Passive smoking: A danger to children''s health

The most common cause of illness in infancy and childhood is acute infection of the respiratory tract. Several recent studies have reported that life-threatening respiratory disease in infancy, such as pneumonia and bronchiolitis, is directly related to the smoking habits of parents. The effects of smoking are more hazardous to youngsters because babies and young children breathe more rapidly than adults. Because of this higher breathing rate, they inhale more air—and more pollution—in comparison to their total body weight. The harmful effects of cigarette smoking on infants and children and recommendations for specific interventions to minimize or eliminate this health hazard are discussed.     

Partial Adrenalectomy for Renal Cell Carcinoma With Bilateral Adrenal Metastases

Resection of the adrenal glands precludes participation in many immunotherapy protocols for metastatic renal cell carcinoma. We performed radical nephrectomy with adrenalectomy and contralateral partial adrenalectomy, including adrenal vein ligation for a 4 cm. hilar metastasis without perioperative complications or local recurrence after 30 months. Adrenal function, measured by cosyntropin stimulation tests 6 weeks and 10 months postoperatively, was normal. Partial adrenalectomy with preservation of adrenal function is possible.     

Low-artifact intravascular devices: MR imaging evaluation

Flow-phantom magnetic resonance (MR) imaging, with use of both spin-echo (SE) and gradient-echo (GRE) techniques at 1.5 T, was performed on the percutaneous Greenfield (beta-III titanium alloy [TMA wire]), Amplatz (MP32-N alloy), and Simon nitinol filters and TMA wire facsimiles of the bird's nest, Gunther, new retrievable, and Amplatz vena caval filters. SE imaging allowed detection of thrombi as small as 5 X 5 mm trapped within the percutaneous Greenfield, Simon nitinol, and TMA-wire facsimile filters; with the MP32-N Amplatz filter, a larger volume of thrombus (10 X 20-mm clots) was necessary for clot detection. GRE imaging allowed detection of intraluminal tilting of the percutaneous Greenfield and facsimile Amplatz (TMA-wire) filters. GRE imaging was useful for demonstrating postfilter turbulence due to clots, which was greatest for the Amplatz filter. Imaging of facsimile vascular devices made of tantalum or TMA wire did not cause the severe "black-hole" MR artifacts typical of the stainless-steel devices. SE and GRE imaging were very useful for determining caval patency in two patients with previously placed Mobin-Uddin filters. Noninvasive MR evaluation of blood vessels in the presence of a variety of low-artifact intravascular devices appears feasible.     

Lymphokine production by MLR-reactive reaction lymphocytes obtained from normal mice and mice rendered tolerant of class II MHC antigens

A large proportion of mice rendered neonatally tolerant of class II MHC antigens respond to the tolerogen in vitro in an MLR, while simultaneously maintaining tolerance in vivo as evidenced by acceptance of a skin graft bearing the tolerated antigens. To determine whether this discrepancy between in vivo and in vitro tolerance is reflective of differences in the amount and/or type of lymphokines produced by tolerant lymphocytes, we have examined the ability of tolerogen-reactive lymphocytes to produce IL-2, IL-4/5, and IFN in vitro in an MLR. Our results demonstrate that when stimulated with the tolerogen, lymphocytes from both normal and tolerant responders produce IL-2 and interferon. However, in comparison to normal cells, 2 alterations in the tolerogen-specific responses of lymphocytes obtained from tolerant mice were identified. (1) The amount of IL-2 in the supernatants derived from tolerant cultures declines prematurely compared to normal cultures. This premature decline in IL-2 production was due neither to a lower frequency of Th cells as judged by limit dilution analysis nor to an increase in IL-2R expression on tolerant lymphocytes as measured by FACS analysis. (2) IL-4 and presumably IL-5 can be demonstrated in supernatants of tolerant, but not normal, lymphocytes stimulated by the tolerogen. Thus although lymphocytes from MLR-positive tolerant mice generate substantial quantities of lymphokines in response to the tolerogen, the pattern of lymphokine production is unusual when compared to that of normal lymphocytes. These results are inconsistent with the notion that a global lack of helper activity, per se, is responsible for the maintenance of tolerance in these mice and furthermore suggest that tolerance could be the result of "inappropriate" lymphokine production.