IFN-gamma production by Th1 cells generated from naive CD4+ T cells exposed to norepinephrine.

During activation in vivo, naive CD4(+) T cells are exposed to various endogenous ligands, such as cytokines and the neurotransmitter norepinephrine (NE). To determine whether NE affects naive T cell differentiation, we used naive CD4(+) T cells sort-purified from either BALB/c or DO11.10 TCR-transgenic mouse spleens and activated these cells with either anti-CD3/anti-CD28 mAbs or APC and OVA(323-329) peptide, respectively, under Th1-promoting conditions. RT-PCR and functional assays using selective adrenergic receptor (AR) subtype antagonists showed that naive CD4(+) T cells expressed only the beta 2AR subtype to bind NE and that stimulation of this receptor generated Th1 cells that produced 2- to 4-fold more IFN-gamma. This increase was due to more IFN-gamma produced per cell upon restimulation instead of more IFN-gamma-secreting cells, as determined by IFN-gamma-specific immunofluorescence and enzyme-linked immunospot. In contrast, Th1 cell differentiation was unaffected when naive T cells were exposed to NE and activated either in the presence of a neutralizing anti-IL-12 mAb or by APC from IL-12-deficient mice. Moreover, the addition of IL-12 to the IL-12-deficient APC cultures restored the ability of NE to increase Th1 differentiation. Taken together, these results indicate that a possible link may exist between the signaling pathways used by NE and IL-12 to increase naive CD4(+) T cell differentiation to a Th1 cell.

Health Jeopardy: a game to market school health services.

Health Jeopardy was developed by members of the School Nurse Organization of Minnesota to present information about health and to market the role of the school nurse. Although it was created for the Minnesota State Fair, it has been used in a variety of community settings. This interactive and fun game has been popular with both children and adults. Contestants were selected from the state fair audience, and each competed for prizes by answering questions about school health under the five categories of first aid and safety, nutrition, immunizations, communicable diseases, and school nurse facts. In addition to the state fair, Minnesota school nurses have used this game as both an informational and promotional tool in their school and community fairs.

Cytokine production by naive and primary effector CD4+ T cells exposed to norepinephrine.

We recently showed that clones of Th1 cells, but not Th2 cells, expressed a functional beta-2-adrenergic receptor (beta2AR) and that either norepinephrine or the beta2AR agonist terbutaline stimulated this receptor to modulate the level of Th1 cytokines produced. In the present study, we show that norepinephrine and terbutaline stimulate the beta2AR to decrease the level of IL-2 produced by freshly isolated murine splenic naive CD4+ T cells from either Balb/C or DO11.10 transgenic mice and activated polyclonally with anti-CD3 and anti-CD28 mAbs. In contrast, the level of cytokines produced by primary effector Th1 and Th2 cells were unaffected when norepinephrine, terbutaline, or cAMP analogs were added at the time of restimulation. These results suggest that a diversity exists among CD4+ T-cell subsets with respect to the level of adrenergic receptor expression, responsiveness to cAMP, stage of cell differentiation, or a combination of the above.

Organ and tissue donation: rights and responsibilities.

Critical care staff members have an obligation to facilitate the rights of individuals and their families regarding organ and tissue donation. These rights can be promoted through collaboration between a hospital and an organ procurement organization. Collaboration and education will help organ and tissue donation become part of institutional norms, and health care professionals will be able to provide the option of donation as part of the continuum of care.

Noncompliance in organ transplant recipients.

The frequency of noncompliance with postoperative medical therapy ranges from 2% to 43% in organ transplant recipients and causes more graft loss than uncontrolled rejection in compliant patients. Retrospective and prospective studies undertaken at our center showed no difference in the rate of noncompliance between males and females or between recipients of cadaveric kidneys and those from living, related donors. Patients less than 20 years of age were statistically the most noncompliant (p = 0.0001) compared with those over 40 years. A significant difference in compliance was seen among blacks, Hispanics, and non-Hispanic whites, with the greatest frequency in blacks. This was not due to race, but to socioeconomic status, with those in the low socioeconomic group the most noncompliant. Problems of noncompliance may be reduced if they are identified early in the treatment course.

Free thyroxine and free thyroxine index in women taking oral contraceptives.

This study compares the accuracy of the free thyroxine index and free serum thyroxine radioassay in evaluating the metabolic status of 36 euthyroid women, 17 of whom were taking oral contraceptive drugs. Results indicate that the free thyroxine index does not uniformly compensate for estrogen-induced elevations in total serum thyroxine concentrations and that the free serum thyroxine is the test of choice in assessing the functional thyroid status of women taking oral contraceptive drugs.

PIP: A comparative laboratory study was conducted to assess the comparability of FTI (free thyroxine index) and measured free T4 (thyroxine) levels in 36 euthyroid women. The 36 women in the study were not pregnant; 17 of them were taking OCs (oral contraceptives). The frequency distribution of free T4 values were comparable for the OC users and the nonusers. There was a definite highly significant bimodal distribution in values for FTI between the 2 groups, with the values higher in the OC group. The lack of agreement between the 2 measurements--FTI and free T4--was probably due to the failure of the T3% RU (T3% resin uptake) to adequately compensate for estrogen-induced elevations in serum thyroxine binding proteins and total serum T4 levels. The FTI only partially compensates for estrogen-induced elevations in total T4 concentrations, resulting in abnormally high FTI values in many euthyroid women using OCs. The free T4 test was not influenced by elevated serum thyroxine binding protein levels and is, therefore, a more useful test in screening for thyroid dysfunction during pregnancy or estrogen therapy.

Gastroesophageal scintigraphy with and without compression.

This study compares the results of radionuclide gastroesophagography performed by the compression and computer-assisted noncompression techniques. The overall accuracy of the compression and noncompression methods was 71% and 84%, respectively. The use of computer processing significantly enhances the ability to detect minor degrees of reflux and may explain the better results obtained with the noncompression method. Other advantages of the noncompression technique include its technical ease and uniformity and the acquisition of more physiologic data for comparison with results of the acid reflux test.