Invited commentary.
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Aortic Coarctation↗
Biomedical subjects
Frank M Midgley
Publications and source records attributed to Frank M Midgley.
Thymic expression of peripheral tissue antigens in humans: a remarkable variability among individuals.
The majority of maturing T lymphocytes that recognize self-antigens is eliminated in the thymus upon exposure to their target antigens. This physiological process of negative selection requires that tissue-specific antigens be expressed by thymic cells, a phenomenon that has been well studied in experimental animals. Here, we have examined the expression in human thymi of four retinal antigens, that are capable of inducing autoimmune ocular disease retinal S-antigen (S-Ag), recoverin, RPE65 and inter-photoreceptor retinoid-binding protein (IRBP)], as well as four melanocyte-specific antigens, two of which are used as targets for melanoma immunotherapy [gp100, melanoma antigen recognized by T cells 1, tyrosinase-related protein (TRP)-1 and TRP-2]. Using reverse transcription (RT)-PCR, we found that all thymic samples from the 18 donors expressed mRNA transcripts of most or all the eight tested tissue antigens. Yet, the expression of the transcripts varied remarkably among the individual thymic samples. In addition, S-Ag, RPE65 and IRBP were detected by immunostaining in rare cells in sections of human thymi by antibodies against these proteins. Quantitative real-time RT-PCR analysis revealed that the retinal antigen transcripts in the human thymus are present at trace levels, that are lower by approximately five orders of magnitude than those in the retina. Our observations thus support the notions that thymic expression is a common feature for all tissue-specific antigens and that the levels of expression play a role in determining the susceptibility to autoimmunity against these molecules.
Antigens, Neoplasm↗
Separation of thoracopagus-cardiopagus twins joined by a myocardial bridge.
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Heart Defects, Congenital↗
Prolonged cannulation of the left internal mammary artery (LIMA) for blood pressure monitoring in a child after cardiopulmonary bypass.
Cannulation of the radial artery percutaneously or by cut down is frequently used to monitor blood pressure in infants and children undergoing cardiopulmonary bypass. When radial artery cannulation is difficult because of previous cannulation attempts, and/or surgical cut downs, posterior tibial artery cannulation is sometimes undertaken. We describe a child in whom the left internal mammary artery (LIMA) was chosen for monitoring arterial blood pressure because of malfunction of the existing posterior tibial arterial pressure line after cardiopulmonary bypass. This line was used for more than 3 weeks postoperatively in the intensive care unit for monitoring and for sampling. There were no complications with the placement and/or the removal of this arterial line on the 25th postoperative day. When standard arterial monitoring sites are not accessible, internal mammary artery cannulation can provide reliable access for prolonged arterial blood pressure monitoring in the postoperative period in children.
Blood Pressure↗
Long-term follow-up of direct heart shunts in the management of hydrocephalus.
The authors performed a retrospective review of clinical data on 60 patients treated with direct heart shunts (DHSs) for hydrocephalus at the Children's National Medical Center from 1976 to 1979. Mean shunt survival was 79 months. Rates of proximal revision and infection were comparable to those in previous shunt series. Distal revision rates were lower than those reported in previous ventriculoatrial shunt series. The DHS is an effective self-lengthening cerebrospinal fluid shunt that may be considered as a salvage technique in the challenging shunt-dependent patient.
Adolescent↗