Spinal fluid samples were obtained from 18 asphyxiated term (GA 40 + 2 wks, BW 3064 2 583 gms) neonates to determine whether CSF LDH and CPK are useful predictors of neurologic disability following perinatal asphyxia. These values were compared with CSF enzymes from 7 term (GA 40 5 1 wk, BW 3521 + 510 gms) nonasphyxiated infants. Asphyxia was present if the 5 min. Apgar score was < 4 or pH < 7.0 or failure to breathe by 10 min. or hypotonia persisting for 2 hrs. Spinal fluid samples were obtained from the asphyxiated infants at 11.8 2 5.3 hrs. and from control infants at 32.4 + 29 hrs. Neurodevelopmental follow-up ranges from 3-15 months in the 15 surviving infants. Abnormal outcome includes death (3), some form of cerebral palsy (8), a& normal Gesell screening (7) or abnormal brain stem auditory responses (4). 8 infants are presently normal. CSF-LDH ( Si dbury) .A number o f endogenous chemical f a c t o r s p l a y a r o l e i n development o f the b r a i n . W e have shown t h a t several peptide neurotransmitters i n f l u e n c e neural development by permanently r e g u l a t i n g t h e expression o f t h e i r own receptors. The regulat i o n o f t h e r e c e p t o r s a f f e c t s t h e animalbs s e n s i t i v i t y t o t h e peptide and i t s behavior. For example, substance P (SP) i s a p e p t i d e important i n p a i n pathways. When administered t o neon a t a l r a t s (1 ~g/pup/day) d u r i n g t h e f i r s t week a f t e r b i r t h , SP permanently increased t h e number o f SP r e c e p t o r s i n several sensory regions o f the b r a i n . The r a t s as a d u l t s showed g r e a t e r s e n s i t i v i t y t o cutaneous s t i m u l a t i o n than c o n t r o l r a t s . S i m i l a rl y , r a t s i n j e c t e d as neonates w i t h o p i a t e peptides d u r i n g t h e f i r s t week a f t e r b i r t h ( 1 pg/pup/day) had more o p i a t e recept o r s i n several b r a i n regions than c o n t r o l s . These r a t s showed g r e a t e r t o l e r a n c e o f m i l d l y noxious s t i m u l a t i o n than c o n t r o l s , i n d i c a t i n g t h a t they were more s e n s i t i v e t o t h e i r endogenouslyreleased o p i o i d peptides.These experiments i n d i c a t e t h a t e a r l y exposure t o neuropeptides has a long-term i n f l u e n c e on b r a i n f u n c t i o n by r e g u l a t i n g expression o f peptide receptors, and t h e r e f o r e t h e b r a i n ' s a b i l i t y t o respond t o neuropeptides.NEUROTOXIC COMPLICATIONS OF CONTRAST CT I N CHILDREN. Computed c r a n i a l tomography (CT) has been considered a safe and accurate method f o r studying i n t r a c r a n i a l l e s i o n s i n children. As a d i a g n o s t i c adjunct, r a d i o g r a p h i c c o n t r a s t m a t e r i a l i s adm i n i s t e r e d i n t r a v e n o u s l y ( I V ) t o enhance and f u r t h e r c h a r a c t e r i z e l e s i o n s such as vascular malformations. T r a d i t i o n a l i o n i c cont r a s t agents can penetrate t h e blood b r a i n b a r r i e r (BBB) and e x e...