Hospital concern shown with new pay methods based on case mix, diagnosis-related groups.
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Biomedical subjects
Publications and source records attributed to L Henry.
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The ultrastructure of the lymph node post-capillary venules (PCV) was studied in control, gonadectomised and gonadectomised-Hexoestrol treated male and female mice, infected or not with Toxoplasma gondii. The percentage of the cytoplasmic area of the endothelial cells occupied by Golgi apparatus was estimated by quantitative stereology. The endothelial cells of the PCV are higher and contain more Golgi elements in female than male controls. Oophorectomy decreases the percentage of Golgi apparatus and the height of the endothelial cells while orchidectomy does not affect the former but increases the latter. The endothelial cells react to Hexoestrol similarly in male and female mice, by increasing their height and becoming more heavily structured, with an effect particularly on the Golgi apparatus. All groups of mice infected with Toxoplasma gondii, show increased numbers of lymphocytes passing through the wall of the PCV. The endothelial cells of the latter show increased numbers of ribosomes both free and attached to rough endoplasmic reticulum. Golgi elements are decreased. In view of these findings the mechanisms for selective lymphocyte migration through the walls of the PCV are discussed.
1. A case is described of an Englishman who suffered severe 'wet beriberi' whilst a prisoner of war (POW) of the Japanese in World War II. 2. Following release he developed a congestive cardiomyopathy which increased in severity until his death 31 years after repatriation. 3. Autopsy findings were consistent with chronic cardiac damage due to beriberi.
Groups of male and female mice were gonadectomized and some implanted with a pellet of hexoestrol. Half of the animals in each group, including controls, were infected with a low-virulence strain of Toxoplasma gondii. The animals were killed 6 weeks after infection. Gonadectomy increased the relative thymic weight in both sexes, but more so in the male, and the paracortical area of the lymph node was enlarged, as was the thymus-dependent area of the spleen. Hexoestrol administration induced almost complete thymic atrophy and partial involution of the peripheral lymphoid tissues. Greater resistance to toxoplasmic infection was found in the gonadectomized mice than in controls of both sexes, possibly due to a better cell-mediated immunity in the gonadectomized animals. Overwhelming toxoplasmosis with increased mortality was found in the hexoestrol-treated mice after infection, probably resulting from a depression of cell-mediated immunity caused by hexoestrol. It is postulated that the cellular immune response is of greater importance than the formation of antibody in resistance to toxoplasmic infection. The role of the thymolmphatic--sex hormonal interrelation on the age--sex differences seen in the incidence of toxoplasmic lymphadenopathy is also discussed.
The incidence of solitary toxic adenoma of the thyroid in a general surgical unit with an interest in thyroid disease has been reviewed over a 15-year period. Six hundred and thirty thyrotoxic cases were treated surgically, 35 (5.6 per cent) having a solitary toxic adenoma. Thyroid enlargement or toxicity had been present for more than 5 years in 7 patients (20.0 per cent). Cardiovascular complications were present in 6 cases (17.1 per cent). Thyroid lobectomy resulted in 30 (85.7 per cent) euthyroid and 5 (143.3 per cent) hypothyroid patients. One toxic adenoma contained a focus of carcinoma. The clinical features, diagnosis and management of solitary toxic adenoma, and the management of symptomatic nodules which are 'hot' but not biochemically toxic, are discussed.
The effects of gonadectomy and oestrogen administration on the response of lymph-node post-capillary venules to infection with Toxoplasma gondii have been studied in mice. The endothelial cells of the post-capillary venules were significantly higher in the female than in the male controls. Oophorectomy had no significant effect while orchidectomy increased the height of the cells. However, hexoestrol administration resulted in a rise of the height to maximum levels in the female and in the male gonadectomised animals. The endothelial cells of male and female control and gonadectomised mice were higher after infection with Toxoplasma while in the infected hexoestrol-treated animals, lower cells were seen. The number of lymphocytes passing through the post-capillary venule wall was increased by gonadectomy and decreased by hexoestrol administration in both sexes. The same pattern was seen in the infected groups. The influence of sex hormones on the post-capillary venules and its possible contribution to the differences seen in the immune response between the two sexes is discussed.
