ORIGINAL ARTICLES

February 2015
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816-22.

50 Years Ago in THE JOURNAL OF PEDIATRICS

Surface Properties and Lipids from Lungs of Infants with Hyaline
Membrane Disease
Adam FH, Fujiwara T, Emmanouilides G, Scudder A. J Pediatr 1965;66:357-46

ollowing the seminal report from Avery and Mead in 19591 that saline extracts of lungs of infants who had died of
respiratory distress syndrome (RDS) had high surface tensions, other investigators explored in more detail surfactant and its relationship to RDS. In this 1965 study, Adams et al measured surfactant lipid amounts, lipid compositions, and surface tensions for saline and organic solvent extracts of lungs of preterm infants. In general, samples from
infants with very low birth weights had less lipids and high surface tensions. The lecithin (phosphatidylcholine) content also was low. However, two infants with RDS had high amounts of lipids with good surface properties. The authors described the cases: one with 4 weeks rupture of membranes (probably infected) and the other with
intraventricular hemorrhage. They discuss the possibility that other substances lost in the extraction procedures could
interfere with surfactant function, a now well-known phenomenon that was not appreciated at the time. This article is
an early report that contributed to an understanding of surfactant deficiency. Dr Adams published 48 reports in The
Journal from 1946 to 1975, many on fetal lung development. Dr Fujiwara was a visiting scientist with Dr Adams at
University of California, Los Angeles in 1965, and he subsequently published the first report of the successful treatment
of RDS with animal source surfactant in 1980.2 The techniques he used to recover and purify that surfactant were
similar to those used in 1965 for these studies with premature infant lungs.

Alan H. Jobe, MD, PhD

Division of Pulmonary Biology
Cincinnati Childrens Hospital Medical Center
Cincinnati, Ohio

References

http://dx.doi.org/10.1016/j.jpeds.2014.08.061

1. Avery ME, Mead J. Surface properties in relation to atelectasis and hyaline membrane disease. AMA J Dis Child 1959;97:517-23.
2. Fujiwara T, Maeta H, Chida S, Morita T, Watabe Y, Abe T. Artificial surfactant therapy in hyaline-membrane disease. Lancet 1980;1:55-9.

The Protective Role of Family Meals for Youth Obesity: 10-Year Longitudinal Associations

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