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Adaptive immune responses are initiated when T cells encounter antigen on dendritic cells (DC) in T zones of secondary lymphoid organs. T zones contain a 3-dimensional scaffold of fibroblastic reticular cells (FRC) but currently it is unclear how FRC influence T cell activation. Here we report that FRC lines and ex vivo FRC inhibit T cell proliferation but(More)
A series of 52 patients in whom 0.5% bupivacaine was used to produce spinal analgesia for awake Caesarean section is described. Analgesia tended to be asymmetrical and of limited extent until the patients were turned from the left lateral to the right lateral position immediately after injecting the spinal solution. This movement produced a more symmetrical(More)
Central and peripheral tolerance prevent autoimmunity by deleting the most aggressive CD8(+) T cells but they spare cells that react weakly to tissue-restricted antigen (TRA). To reveal the functional characteristics of these spared cells, we generated a transgenic mouse expressing the TCR of a TRA-specific T cell that had escaped negative selection.(More)
We have studied magnetic resonance images of the lumbar spine of 39 subjects to examine the anatomy of the lumbar extradural region. The segmental nature of the posterior extradural region at each lumbar level may explain reports of easier cranial passage of extradural catheters introduced by the paramedian approach. This approach may thus provide a more(More)
The incidence of instrumental delivery and malposition immediately before delivery was compared in patients who were given lumbar epidural analgesia and those who were not. Instrumental delivery was five times more common and a malposition of the fetal head was more than three times as common in the epidural group as in women who did not receive regional(More)
An in vitro model was used to determine the force required to pierce bovine dura with a range of new spinal needles and to measure the subsequent leakage rate of cerebrospinal fluid (CSF). A significantly greater force was required to pierce the dura with pencil-point style needles compared to Quincke needles of the same size. Quincke needles caused a(More)
Spinal anesthesia has the advantages of speed of onset, reliability and lack of toxicity over lumbar epidural block. Against this must be offset several disadvantages, but these can be largely eliminated by careful choice of equipment and meticulous attention to details of technique. Only experienced obstetric anesthetists should perform spinal anesthesia,(More)