The combined use of typhoid vaccine and P32 labeling to assess myelopoiesis

1. The intravenous administration of killed typhoid organisms to dogs resultsin the development of a severe leukopenia which is followed by a markedleukocytosis.

2. The myelopoietic response of dogs to typhoid injections is quite similar tothe response following leukopheresis.

3. Leukocyte DNA-P³² studies indicate that in response to typhoid stimulation, as with leukopheresis, the bone marrow constitutes the main reservoir forgranulocytes contributing to peripheral blood leukocytosis.

4. Evidence is presented that, under these experimental conditions, leukocytes, after once having left the vascular tree, are unable to re-enter in any significant numbers.

5. The use of typhoid vaccine to stimulate leukocytosis combined with the useof P³² to measure the fate of cells released from the marrow is presented as anaccurate and reasonably simple method to measure certain aspects of myelopoiesisin the experimental animal.

Submitted on August 20, 1956 Accepted on November 3, 1956     

Clinical care pathways: Decreasing resource utilization in head and neck surgical patients

In this era of decreasing reimbursement, health systems have been forced to become more efficient and decrease resource utilization to remain financially viable. One of the methods of internal cost control has been the use of clinical pathways. Given the complexity of treatment of head and neck cancer patients, clinical pathways can help to standardize decision making and introduce uniformity in resource utilization. The objective of this study is to compare resource utilization and outcomes before and after implementation of a clinical pathway for head and neck surgical patients. We observed significant decreases in hospital costs as well as shorter lengths of stay after pathway implementation. It is our belief that a uniform management tool is beneficial in this complex disease.