J. W. Quin

The influence of the lymph node on the protein concentration of efferent lymph leaving the node.

1. Experiments have been performed in sheep to determine the contribution of lymph formed within a lymph node to the total protein output in lymph leaving the node. 2. The lymphatic duct leaving the popliteal lymph node was cannulated and the protein and lymphocyte output in efferent lymph determined. The afferent lymph flow to the popliteal node was then diverted and lymph formed only within the lymph node collected from the efferent cannula. It appeared from the results that the popliteal lymph node forms lymph at the rate of approximately 1 ml. per hour and may contribute 30‐50% of the protein output observed in efferent lymph. 3. The importance of lymph formation within the lymph node varied between nodes found in different regions of the body. This was due in part to the different protein concentrations in the afferent lymph to the different nodes. 4. A positive correlation was found between the protein and lymphocyte concentrations in efferent lymph from the popliteal lymph node in seven out of eleven sheep and in lymph formed within the popliteal lymph node in two out of three sheep. It is suggested that this relationship may be due to an increased transfer of plasma proteins through the post‐capillary venules in the lymph node accompanying the continual traffic of lymphocytes across the wall of these vessels. The results indicated that the protein transfer across the post‐capillary venules was not an indiscriminate transfer of plasma per se but a selective transport from the blood plasma compartment based on molecular size.

THE LIMITED (NEEDLE BIOPSY) AUTOPSY AND THE ACQUIRED IMMUNODEFICIENCY SYNDROME

&NA; It is often uncertain whether deaths that occur during active treatment for complications of AIDS result from diagnostic or therapeutic failure. Accurate diagnosis of infections is particularly important, and has relevance not only for the patient but also to partners, relatives, hospital staff and other patients. In the absence of adequate physical facilities and in view of the lack of success in obtaining formal autopsies in patients dying with AIDS, a limited autopsy protocol was devised for routine application at our hospital, beginning in 1989. The major aim of this protocol was to enable the safe collection of diagnostic material from patients who died despite active therapy, to ascertain unrecognized conditions and confirm existing diagnoses. We present findings from the first 16 limited autopsies which resulted in 12 additional diagnoses and a revision of the principal cause of death in 7 cases.

The origin of the immunoglobulins in intestinal lymph of sheep.

Various immunoglobulins were labelled with radioactive iodine and their distribution between intestinal lymph and plasma followed in order to determine the origin of the immunoglobulins found in intestinal lymph. By comparing specific activities in plasma and lymph, it was computed that 25 percent of the IgG1 and IgG2 and 90 percent of the IgA in intestinal lymph were locally synthesised. The results suggest that virtually all of the IgA and a proportion of the IgG1 computed to be synthesised locally were derived from plasma cells of corresponding specificity in the lamina propria of the intestine.

Relationship between the recirculation of lymphocytes and protein concentration of lymph in sheep.

The concentration and output of lymphocytes in lymph from the popliteal node in sheep were varied by antigenic stimulation of the lymph node and by intravenous administration of bovine anti-lymphocyte serum (ALS). The 4-5-fold increase in output and concentration of lymphocytes in lymph following antigenic stimulation of the node was accompanied by a 25-35% increase in the concentration of total protein and albumin. The above changes were not observed in afferent lymph draining the site of antigen injection. There was a 75-80% decrease in concentration of lymphocytes in lymph from the unstimulated popliteal lymph node following the administration of ALS and this was accompanied by decreases of 10-35% in the concentration of albumin and immunoglobulin. Essentially the same changes were observed when ALS was administered 6 days after antigenic stimulation of the node. Administration of ALS to sheep with cannulated intestinal lymphatic ducts was followed by a 75-80% reduction in lymphocyte concentration and in decreases ranging from 12-50% in the concentration of albumin, IgM and IgG-2. It is suggested that a significant loss of plasma protein is associated with the migration of lymphocytes between the endothelial cells of the post-capillary venules in lymph nodes.

Impairment of Acute Phase Protein Reactivity in Chronic Renal Failure

The acute phase protein response was studied after elective surgery in 13 normal subjects and 9 patients with severe chronic renal failure. Total haemolytic complement reactivity (CH50) and serum conc

Clinical audit: virological and immunological response to combination antiretroviral therapy in HIV patients at a Sydney sexual health clinic

Aim: Bigge Park Centre (BPC) is a sexual health clinic located in a socially disadvantaged area in Southwest Sydney. This served as a retrospective clinical audit, documenting patient demographics, identifying factors associated with virological, immunological and discordant responses, evaluating the centres ability in HIV control and investigating changes in practice from 1996 to 2007.

A simple radioactive binding assay for the detection of rheumatoid factor in serum

A simple radioactive binding assay for the detection of rheumatoid factor (RF-RBA) is described. Test sera are complement inactivated by incubation in 0.13 M ethylene diaminetetraacetic acid (EDTA) at 37 degrees C and then incubated with 125I-labelled heat-aggregated IgG. Rheumatoid factor bound, labelled IgG is separated from free by precipitation with 2.5% (w/v) polyethylene glycol 6000. Sera from 78 patients and 24 controls were tested in the RF-RBA assay and the results compared with those obtained by the rheumatoid latex test and the rheumaton test. 37 sera were positive and 59 sera were negative for rheumatoid factor by the 3 methods used. A positive correlation (r = 0.56, P less than 0.01) was observed between the rheumaton titre and the RF-RIA result.

Hormonal Influence on the Recirculation of Lymphocytes Through the Regional Lymph Node and Regional Tissues of the Sheep

There is a large scale migration of lymphoid cells from the blood vascular system into lymphoid tissues and a return by way of the lymphatic system as described by Gowans and others (see reviews 1,2). Despite the magnitude of this recirculation process, as shown in Fig. 1, little is known of the factors controlling lymphocyte recirculation and, particularly, the action hormones may have on this process. With this aim in mind, the effects of relatively small doses of ACTH and hydrocortisone on the recirculation process at the level of the local lymph node and through peripheral tissues were investigated in the sheep. A more detailed report of earlier work in this area has been presented elsewhere (3).

Bilirubin in Afferent and Efferent Lymph in the Sheep

Efferent (postnodal) lymph in the conscious sheep is characterised by a distinctive yellow colour which contrasts sharply with the almost colourless appearance of afferent (prenodal) lymph. The yellow colour of efferent lymph was analysed qualitatively and quantitatively by biochemical methods and was shown to be due to bilirubin (1). Qualitative analysis demonstrating this association included a positive indirect Van den Bergh reaction and a similar Rf value to bilirubin standards on thin-layer chromatography. Quantitative analysis of the bilirubin content of both plasma and lymph was carried out using a modification of the alkaline diazo-coupling method described by Brodersen and Jacobsen (2).