The changes induced in the lymph-node post-capillary venules of male and female mice, 1, 2, 4, 7, 10 and 14 days after oestrogen administration were studied in 1 micron sections and with the electron microscope. The endothelial cells of the post-capillary venules are higher in female than in male control mice. On the first and second days after Hexoestrol administration there is an increase in the number of ribosomes and polyribosomes lying free in the cytoplasm of the endothelial cells. These cells were significantly increased in height between day 2 and day 7, in both male and female Hexoestrol-receiving mice, remaining at high levels thereafter. The increase in height was accompanied by an increase in the Golgi elements which occupied the major part of the cytoplasm of the endothelial cells. Lysosomes, multivesicular bodies and signs of phagocytosis were more often seen. In contrast, the numbers of lymphocytes passing through the post-capillary venule wall were significantly decreased, probably due to a direct effect of Hexoestrol on the thymus. The relation of an oestrogenic effect on the ultrastructure of the post-capillary venules to the sex differences seen in the immune response is discussed. The possibility that this may constitute a part of a general oestrogenic effect on the reticuloendothelial system is also considered.
Numerous Foà-Kurloff (FK) cells have been found in the circulation, spleen, bone marrow, thymus and placenta of guinea pigs under endogenous or exogenous oestrogenic stimulation. The origin of these cells is obscure. In the present experiment, the distribution of FK cells in organs other than those stated above was studied following gonadectomy and hexoestrol administration in guinea pigs of both sexes for either 1 or 10 weeks. More FK cells than those expected from the vascularity of the organ were found in the liver and lungs of male and female animals. The number of FK cells in these organs was larger after the long-term treatment with hexoestrol and it was accompanied by a significant decrease in the number of Kupffer cells of the liver. The latter observation is in contrast to previous reports of increased numbers of Kupffer cells in the liver of oestrogen-receiving mice, a species not producing FK cells. These observations suggest a relation between the two types of cells. No transformation of mature Kupffer cells into FK cells was seen with the electron microscope. However, other findings suggest that both Kupffer cells and FK cells may well be derived from a common precursor of MPS in the bone marrow.
The role of cell-mediated immunity in the pathogenesis of toxoplasmic lesions in non-lymphoid organs and its significance in resistance to infection with Toxoplasma gondii were studied in guinea-pigs. Alteration of the sex hormonal environment in both sexes has significant effects on the immunological status of the guinea-pig, changing its reaction to toxoplasmic infection. Thus, gonadectomy appears to enhance delayed hypersensitivity, leading to a greater prominence of lesions in the non-lymphoid organs of gonadectomized male and female animals than in controls. This observation supports the possibility that delayed hypersensitivity plays a major role in the pathogenesis of non-lymphoid, toxoplasmic lesions. Hexoestrol administration for a long period of time induces complete thymic atrophy and severe involution of the thymus-dependent areas of the lymph nodes and spleen, leading to the suppression of cell-mediated immunity and overwhelming disease in those animals infected with Toxoplasma gondii, suggesting that cell-mediated immunity is of importance in resistance to toxoplasmic infection. In view of these findings, the difficulties in the treatment of non-lymphoid toxoplasmic lesions, such as ocular ones, by depressing cellular immunity, are discussed.
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We investigated three black women who had anemia and skin hyperpigmentation. They were found to have pernicious anemia (PA) and normal adrenal functions. To our knowledge, this is the first report of skin hyperpigmentation of PA in black patients. This report reemphasizes the similarities in clinical features of PA and Addison's disease.
Piglets eight to 10 days old and one day old were infected with a cyst-forming strain of Toxoplasma gondii of low virulence. The older piglets developed an immunological response to the infection and survived, although inflammatory lesions were demonstrable in a variety of tissues. Some of the one-day-old piglets died; they exhibited more severe inflammatory lesions and lymphoid depletion in the lymph nodes, spleen and thymus. The tissue reaction resembled infection with a high-virulence strain of the organism. Control animals showed a delay in maturation of the lymphoid system during the first week of life. The virulence of the organism in therefore modified to a certain extent by the competence of the animal to develop an immunological response to the infection.
A case of renal papillary necrosis is reported that was associated with renal candidiasis occuring in a patient with Hodgkin's disease (lymphocyte depletion histology) with profound cellular immunodepression.
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Nine calves were inoculated with tissue cysts of a low virulence strain of Toxoplasma gondii and killed at intervals up to 10 weeks. An immunological response took the form of circulating antibodies and reactive changes in the lymph nodes. The organism could only be recovered from the lymph nodes and this only during the first four weeks after infection. No tissue cysts were demonstrated and only a few inflammatory lesions occurred. Thus, although calves can be infected, the immunological response is prompt with rapid elimination of the organism.