ABSTRACT. Objective. Since 1989, American parents have adopted 18 846 Chinese children. This study assesses the health and developmental status of these children after their arrival in the United States.Patients and Methods. A total of 452 children (443 girls) in 2 groups were evaluated. The clinic group children (n ‫؍‬ 192) included all Chinese adoptees seen in an international adoption clinic between 1991 and 1998. The travel group comprised 260 of 325 Chinese children placed by a single Massachusetts adoption agency between 1991 and 1996 whose adoptive parents and American physicians responded to mailed questionnaires. One hundred ninety-one of the travel group children were cared for by 1 of us (N.W.H.) during the adoption process in China.Results. Growth and developmental delays were frequent in the clinic group. Z scores <؊2 were found in 39% of children for height, 18% for weight, and 24% for head circumference. The duration of orphanage confinement was inversely proportional to the linear height lag (r ‫؍‬ .9), with a loss of 1 month of height age for every 2.86 months in the orphanage. Of the children, 75% had significant developmental delay in at least 1 domain: gross motor in 55%, fine motor in 49%, cognitive in 32%, language in 43%, social-emotional in 28%, activities of daily living in 30%, and global delays in 44%.The incidence of medical problems was similar in both groups of children (travel group and clinic group). Overall, among the 452 children, elevated lead levels were found in 14%, anemia in 35%, abnormal thyroid function tests in 10%, hepatitis B surface antigen in 6%, hepatitis B surface antibody in 22%, intestinal parasites (usually Giardia) in 9%, and positive skin test results for tuberculosis in 3.5%. One child each had hepatitis C exposure and congenital syphilis. No child had human immunodeficiency virus infection. Unsuspected significant medical diagnoses, including hearing loss, orthopedic problems, and congenital anomalies, were found in 18% (81/ 452) of the children.Conclusions. Chinese adoptees display a similar pattern of growth and developmental delays and medical problems as seen in other groups of internationally adopted children. An exception is the increased incidence of elevated lead levels (overall 14%). Although serious medical and developmental issues were found among the children, overall their condition was better than expected based on recent publicity about conditions in the Chinese orphanages. The long-term outcome of these children remains unknown. Pediatrics 2000;105(6). URL: http://www. pediatrics.org/cgi/content/full/105/6/e76; China, adoption, orphanage, institutionalized child.ABBREVIATIONS. AST, asparate aminotransferase; ALT, alanine aminotransferase; HIV-1, human immunodeficiency virus type 1; SD, standard deviation; TSH, thyroid-stimulating hormone.

Interleukin 1 receptor antagonist (IL-lra), a naturally occurring polypeptide with amino acid sequence homology to interleukin la (IL-la) and interleukin 113 (IL-1.8),prevents Escherichia coli-induced shock and death. Both IL-i and IL-lra are produced by monocytes stimulated with lipopolysaccharide (LPS). Because interleukin 4 (IL-4) suppresses IL-1 production, we investigated whether IL-4 modulated IL-ira synthesis in LPS-stimulated human peripheral blood mononuclear cells. IL-113 and IL-lra were measured by specific RIAs. IL-4 alone (0.01-100 ng/ml) did not stimulate IL-1p3 synthesis but rather induced IL-lra (4.82 ± 0.94 ng/ml). LPS induced synthesis of both IL-113 (6.67 + 1.06 ng/ml) and IL-ira (10.77 ± 2.79 ng/ml). IL-4 suppressed LPS-induced IL-1.8 mRNA accumulation and synthesis. However, IL-4 acted synergistically with LPS in inducing IL-ira. IL-4 enhanced LPS-induced IL-lra mRNA accumulation 4-fold and IL-lra protein synthesis nearly 2-fold. Moreover, IL-lra mRNA levels were maximal after 6 hr of exposure to LPS but peaked within the first 3 hr in the presence of IL-4. IL-4 added as late as 12 hr after LPS stimulation still enhanced IL-Ira synthesis. In human peripheral blood mononuclear cells stimulated with IL-ia, IL-4 markedly suppressed IL-1p8 production but enhanced IL-lra synthesis >2-fold. Because IL-4 favors synthesis of the natural antagonist IL-lra over synthesis of the agonist IL-1, IL-4 may exert potent antlinflammatory effects on host responses to Gram-negative infections.Interleukin 4 (IL-4), a 20-kDa polypeptide secreted by T cells and mast cells, has pleiotropic effects on hematopoietic cells (1). Human IL-4 promotes growth of activated B and T cells (2, 3), induces IgE production (4), and enhances expression of B cell surface antigens, including the low-affinity receptor for IgE (FceRII/CD23) (5, 6) and class II major histocompatibility complex molecules (7). Nonlymphoid hematopoietic cells also express IL-4 receptors (8). IL-4 induces FcERII on human monocytes (6, 9) but down-regulates the expression of all three Fcy receptors (10). Furthermore, IL-4 induces in vitro differentiation of human monocytes-i.e., changes in morphology and enhanced expression of class II major histocompatibility complex antigens (11). Moreover, IL-4 suppresses interleukin 1 (IL-1) synthesis (12,13 (Whittaker Bioproducts)/2 mM L-glutamine/penicillin at 100 units per ml/streptomycin at 100 ,ug/ml (GIBCO). PBMC (2.5 x 106 cells per ml) were stimulated with lipopolysaccharide (LPS) from Escherichia coli 055:B5 (10 ng/ml; Sigma) or human recombinant IL-la (10 ng/ml; provided by A. Tagliabue, Sclavo Research Center, Siena, Italy) with or without human recombinant IL-4 (0.01-100 ng/ml; provided by T. Nagabhushan, Schering-Plough, Bloomfield, NJ). PBMC cultures were incubated in 12 x 75 mm polypropylene round-bottom tubes (Becton Dickinson) for 24 hr at 370C in a humidified atmosphere containing 5% C02.Cytokine RIAs. After incubation, cultures were subjected to three freeze-thaw cycles. This procedure is op...

Nucleus magnocellularis (NM) and nucleus laminaris (NL) are, respectively, second- and third-order auditory nuclei in the chicken brain stem. In this report the morphogenesis of these nuclei is examined. The times of origin of the cells of these nuclei were studied with 3H-thymidine autoradiography. The number of cells in each nucleus and their rostro-caudal distribution within each nucleus was determined in Nissl-stained sections at 9, 11, 13, 15, 17, 19, and 21 days of incubation. For the above ages the volumes of NM and NL were also calculated planimetrically and the rostro-caudal distribution of volume within each nucleus was studied.

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