M. Roy Schwarz

Globalization and medical education

Few would argue with the statement that we now live in a global village. While there have been protests against the expected outcomes of the globalization process such as rich countries exploiting poor countries, setting aside labor regulations designed to protect workers and/or environmental exploitation, these protests have not, in the main, opposed the reality of the village or the process leading to its emergence. Watching this phenomenon evolve may lead one to ask: ‘What has created this global village and what forces are driving its formation?’ The answer is primarily four processes as follows:

Vitamin B6 deficiency and the lymphoid system: I. Effects on cellular immunity and in vitro incorporation of 3H-uridine by small lymphocytes

Abstract Thoracic duct lymphocytes from vitamin B6-deficient rats were found to have a reduced capacity to respond to foreign lymphoid cells in the mixed lymphocyte reaction (MLR), to produce normal lymphocyte transfer reactions, and to incorporate 3H-uridine in vitro. These findings indicate that specific nutritional deficiencies may impair cellular immunity and that this impairment can be monitored by the MLR. It is suggested that the reduction in MLR activity and in 3H-uridine uptake by TDL cells reflected either a shift in the proportions of T and B cells in the TDL and/or an impairment in the capacity of such cells to function in the MLR and in the in vitro test for 3H-uridine incorporation.

Thymidine and Testosterone Incorporation by Bursal and Thymic Lymphocytes

After 12 days of incubation tritiated thymidine (3HTdR) was injected into the allantoic cavity or applied to the air cell of fertile eggs. At varying time periods after 3HTdR administration the bursa of Fabricius, thymus, and spleen were removed from the chick embryo and the amount of 3HTdR was assayed by liquid scintillation. The highest concentration of 3HTdR was observed two days after applying the isotope to the air cell with the greatest concentration of 3HTdR being in the spleen, then the bursa, and finally the thymus.The in vitro exposure of bursal and thymic cells to 3HTdR or to tritiated testosterone (3HTestR) revealed significantly more uptake of both isotopes by bursal than thymic cells. These data establish an optimum route and sampling period for in vitro 3HTdR studies with embryos and suggest that bursal cells are more receptive than thymic cells to both 3HTdR and 3HTestR. The latter may, in part, explain why cold testosterone administered to chicken embryos will eliminate bursal cells with ...

The outcomes of global minimum essential requirements (GMER) pilot implementation in China

Defining global standards for medical education in the form of competencies and the methods to evaluate whether an individual student possesses these competencies at graduation has long been a dream of some medical educators. The development of such standards, the methods to assess their presence and the pilot test study of the standards in graduating students at eight medical schools in China, as well as the process for establishing student and school performance “cut points”, has been previously described. This paper reports on the performance of a single student who went through the assessment process, the performance of all students at one of the eight medical schools and the collective performance of all students at all eight medical schools. The actual quantitative data is presented, as is the conclusion of where the student, the school and all schools had strengths, where they were borderline in performance and/or where they need improvement. The results are serving as a blueprint for medical education reform in China. Implications of the pilot test and the entire process are discussed, as is the potential for global adoption of outcome based assessments.

Vitamin B6 deficiency and the lymphoid system: II. Effects of vitamin B6 deficiency in utero on the immunological competence of the offspring☆

Abstract Results of this study indicated that an absence of vitamin B6 from the diet of pregnant rats led to reduced immunological competence in the offspring. While the numbers of cells in the thoracic duct lymph (TDL) of rats approximately 3 months old and progeny of vitamin B6-deficient mothers were nearly equivalent to control values, such cells had a reduced capacity to respond in the mixed lymphocyte and normal lymphocyte transfer reactions. It is suggested that this reduction may have reflected (i) an alteration in the capacity of TDL cells or their precursors to give rise to immunologically competent cells, (ii) a shift in the proportions of T and B cells in the TDL, and/or (iii) an absence or ineffectiveness of a humoral factor required for the development of immunologically competent lymphocytes.

Appearance of radioactivity in mouse cells after administration of labeled macromolecular RNA.

Although various induced effects have been reported to follow administration of ribonucleic acid, direct evidence of cellular uptake has been lacking. Radioautographic evidence is presented of incorporation of label from radioactive macromolecular RNA presented to normal and neoplastic mouse cells. Although most of the label appeared in cellular RNA, deoxyribonucleic acid also was occasionally labeled. This suggested that at least partial degradation of the RNA occurred prior to or after incorporation.

Mixed Lymphocyte Reaction: An in vitro Test for Antilymphocytic Serum Activity

When Lewis rats were exposed to antilymphocytic serum, produced in rabbits, to Lewis lymphoid cells, the transformation of their thoracic duct lymphocytes in response to foreign lymphoid cells was markedly reduced in comparison with that in response to similar cells from donors treated with saline or normal rabbit serum. It is suggested that the mixed lymphocyte reaction may be used as an in vitro test for the in vivo activity of antilymphocytic serum.

Communication Satellites: Their Role in Medical Education and Health Care Delivery

This article describes an experiment in distance teaching/learning in large rural areas of North America using full duplex audiovisual interactive satellite communication. The effectiveness of the approach is compared with more conventional techniques in terms of regional faculty sharing, admissions and minority recruitment, the consultation process, independent learning and communication between public policy makers. Attention is paid to the cost and cost effectiveness of this form of communication.

The mechanism of action of antilymphocytic serum: an electron microscopic study☆

Abstract Antilymphocytic serum (ALS) was prepared from rabbits immunized against Lewis rat lymph node and thymus gland cell suspensions. The antiserum was shown to be immunosuppressively active by the normal lymphocyte transfer reaction. Intraperitoneal injection of active antilymphocyte serum into male Lewis rats resulted in the following findings. First, peripheral blood lymphocyte counts were depressed up to 95%. Second, extensive phagocytosis of lymphocytes was observed from 2–4 hr after treatment. This phagocytosis was more prominent in the liver followed by lymph node and spleen. Third, the phagocytic process included engulfment of the lymphocytes, lysosomal association with the phagosomes, presumably release of enzymes into the phagosomes, and lymphocyte degradation. Fourth, erythrocytes were also phagocytized. The implications of these findings were discussed in relationship to the proposed mechanisms of action of the ALS.