PULMONARY OEDEMA FOLLOWING AIRWAY OBSTRUCTIN IN A PATIENT WITH HODGKIN'S DISEASE

We report a case of pulmonary oedema follwing airway obstructionin a patient who underwent biopsy of a tumo ur in volving theanterior mediastinum and neck. The occurrence of airway obstructionin patients with anterior mediastinal masses, and the pathogenesisof pulmonary oedema occurring in association with airway obstruction,are discussed.     

SCREENING FOR ALCOHOLISM IN GENERAL MEDICAL PATIENTS

Medical patients (N = 108) were administered a brief screeninginstrument (LAMSI) and a structured diagnostic interview (SUDDS).Twenty-five patients met DSM-III criteria for an alcohol usedisorder, 20 current, five in remission. The four-item scaleembedded in the screen identified the alcoholics with 88% sensitivityand 96% specificity.     

Enhancing and suppressive effects of tumour necrosis factor/cachectin on growth of Trypanosoma musculi

The effect of human recombinant TNF on the growth of T. musculi has been investigated. When added to parasites cultured in vitro, TNF inhibited their growth. In the presence of thioglycollate-elicited peritoneal exudate cells, the opposite effect was seen and TNF enhanced the growth of trypanosomes in vitro. Similarly, administration of TNF in vivo during the course of infection led to a net increase in the parasite population. It is suggested that TNF exerts a direct antitrypanosomal effect while simultaneously promoting the growth of the parasite through an indirect effect mediated via the host's cells, possibly the macrophages.     

Higher risk of infantile atopic dermatitis from maternal atopy than from paternal atopy

The risk of infantile atopic dermatitis (AD) posed by maternal atopy and paternal atopy, respectively, were compared in the infants from a birth cohort in whom one of the parents had been designated atopic by skin prick testing. Nineteen with atopic mothers were compared with 20 with atopic fathers. AD, other atopic manifestations and potentially influential factors such as breast-feeding were documented prospectively during the first year in all infants. At 3, 6 and 12 month assessments skin prick sensitivity and total serum IgE concentration were determined. Nine of 19 infants with atopic mothers and two of 20 with atopic fathers had AD (P = 0.023) giving a relative risk of 4.7 (95% confidence interval 2.5 to 9.0). Seven of 19 with atopic mothers and none with atopic fathers had AD with onset before 6 months (P = 0.007). When all types of disease evidence (AD, recurrent wheeze and food reactions) were analysed together no significant difference was apparent between the groups. The two groups were found to be well matched with regard to breast-feeding, time of starting cow's milk, solids and egg, sex, month of birth, parental AD and smoking, race, household pets and neonatal IgE concentration. IgE concentrations at each age and the prevalence of skin prick positivity were similar between the groups. Maternal atopy poses a higher risk for infantile AD and paternal atopy. Whether this may be due to genetic or congenital factors or both is uncertain, but clearly the finding is of relevance in the prediction of allergy in childhood.     

T cell clones from a Sjögren's syndrome salivary gland biopsy produce high levels of IL-10

Sjögren''s syndrome (SS) is characterized by a focal periductal salivary gland infiltrate consisting mainly of T and B lymphocytes. Most of the T cells bear the memory of CD4⁺ Th-1-like phenotype and express high levels of class II, though CD8⁺ cells are also present. We have studied 17 labial salivary gland and 15 peripheral blood T cell clones from a patient with primary SS. The tissue clones were 71% CD8⁺ and 29% CD4⁺, and the peripheral blood-derived clones were 60% CD8⁺ and 40% CD4⁺. The CD4⁺ T cell clones from both the salivary gland and autologous peripheral blood were of the Th1 phenotype, in that they produced interferon-gamma (IFN-γ) and IL-2 but very little IL-4 after 24 h stimulation with phorbol myristate acetate and anti-CD3 antibody. The salivary gland-derived CD4⁺ clones produced 15 times more IL-10 (7·92 ng/ml) than peripheral blood-derived CD4⁺ clones (0·52 ng/ml, P≤0·02). The tissue CD8⁺ clones produced 1·2 times (P<0·04) more IFN-γ and CD4⁺ clones produced 3·5 times less IL-2 (P<0·02) than the respective PBM-derived clones. The accumulation of Th1-type cells producing high levels of IL-10 in the salivary gland suggests a specific immunoregulatory function at the site of inflammation in SS.     

The IgG subclass antibody response to an inhalant antigen (Dermatophagoides pteronyssinus) during the first year of life: evidence for early stimulation of the immune system following natural exposure

This study investigates the early humoral immune response following natural exposure to an inhalant antigen (Dermatophagoides pteronyssinus) in 36 babies, from birth until 1 year of age. The total IgG and subclass 1 and 4 D. pteronyssinus-specific antibody levels were assayed in sera collected at 7 days, 3 and 12 months by ELISA. After an initial fall, due to the progressive loss of maternal antibodies, an IgG specific response to D. pteronyssinus was seen between 3 and 12 months. This was restricted to the IgG1 subclass when the values at 12 months were significantly higher than those detected at the third month (P less than 0.001, paired t test). No D. pteronyssinus-specific IgG4 antibody was detected in any subject at any of the time points tested. The present study demonstrates that inhalant as well as food antigens are able to stimulate the immune system during the first year of life and that the antibodies produced are of the IgG1 subclass.