Perfluorochemical (PFC) liquids are biologically inert and nonbiotransformable substances that, when used as breathing medium, may be transported across the lung epithelium in small quantities, distributed throughout the body, and ultimately vapourized through the lungs and transpired through the skin. To further evaluate the uptake, biodistribution and elimination of a PFC liquid (perfluorodecalin) in the neonatal population, arterial blood, tissue and expired gas samples were obtained from preterm lambs (105-114 days gestation). Two groups of premature lambs were studied: Group I (n = 4) lambs were liquid ventilated from birth for 1 h and killed without exposure to gas ventilation (GV) and Group II (n = 5) lambs were liquid ventilated for 1 h followed by up to 2 h of GV. Samples were analysed by electron-capture gas chromatography and data were expressed in nl of PFC/ml of blood or gas and nl of PFC/gm tissue. During liquid ventilation and subsequent GV, PFC blood levels significantly increased (P < 0.001) from baseline control levels (0.007 +/- 0.001 SE nl PFC/ml blood) to a high of 2.95 +/- 1.03 SE nl PFC/ml blood. Perfluorochemical levels measured in expired gas (Group II) demonstrated a rapid decrease as a function of time of GV. Tissue levels of PFC indicated that uptake of PFC in Group I was significantly different (P < 0.001) than baseline levels and organ dependent; the highest levels were in the lungs (221 +/- 26.2 SE nl PFC/g tissue) and the lowest in the liver (2.24 +/- 1.6 SE nl PFC/g tissue). Comparison of tissue levels of PFC between groups indicated a 34.8% mean decrease across organs in Group II compared with Group I. These data indicate that PFC uptake and elimination is organ dependent and that PFC liquids can be eliminated through the lungs upon return to GV. Sustained PFC blood levels may be related to residual PFC in the organs and lung as well as regional variation in ventilation-perfusion matching upon return to GV.

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To evaluate human immunodeficiency virus (HIV) partner notification and referral across index case groups, we analysed results of services provided by the Colorado Department of Health during 1988. Services were offered to 231 index cases; 226 (98%) accepted; 124 (65%) with unsafe behaviours identified 239 partners; 79% of partners were notified; 68% accepted counselling. Seropositivity was 21% in newly tested partners. Index cases chose patient referral for 25% of partners and referred 20% of eligible partners; the provider referred 71%. Index case acceptance of service, proportion of index cases with newly identified HIV positive partners, and choice of partner referral method were similar across groups. Gay men identified fewer partners, had a lower proportion of partners accepting new counselling and testing and referred a lower proportion of partners than heterosexual men. The total costs of the service were $19,496. Twelve new cases of HIV were identified through patient and provider referral and cost per case identified was $1625. Partner notification and provider referral should be offered to all HIV infected individuals in Colorado, as few differences across groups emerged and only 20% of located and eligible partners received counselling through patient referral.

Objectives. 1) To examine a wide range of potential risk factors for delayed childhood immunization against measles, mumps, and rubella and 2) to determine the parental response to proposed solutions regarding the problem of delayed childhood immunization. Design. A case-control study in which subjects had (controls) or had not (cases) received measles, mumps, and rubella vaccine (MMR) by 2 years of age. Parents of subjects were also surveyed to find out whether they thought selected proposals to improve immunization rates would be successful. Results. Maternal education of high school or less at the time of the child's birth, more than or equal to two moves between birth and age 2, maternal age &lt;21 years of age at the time of the child's birth, more than or equal to two older siblings, participation in The Special Supplemental Food Program for Women, Infants, and Children (WIC), participation in the federal food stamp program, and incorrect knowledge of the recommended age for MMR significantly elevated the odds ratio (OR) for delayed immunization. At least two older siblings (OR = 3.2), maternal age &lt;21 years of age at the time of the child's birth (OR = 2.8), and incorrect knowledge of the recommended age for MMR (OR = 2.7) remained significant risk factors in a multivariate logistic regression model. Insurance status and cost factors were not significant risk factors for delayed immunization. Parents thought that reminders for immunizations and a central record system would have made obtaining immunizations easier. Conclusions. Based on our findings of the importance of immunization knowledge and demographic characteristics as risk factors for delayed immunization, we suggest that a message (the recommended age for immunizations) and a target group for that message (families who move frequently, have older children, and are headed by younger parents) be evaluated as an intervention to improve immunization rates.

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