Pulmonary appendix of the short-tailed shrew (Blarina): a unique immunologic organ.

The right bronchus of the short-tailed shrew, Blarina brevicauda, terminates in a nonrespiratory pulmonary appendix (PA) containing two bronchial extensions. The experimentally demonstrated ability of these structures to collect and peristaltically expel aspirated material was initially assumed to be a sufficient reason for their developmental persistence, but as bronchus associated lymphoid tissue (BALT) became a subject of immunologic interest in other species, a possible immunologic role for the concentrations of BALT observed in the shrew PA were investigated. As the BALT of the PA contained many well-differentiated plasma cells and numerous particle-containing macrophages, 6-mu paraffin sections were treated with an immunoperoxidase avidin-biotin preparation that chromogenically identified alpha chains of IgA in many of the PA plasma cells and their associated luminal secretions. Also, vascular injections revealed that the PA had a complex relationship with anastomotic sinusoids connecting the bronchial and pulmonary circulation systems, and scanning electron microscopy showed that the luminal epithelial surfaces of the PA were virtually identical to the scattered BALT aggregates in the bronchi of other animals. It thus appeared that these unique structures in the shrew are morphologically and topographically suited to receive aspirated antigens that induce secretory IgA production, while possibly providing other humoral and cellular immunologic products to the general circulation.

The vascular pattern of the human dorsal root ganglion and its probable bearing on a compartment syndrome.

STUDY DESIGN: A descriptive anatomic investigation of the vasculature of the dorsal root ganglions. OBJECTIVES: To determine whether the blood supply of the various spinal ganglions is sufficiently consistent to derive a "generic" description and illustration that would be applicable to all spinal levels, and to ascertain whether this vascular pattern is inherently predisposed to the development of a closed compartment syndrome. SUMMARY OF BACKGROUND DATA: The few previous descriptions of spinal ganglionic vasculature do not include photographic evidence showing uniformity in the arterial distribution plan at all ganglionic levels. The venous drainage, although verbally reconstructed from microscopic sections, lacks any indication of its probable role in the etiology of a compartment syndrome. METHODS: Three perinatal cadavers received latex/India ink injections, and their removed radiculomedullary systems were cleared, transilluminated, and macroscopically photographed. Paravertebral sections were grossly removed from the spines of two adult anatomic cadavers and received retrograde venous injections of a fine suspension of barium sulfate. The intervertebral foraminal tissues were then dissected from the bone, and radiographs of them were made. For comparative reference, a nerve root/ganglion complex of a rabbit was arterially injected with a more dilute preparation of the latex/India ink suspension. RESULTS: Macroscopic photographs of perinatal dorsal root ganglions showed that the pattern of the intraganglionic arterial distribution was sufficiently consistent to allow a graphic rendering and labeling of a "generic" ganglion. The series of incomplete retrograde venous injections adequately indicated the pressure labile location of a periganglionic venous plexus. CONCLUSIONS: The common development, structure, and function of the human dorsal root ganglions have resulted in the evolution of a uniform nutritional vascular pattern that can be conceptualized in a single visual image. Its plan of a primarily internal arterialization with a superficial venous drainage renders it vulnerable to the ischemic conditions consequent on external pressures and/or internal edematous swelling. This vascular arrangement may contribute to a propensity for the ganglion to develop a compartment syndrome when subjected to compression by periforaminal degenerative or neoplastic space-occupying lesions.