Myasthenia Gravis: Anesthetic and Surgical Management of the Patient Undergoing Thymectomy

Experience in the anesthetic and surgical management of 25 patients with myasthenia gravis is recorded. These are subdivided into two groups: those operated on during the period 1950-1958 and those operated on during the period 1959-1964. The purpose of this paper is to indicate improvement in mortality and morbidity due to three major advances: (1) use of the decamethonium diagnostic test in a myasthenia gravis clinic; (2) improvements in assessment and management of respiratory insufficiency; and (3) avoidance of anticholinesterase treatment in the immediate and early postoperative recovery period.Fourteen patients with myasthenia gravis, including five with thymoma and two who were refractory to medication, were in the second (1959-1964) group. There were no deaths and no myasthenic or cholinergic crises. Three prophylactic tracheostomies were performed. No emergency bronchoscopies or tracheostomies were required.     

The interactions of bilirubin with model and biological membranes

The partitioning of bilirubin between albumin and model and biological membranes and the differential partitioning of bilirubin between membranes with different lipid and protein compositions were measured. Partition coefficients were independent of the concentration of bilirubin in membranes up to at least 7 mol of bilirubin/mol of phospholipid. The avidity of albumin for bilirubin was greater than that of membranes, but the avidity of the latter for bilirubin depended on the composition of the membrane. Bilirubin partitioned preferentially into model membranes comprised of microsomal lipids greater than dioleoylphosphatidylcholine = plasma membrane lipids much greater than egg phosphatidylcholine = dimyristoylphosphatidylcholine. Partitioning into membranes was increased if these contained proteins, but the effect of proteins could not be attributed to specific binding to sites on proteins, as reflected by the temperature independence of partition coefficients. Differential partitioning of bilirubin into different membranes of pure lipids also was independent of temperature. Differences in the bulk phase fluidity of membranes does not appear to account for the preferential partitioning of bilirubin into some membranes. It appears that bilirubin partitions into elements of free volume of differing sizes in membranes with variable lipid compositions and that the size of these elements can be increased by adding proteins to membranes.     

Chromosomal deletion 4p15.32----p14 in a Treacher Collins syndrome patient: exclusion of the disease locus from and mapping of anonymous DNA sequences to this region.

Treacher Collins syndrome is an autosomal dominant condition of bilateral craniofacial abnormalities of structures derived from the first and second branchial arches. A patient with severe manifestations of Treacher Collins syndrome and a de novo chromosomal deletion in region 4p15.32----p14 was identified. Anonymous DNA sequences of loci D4S18, D4S19, D4S20, D4S22, and D4S23 were mapped to the deleted region. DNA probes previously mapped to loci on chromosome 4p (D4S10, D4S15, D4S16, D4S26, D4S35, D4S95, D4S144, RAF1P1, QDPR, and HOX7) were not deleted in this patient. Linkage analysis between the D4S18, D4S23, and QDPR loci and Treacher Collins syndrome in eight families excluded the Treacher Collins syndrome locus from the region of the deletion.     

Sequence-based genetic markers for genes and gene families: single-strand conformational polymorphisms for the fatty acid synthesis genes of Cuphea

 Gene sequences are rapidly accumulating for many commercially and scientifically important plants. These resources create the basis for developing sequence-based markers for mapping and tracking known (candidate) genes, thereby increasing the utility of genetic maps. Members of most of the gene families underlying the synthesis of seed oil fatty acids have been cloned from the medium-chain oilseed Cuphea. Allele-specific-PCR (AS-PCR) and single-strand conformational polymorphism (SSCP) markers were developed for 22 fatty acid synthesis genes belonging to seven gene families of Cuphea using homologous and heterologous DNA sequences. Markers were developed for 4 fatty-acyl-acyl carrier protein thioesterase, 2 β-ketoacyl-acyl carrier protein synthase I, 4 β-ketoacyl-acyl carrier protein synthase II, 3 β-ketoacyl-acyl carrier protein synthase III, 3 acyl carrier protein, 2 β-ketoacyl-acyl carrier protein reductase, and 4 enoyl-acyl carrier protein reductase loci. Eighty-eight percent (14 of 16) of the SSCP loci were polymorphic, whereas only 9% (2 of 22) of the AS-PCR loci were polymorphic. These markers were mapped using a Cuphea viscosissima×C. lanceolata F₂ population and produced linkage groups of 10, 3, and 2 loci (3 loci segregated independently). The 10-locus linkage group had every gene but one necessary for the synthesis of 2- to 16-carbon fatty acids from acetyl-CoA and malonyl-ACP (the missing gene family was not mapped). SSCP analysis has broad utility for DNA fingerprinting and mapping genes and gene families. Received: 3 May 1996 / Accepted: 30 August 1996     

Interleukin-21: a modulator of lymphoid proliferation, apoptosis and differentiation

