Atherosclerosis is an inflammatory disease of large arteries. We developed and validated a flow cytometry-based method to investigate the immune cell composition of the normal/non-inflamed and atherosclerosis-prone murine aortas. Flow cytometry of aortic cell suspensions shows that B- and T-lymphocytes, some macrophages and dendritic cells are already present in the adventitia of normal/non-inflamed mouse aortas. Adoptively transferred lymphocytes constitutively homed to the aorta and resided within the adventitia up to 7 days after transfer. The lymphocyte trafficking was partially L-selectin-dependent. During progression of atherosclerosis in apolipoprotein-E-deficient (ApoE−/−) mice, the total number of macrophages, T-cells and dendritic cells, but not B-cells increased significantly. This alteration in immune composition was accompanied by the formation of follicular-like structures in the adventitia of atherosclerotic aortas. These results demonstrate that lymphocytes already reside within the normal/non-inflamed aorta before the onset atherosclerosis as a consequence of constitutive trafficking. Atherosclerosis induces the formation of tertiary lymphoid tissue that may support antigen presentation. This work was supported by NIH grants HL 58108, 55798 (to K.L) and AHA grant 0525532U (to E.G.).
Accumulation of numerous pieces of information that must be readily available to the practicing surgeon is by necessity a slow process. It begins in medical school and is usually aided by the little black book or "peripheral brain" of the senior student, in which he has jotted down the various syndromes, statistics, and studies that his training has presented him. On July 1, however, it becomes evident within the first few hours that some of the most important bits are lacking in his file, namely, the essential daily routines and problems that confront him in the care of the surgical patient. While we are moving away from prolonged surgical training programs, four years seems the minimum of time to assimilate the body of knowledge required. TheManual of Surgical Therapeuticspresented in its first edition a pocket-sized adjunct to the house officer's black book, a more surgically oriented version of
Modern advances in neurosurgical technique and improvements in cardiopulmonary bypass technology have facilitated a renewed interest in the ligation of giant cerebral aneurysms utilizing deep hypothermia and low-flow conditions. The widespread introduction of biocompatible heparin-bonded bypass circuits presents perfusionists with the opportunity to curtail sharply the need for heparin and protamine in these patients. We briefly discuss the merits of this procedure and describe our clinical experience.
