Orthopaedics is an important component of clinical practice and education in this subject is important. In order to discover how best to teach it a questionnaire was presented to undergraduates at Bristol University at the conclusion of their course. From their replies a course length of 6 weeks with maximum clinical contact, small groups and minimum number of lectures is recommended. Orthopaedic courses nationally have also been analysed and found to rely overmuch upon lectures, to have student group which are too large and to combine orthopaedics with other courses too frequently. It is concluded that undergraduate and postgraduate medical training should be integrated and that 1 clinical year should contain courses which would be optional.
Little is known about hepatic T lymphocyte subpopulations in the human liver. The aim of this study was to document the various subpopulations present in the liver and compare them to peripheral T lymphocytes in the same patients. Normal hepatic tissue was obained at time of transplant from five patients, and a single cell suspension of lymphocytes were prepared by standard methods. Ceils were stained with monoclonal antibodies specific for CD8ct and CD8B chains, CD4, CD8, CD3, o~BTCR, and ySTCR, and analyzed by two and three colour flow cytometry. Of the hepatic CD3+ cells, 71% were CD8+ and 25% were CD4+, with a CD4/CD8 ratio of 1:3 in contrast to the peripheral CD4/CD8 ratio of 2:1.18% of the hepatic CD3+ cells expressed ySTCR. Significantly, CD8~ct accounted for 27% [mean] of the total hepatic CD8+ population. Conclusion: There is now evidence that the adult human gut can support extrathymic T cell differentation. A significant population of hepatic CD8txct cells would suggest that the liver is also a site of extrathymic differentiation, which may have important implications for the understanding of autoimmunity and graft tolerance.
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