The interleukin-21 (IL-21)-IL-21-receptor system was discovered in 2000. It was immediately of great interest because of the homology of IL-21 to IL-2, IL-4 and IL-15, and of the IL-21-receptor subunit IL-21R to the beta-subunit of the IL-2 receptor, and because the IL-21 receptor also contains the common cytokine-receptor gamma-chain, the protein that is mutated in X-linked severe combined immunodeficiency. As we discuss, IL-21 has pleiotropic actions, from augmenting the proliferation of T cells and driving the differentiation of B cells into memory cells and terminally differentiated plasma cells to augmenting the activity of natural killer cells. Moreover, it has antitumour activity and might have a role in the development of autoimmunity, so these findings have implications for the treatment of cancer and autoimmune diseases.     

D2O induced alterations of mitosis in PtK1 cells

Deuterium oxide (D2O) was applied to PtK1 cells to assess its effect on mammalian mitosis. Cells exposed to culture medium containing up to 50% D2O were able to enter and complete mitosis, but the duration of mitosis was increased proportionally to the concentration of D2O applied. Cells exposed to 50% D2O showed increases of more than 300% for the interval between nuclear envelope breakdown and anaphase onset, and approximately 65% for the interval between anaphase onset and initial furrowing. At a concentration of 80%, D2O acted as an inhibitor of mitosis; after 8 h exposure to this concentration, cultures showed an increase in the proportion of mulinucleate cells and an absence of mitotic figures. When applied early in anaphase, 80% D2O effectively slowed chromosome separation, prolonging anaphase for more than 60 min. Normal chromosome motion was restored when medium containing D2O was replaced with control medium. Mitotic chromosomes remained condensed throughout prolonged anaphase intervals. Immunofluoresence examination of spindles stained using a monoclonal anti-tubulin revealed no pronounced increase in microtubule polymerization after exposure of cells to 20-80% D2O.     

The response of alkaline phosphatase to osmoregulatory changes in the trout,Salmo gairdneri

Summary The relationship between alkaline phosphatase and environmental salinity was examined in the rainbow trout and the migratory rainbow (steelhead),Salmo gairdneri. The enzyme activity in tissues involved in osmoregulation was strongly correlated with the adaptation salinity and thus to the degree of salt and fluid transport in those tissues. After transfer from freshwater to seawater, the specific activity of the enzyme increased over 260% in the intestine, decreased by 50% in kidney, and was unchanged in the liver, an organ not directly involved in osmoregulation. The sea-run steelhead trout response was similar to the nonmigratory rainbow; although, the pre-migratory transformation (smoltification) had no effect on enzyme activity. Amino acid inhibitors of alkaline phosphatase significantly reduced fluid absorption in the isolated intestine of rainbow trout, reaffirming the relationship between the enzyme and fluid movement. Electrophoretic identification of trout alkaline phosphatase isozymes, clearly distinguishes the enzyme from different tissue origins. However, from the analysis of intestinal electrophoretic patterns, osmoregulatory adjustments are not associated with the induction of new alkaline phosphatase isozymes, or in the large scale preferential stimulation of one of the two existing intestinal isozymes over the other.     

MicroRNA Profiling in Prostate Cancer - The Diagnostic Potential of Urinary miR-205 and miR-214

Prostate cancer (PCa) is the most common type of cancer in men in the United States, which disproportionately affects African American descents. While metastasis is the most common cause of death among PCa patients, no specific markers have been assigned to severity and ethnic biasness of the disease. MicroRNAs represent a promising new class of biomarkers owing to their inherent stability and resilience. In the present study, we investigated potential miRNAs that can be used as biomarkers and/or therapeutic targets and can provide insight into the severity and ethnic biasness of PCa. PCR array was performed in FFPE PCa tissues (5 Caucasian American and 5 African American) and selected differentially expressed miRNAs were validated by qRT-PCR, in 40 (15 CA and 25 AA) paired PCa and adjacent normal tissues. Significantly deregulated miRNAs were also analyzed in urine samples to explore their potential as non-invasive biomarker for PCa. Out of 8 miRNAs selected for validation from PCR array data, miR-205 (p<0.0001), mir-214 (p<0.0001), miR-221(p<0.001) and miR-99b (p<0.0001) were significantly downregulated in PCa tissues. ROC curve shows that all four miRNAs successfully discriminated between PCa and adjacent normal tissues. MiR-99b showed significant down regulation (p<0.01) in AA PCa tissues as compared to CA PCa tissues and might be related to the aggressiveness associated with AA population. In urine, miR-205 (p<0.05) and miR-214 (p<0.05) were significantly downregulated in PCa patients and can discriminate PCa patients from healthy individuals with 89% sensitivity and 80% specificity. In conclusion, present study showed that miR-205 and miR-214 are downregulated in PCa and may serve as potential non-invasive molecular biomarker for PCa.