Children with Kawasaki disease are at risk for the development of coronary-artery aneurysms. Standard therapy for this disorder includes intravenous immune globulin and aspirin. This study shows that, as compared with placebo, the addition of a single pulsed dose of intravenous methylprednisolone has no further beneficial effect over that of standard therapy and therefore cannot be recommended for routine treatment.

In this randomized trial of 39 patients with chronic pancreatitis and a distal obstruction of the pancreatic duct, surgical drainage was more effective at reducing pain than was endoscopic drainage. Complete or partial relief of pain was achieved in 32% of patients assigned to endoscopic treatment and 75% of those assigned to surgery.

An intranasally administered influenza vaccine may be useful in efforts toward universal vaccination of children less than 5 years of age. In this trial involving 8352 young children, the attack rate for symptomatic influenza was 5% with the live attenuated vaccine, as compared with 10% with the inactivated influenza vaccine administered intramuscularly. However, with the live vaccine, as compared with the inactivated influenza vaccine, there was a higher rate of hospitalization for any cause among children younger than 12 months of age.

Epigenetic silencing of the MLH1 gene, which repairs errors in DNA, is a feature of hereditary nonpolyposis colorectal cancer and usually occurs only in tumor cells. This study identified two women with this syndrome who had germ-line epigenetic silencing of MLH1. One of these women transmitted her silenced MLH1 allele to one of her sons, but the epigenetic change was erased in his spermatozoa. Germ-line transmission of an epigenetic modification of a gene is a novel form of inheritance of a cancer-susceptibility gene.