Thirty-three matched maternal venous and umbilical cord vein and artery plasma samples were obtained at elective caesarean section and t h e concentrations of the individual free fatty acids determined. The maternal levels were 1.009 (SEM 0.043) and t h e umbilical vein-artery difference was 0-036 (SEM 0.011) mmol/l. There was a significant correlation between the mean concentration in maternal venous blood and the vein-artery difference for myristic, palmitic, stearic, linoleic and docosahexaenoic acids but not for oleic acid. When arachidonic acid concentration in the fetus was high, then the veinartery difference was negative (flow t o the placenta), when it was low, t h e difference was positive (How to the fetus). Thus whilst there appears in general t o b e a flow of fatty acid to the fetus dependent 011 maternal free fatty acid concentrations, the transfer of arachidonic acid is largely determined by other factors. T h e reasons why oleic acid does not behave like the other fatty acids is not clear.
Ten patients with psoriasis resistant to conventional topical treatment were given dietary supplements of fish oil, providing approximately 12 g of eicosapentaenoic acid daily for a period of at least 6 weeks. In eight patients there was a modest improvement in their psoriasis, the principal effects being a diminution of erythema and scaling. The dietary treatment resulted in a substantial inhibition of leukotriene B4 production by the peripheral blood polymorphonuclear leukocytes in vitro. The discrepancy between the high degree of inhibition of leukotriene B4 synthesis and the modest therapeutic effect suggests that leukotriene B4 is not the only mediator involved in the development of the psoriatic lesion. Furthermore, the in vivo cutaneous levels of leukotriene B4 might not have been inhibited to the same extent as the polymorphonuclear leukocyte levels in vitro. Further studies on the use of fish oil supplements, both on their own and in conjunction with other forms of treatment in psoriasis are warranted. It will also be important to determine whether the altered profile of 5-lipoxygenase products found in the blood is also seen in the skin.
There is mounting evidence that a variety of drugs delivered as aerosols are likely to be of benefit in neonatal units. To avoid many of the problems associated with the use of jet nebulisers in ventilator circuits, a chamber was designed to be used in conjunction with a metered dose inhaler (MDI). The dimensions (4 cmxll cm) were chosen in an attempt to maximise drug delivery. In vitro studies were subsequently performed in order to determine the optimum operating conditions. Sodium cromoglycate delivered via this system was collected on a filter placed between the tip of an endotracheal tube and a model lung. The dose delivered was determined by means of an ultraviolet spectrophotometric assay. Using a Draeger Babylog 8000 ventilator it was found that drug delivery as maximised by actuating the device just before the inspiratory cycle when the chamber was placed adjacent to the endotracheal tube and by using a long (one second) inspiratory time. Under these conditions 1X5-2% of the original dose was deposited upon the filter at tidal volumes of 11-22 ml. When considered in terms of body weight this is many times the equivalent dose delivered to adults from an MDI. Effective drug delivery to the filter was confirmed using a radiolabeiled aerosol. Radiolabelled studies delivering aerosol to the lungs of intubated rabbits demonstrated that deposition aerosol was distributed uniformly between lobes when corrected for the weight of each lobe.In conclusion, the device appears likely to deliver significant, reproducible quantities of drug to the lower respiratory tract while being simple to use.
Summary The concentrations and fatty acid composition of the plasma free fatty acid, triacylglycerol and phospholipid fractions were determined in maternal and umbilical cord vein blood samples taken at delivery from 17 mares. Maternal and umbilical vein plasma free fatty acid concentrations were of a similar order and a positive correlation was found between the two levels suggesting that the equine placenta is permeable to fatty acid. Substantial amounts of the essential fatty acids and their longer chain derivatives were seen in both umbilical vein plasma free fatty acid and phospholipid fractions supporting this view. Certain long chain polyunsaturated derivatives of the essential fatty acids found in the umbilical venous plasma phospholipid fraction were not seen in the maternal circulating lipids. The precursor fatty acids were readily available to both foetal and placental tissues and therefore must have been elongated and incorporated into phospholipid by either or both. Very small amounts of the essential fatty acids were found in adipose stores in the newborn foal and virtually no fat stores at all in the newborn foal liver.
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