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The NBT test is used as supporting evidence for the diagnosis of sepsis in children and adults. In neonates the previously observed high values in normal subjects preclude such use. Our pre liminary observations on 15 healthy term newborns showed that high heparin doses gave falsely elevated NBT values; when heparin dosage was controlled (1 unit/ml NBT solution) consistent values of <20% were obtained in 68 normal infants of 25-43 wks of gestation. Since respiratory distress is a colrmon presenting sign for both hyaline membrane disease (HMD) and neonatal sepsie we have performed the NBT test in 25 infants with such signs to evaluate the NET test in the differential diagnosis of HMD vs. sepsis. Endotoxin-stimulated NBT preparations were also performed to insure phagocytic inducibility of the neutrophils. NBT slides were read without knowledge of each infant's clinical diagnosis. HMD Endorphins are endogenous polypeptides with morphine-like activity which are widely distributed in the central nervous system and bind to opiate receptors. They presumably function as inhibitory neurotransmitters in pain pathways. We tested the hypothesis that endorphins modified the respiratory response to asphyxia in newborn rabbit pups (3-5 days of age). Pups from the same litter were injected I.P. with either 1 ml saline or 1 ml (0.4mg) naloxone,a specific endorphin antagonist. Five minutes later asphyxia was produced by tracheal occlusion and maintained until gasping r e s w after primary apnea. Four occlusions were done on each pup and 3 minutes allowed for recovery between occlusions. The time to primary apnea increased by 201 from 44.221.5 (S.E.) s a n saline pups to 52.921.9 sec in naloxone pups (p<.001) while the duration of primary apnea decreased by 60% (45.5f11.1 vs 18.3f 2=(p-.01).The tracheal pressure achieved during the first gasp following primary apnea was identical in saline and naloxone pups (54.2f2.7 vs 54.3t2.5 cn H2O). Naloxone acts by competitive blockade of opiate (endorphid receptors. These data therefore provide evidence that endorphins modify the respiratory respcnse to asphyxia by decreasing the frequency of respiratory center Cischarge but do not appear to decrease the amplitude of the respiratory center output at the time of the first gasp. We conducted a retrospective study by telephone interview (12-24 months later) of 26 families who had experienced perinatsl death (7 stillborn. 19 neonatal). 14/26 had had subsequent pregnancies. 6/26 had a prolonged grief reaction (12-20 months). Those mothers with a surviving twin or subsequent pregnancy < 5 months following the death were st higher risk for a prolonged grieving period than were those without subsequent pregnancy or one > 6 months later (p 6.01). 12/26 families obtained information about the cause of death and risk of recurrence only during hospitalization; subsequent contact. weeks to months later, provided additional information in 14/26 (by phone in 5, in person in 9). 22/26 mothers met predetermined criteria for having adequate understanding ...