. Cell morphology was observed by inverted phase contrast microscopy, and the cultured cells were identified with cell clone efficiency determination. The cultured sebocytes were identified with oil red staining and CK4.62, Epithelia Membrane Antigen (EMA) immunohistochemistry staining. The cultured eccrine sweat gland duct cells were identified with CK7, CK19 immunohistochemistry staining.

RESULTSThe isolated sebocytes and eccrine sweat gland cells from human fetal skin could grow by adhering to the wall and proliferate in vitro. The cell clone efficiency of human fetal sebocytes was 2.7%, which was obviously lower than that of human fetal keratinocytes (8.0%, P < 0.01). There was no obvious difference in the cell clone efficiency between human fetal eccrine sweat gland cells (7.3%) and human fetal keratinocytes (7.7%, P > 0.05) . The results of oil red staining indicated that a small quantity of lipid droplets in sebocytes, and immunohistochemistry staining of CK4.62, EMA were positive in subculture sebocytes. The immunohistochemistry staining of CK7, CK19 was positive in subculture eccrine sweat gland duct cells.

CONCLUSIONIn vitro cultured human fetal sebocytes and eccrine sweat gland duct cells displayed the markers and biological characteristics of epithelial lineage, but human fetal sebocytes proliferated more

Cell Culture Techniques ; Eccrine Glands ; cytology ; Fetus ; cytology ; Humans ; Sebaceous Glands ; cytology ; Skin ; cytology ; Vernix Caseosa ; cytology

Intrauterine respiratory movements were speculated from the ancient time, and numerous studies were carried out both in human and animal experiments. Results of these studies suggested that intrauterine respiratory movement exist regularly and there is free flow of amniotic fluid into fetal lung during the fetal life. Amniotic fluid contains desqumated epithelial cells, lanugo, and vernix caseosa. Thus, when the amniotic fluid is aspirated, these amniotic debris will also be aspirated. The effort of aspiration of amniotic debris were also studied by many investigators, and their report indicated that in normal gestation with normal delivery, aspiration of amniotic debris are minimal and gives no significant effect to neonatal infant. However, if the amniotic fluid contains excessive debris, by vigorous fetal movement due to intrauterine anoxia, a large amount of amniotic debris will be aspirate to cause disturbance in neonatal respiration. Demonstration of amniotic debris in the lung is carried out by the identification of desquamated epithelial cells or lipid which is present in vernix caseosa in alveolar lumen. Based on these observations, present study is planned to investigate the amount and distribution pattern of lipids in neonatally dead infant lung to correlate with aspiration of amniotic fluid to clinical data and coexisting pulmonary and systemic diseases. From the autopsy cases performed during January, 1973 and March, 1976, 26 cases of neonatal autopsies aged less than 10 days after the birth were subjected for the studies. From each case, sections of the lung were examined for the presence of amined for the presence of amniotic debris and pulmonary diseases after routine paraffin embedding and hematoxylin-eosin stain. For the demonstration of fat, frozen sections of lung tissue from each case were stained with oil red-O, and the amount and distribution of fat in the lung were recorded. The correlation of amount and distribution of fat with age of infants, gestation period, body weight, types of pulmonary and systemic diseaases were made and following results are obtained. RESULTS AND SUMMARY: 1. Fat is present frequently in the lungs of neonatally dead infants, and distributed widely in bronchioles, alveolar ducts, alveolar lumen, and alveolar wall. 2. As. The infant age is younger, less than 2 days, the larger amount and the wider distribution of the fat are noted. 3. The amount of fat was parallel to the amount of amniotic debris judged by desquamated epithelial cells in the alveolar lumina. 4. The most common associated diseases were congenital anomaly, prematurity, and respiratory distress syndrome.
Amniotic Fluid ; Animal Experimentation ; Anoxia ; Autopsy ; Body Weight ; Bronchioles ; Epithelial Cells ; Female ; Fetal Movement ; Frozen Sections ; Hair ; Humans ; Infant ; Lung Diseases ; Lung* ; Paraffin Embedding ; Parturition ; Pregnancy ; Research Personnel ; Respiration ; Vernix Caseosa

Several physiological skin changes such as vernix caseosa, cutis marmorata, physiologic desquamation, and sebaceous hyperplasia have been described in the neonatal period. There are also clinical characteristics of skin peculiar to neonate and infancy. Skin disorders observed during neonatal and infancy period can be divided into transient skin lesions, birth marks, and other diseases. Transient skin lesions include milia, sebaceous gland hyperplasia, erythema neonatorum, transient neonatal pustular melanosis, and acne neonatorum. Nevocellular nevus, mongolian spot, vascular malformation, hemangioma, epidermal nevus, and sebaceous nevus belong to birth marks. There are several common skin diseases such as miliaria, diaper dermatitis, atopic dermatitis, seborrheic dermatitis, and cutaneous candidiasis.
Acne Vulgaris ; Candidiasis, Cutaneous ; Dermatitis ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Erythema ; Hemangioma ; Humans ; Hyperplasia ; Infant, Newborn ; Melanosis ; Miliaria ; Mongolian Spot ; Nevus ; Parturition ; Sebaceous Glands ; Skin Diseases* ; Skin* ; Vascular Malformations ; Vernix Caseosa

BACKGROUND: Vernix caseosa (VC), which is known as a unique human substance, is a biofilm that covers the skin of most human newborns. VC has many biological functions including anti-infective, skin cleansing and skin barrier repair. OBJECTIVE: In the study, we purpose to investigate the novel effect of lipids extracted from VC on the regulation of filaggrin (FLG) expression and anti-inflammation in normal human epidermal keratinocyte (NHEK) cells. METHODS: The lipids were extracted by chloroform/methanol (Folch method) and the major properties of fatty acid methyl esters were determined with gas chromatography-mass spectrometer. The relative viability of NHEK cells was evaluated by Cell Counting Kit 8 assay. The related expression of skin barrier protein was accessed with real-time quantitative polymerase chain reaction, Western blot and Immunofluorescence in NHEK cells with or without poly (I:C). Meanwhile, the changes of thymic stromal lymphopoietin (TSLP) and tumor necrosis factor alpha (TNF-α) are analyzed by enzyme-linked immunosorbent assay. RESULTS: VC lipids mostly contained saturated and branched chains fatty acids. The expression of mRNA and protein of FLG were significantly increased after the supplement with lipid in NHEK cells. Meanwhile, lipids reversed the inhibition of poly (I:C) on FLG. Moreover, lipids suppressed the over secretion of TSLP and TNF-α induced by poly (I:C). CONCLUSION: These results indicate that lipids extracted from VC has positive effects on the expression of FLG and anti-inflammation, suggesting that lipids of VC may be used for a reference for novel therapeutic method in reducing and remedying skin disease like atopic disease.
Biofilms ; Blotting, Western ; Cell Count ; Enzyme-Linked Immunosorbent Assay ; Esters ; Fatty Acids ; Fluorescent Antibody Technique ; Humans ; Infant, Newborn ; Inflammation ; Keratinocytes ; Methods ; Polymerase Chain Reaction ; RNA, Messenger ; Skin ; Skin Diseases ; Tumor Necrosis Factor-alpha ; Vernix Caseosa