Perivascular nerves in the rat submandibular salivary gland.

Perivascular nerves in the rat submandibular salivary gland have been studied using a variety of histochemical procedures coupled with electron microscopy. Two principal nerve types, adrenergic and cholinergic, appear to predominate and are localized principally around arterioles. Venules are rarely innervated. The possibility that a non-adrenergic non-cholinergic nerve population might influence blood flow is discussed critically in the light of anatomical and physiological findings.     

Cell-mediated immunity in Darier's disease.

Darier's disease, often complicated by skin infections, has been linked with a depressed cell-mediated immunity. Four moderate to severely affected patients with a negative history of skin infections were studied. T cell function was evaluated by standard delayed hypersensitivity skin tests, enumeration of peripheral T cell-mediated immunity was found. The significance of the results when compared with prior studies is discussed.     

Prescription for Disruption: Including a Pharmacist as Part of the Clinical Laboratory Team

Hiring pharmacists to work in the clinical laboratory is a novel and confounding disruption to the common practice of pharmacy and clinical laboratory. Bringing the these two health professions together helps promote the clinical laboratory as an integral health care partner rather than a commodity in the optimization of patient care. Additionally, training pharmacists in the complexities of laboratory medicine enhances their understanding of diagnostic and clinical inefficiencies and creates opportunities to improve the continuum of care. As health care transforms from an unsustainable fee-for-service business model to a value-based patient-centered care model, the pharmacist-laboratorian partnership focuses on creating clinical decision support initiatives that impact health care for the patient and the population. The purpose of this article is to describe the rational for clinical solutions pharmacists in the clinical laboratory and their role in improving community-wide antimicrobial stewardship by capitalizing on the collaboration between pharmacist and laboratorian.     

Inhibitors of leukocyte chemotaxis in alcoholic liver disease

Twenty-one of 42 patients (50 per cent) with alcoholic liver disease showed serum chemotactic inhibitory activity (CIA). CIA was not related to any single biochemical or histologic feature in the patients studied. The frequency of CIA was greatest in those with active infection. Serial studies demonstrated that CIA may be a transient phenomenon, associated with active alcoholic liver disease or appearance of infection. Nine of 15 patients showed skin test anergy; CIA was present in 8 of these 9 patients. Serum immunoglobulin A (IgA) and G (IgG) concentrations were significantly higher in patients with CIA when compared to those without CIA.Sucrose density gradient centrifugation of serums showing CIA yielded three peaks of inhibitory activity. Two had sedimentation coefficients of 10.7S and 6.8S, and the third was approximately 3S. The two higher molecular weight inhibitors were predominant in the 50 per cent ammonium sulfate precipitate. Immunoabsorption by anti-IgA but not by anti-IgG or IgM columns removed the ammonium sulfate precipitable chemotactic inhibitors. The appearance of chemotactic inhibitors in patients with alcoholic liver disease may have relevance to their apparent susceptibility to serious infections.     

Rhizopus osteomyelitis. A case report and review.

Mucormycosis osteomyelitis has previously been described exclusively in association with contiguous infections of rhinocerebral mucormycosis. In a patient with corticosteroid-dependent neutropenia and anemia osteomyelitis of the femur developed caused by the Mucoraceae Rhizopus. Although a primary focus was not identified, we believe this infection was hematogenous in origin. Mitogen stimulation to phytohemagglutinin (PHA) of the patient's lymphocytes revealed depressed cellullar immunity; however, there was specific response to Rhizopus extract. Treatment with systemic amphotericin B prevented further progression of the infection. A review of mucormycosis osteomyelitis is presented.