Lymphatic physiology and secretory immunity.
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Biomedical subjects
Publications and source records attributed to J Hall.
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The spinal cord and brain of a man who died 18 years after a crush injury of lumbar segments contained some unusual lesions. There was a reduced number of myelinated axons in the corticospinal tracts as high as the fifth cervical segment. Such retrograde degeneration has been described in human pyramidal tracts only a few times. The results of reported studies of experimental retrograde degeneration have been inconsistent. The course of the fasciculus gracilis, as delineated by gliosis, was atypical, and an unusual glial nodule, possibly neoplastic, was present in the dorsal columns at C8.
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"Physician extenders" of various types have been produced in the past few years. The University of Alabama in Birmingham has trained surgeon's assistants over the past 9 years, graduating 53 individuals after a 2-year course of didactic, laboratory, and clinical instruction. The graduates have performed satisfactorily, working with surgeons in the community setting and as part of highly specialized teams in large medical centers. One third work in general surgery, one third in cardiovascular thoracic surgery, and one third in other special areas. The authors conclude that these individuals will play an increasing role in allowing surgical therapy to be delivered in an efficient and effective manner.
All patients with adenocarcinoma of the colon treated surgically at the Austin Hospital over a five-year period were reviewed to determine the relevance of anaemia in diagnosis. It was found that one-fifth of the patients presented with symptoms of anaemia to the doctor of first contact, and of these, one-third had an unwarranted delay in diagnosis (mean delay 13 months).
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A spinal cord which is neurologically nonfunctional may be functioning as a conduit for CSF between the ventricular system and the spinal subarachnoid space. Interruption of this pathway can have catastrophic consequences unless there is an adequately functioning shunt.
This paper discusses the currently popular approach to planning health services which is based on demand predictions. From a consideration of the demand concept, the problems of measuring present demand and forecasting future demand, it is concluded that this approach to planning will not provide health care which serves the best interest of patients, or achieves an overall efficient use of scarce resources. The development of an approach which is based on need rather than demand is seen as compatible with providing health services in the best interests of the individual as patient, and the community as tax payers.
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Recirculating lymphocytes were collected from the efferent ducts of peripheral somatic nodes and incubated in vitro with 51Cr. After washing, the labeled cells were returned to the sheep by i.v. injection. The partitioning of the labeled cells between blood and efferent (intermediate) lymph, or between efferent and afferent (peripheral) lymph was monitored for the next 24 h by assaying the radioactivity in appropriate samples of cells. The labeled lymphocytes took several hours to migrate through the nodes so that they equilibrated between blood and lymph in about 10 h. This pattern was not altered grossly during the inductive phase of an immune response. The small numbers of lymphocytes which migrated through peripheral tissues entered the lymph at least quickly as those that migrated through lymph nodes.
The proportion of cells bearing surface immunoglobulin (Ig) and the normal lymphocyte transfer (NLT) reactivity of mononuclear cells obtained from the blood, afferent lymph, and efferent lymph from both somatic and intestinal nodes of sheep were measured. The proportion of Ig-positive lymphocytes was approximately 30% in blood and efferent lymph, but only about 10% in afferent lymph. The proportion of unlabeled lymphocytes (T cells) was about the same in all the preparations, as afferent lymph contains 15--20% macrophages. Despite this apparent uniformity in the T cell content, the NLT reactivity of efferent lymph was 3 to 5 times higher than that of blood or afferent lymph. No humoral factors could be detected by incubating cells in the various plasmas in vitro before injection. No inhibitory cells could be detected when mixtures of cell populations were used to initiate lesions. We suggest that lymphocytes in efferent lymph are more reactive than others because they are "groomed" by macrophages during their recirculatory passage through the substance of the node.
Strontium nitrate Sr 87m bone scans were made preoperatively in a group of women with suspected breast cancer, 35 of whom subsequently underwent radical mastectomy. In 3 of the 35 (9%), the scans were abnormal despite the absence of clinical or roentgenographic evidence of metastatic disease. All three patients has extensive axillary lymph node involvement by tumor, and went on to have additional bone metastases, from which one died. Roentgenograms failed to detect the metastases in all three. Occult bone metastases account in part for the failure of radical mastectomy to cure some patients with breast cancer. It is recommended that all candidates for radical mastectomy have a preoperative bone scan.
Just over 20 years ago, an attempt was made to determine to what extent schools of nursing provide recruitment information for potential candidates to nursing. The recruitment literature and application forms of 40 general hospitals and 20 psychiatric hospitals were analysed. A follow-up investigation was carried out 10 years later, in 1980, which sought to establish to what extent the recruitment process, in terms of information-provision and requisition, for potential nursing candidates had changed. The study was also expanded to include an analysis of the recruitment literature and application forms of 20 mental handicap hospitals. The conclusions from the initial study and the 1980 follow-up, together with a second follow-up study completed in 1990, are outlined here and in Part 2 next month, looking at the extent to which schools of nursing have changed their initial recruitment processes over the past 20 years.