Myasthenia gravis: prognostic significance of clinical data in the prediction of post-thymectomy respiratory crises.

Medical records of 170 patients who had undergone thymectomy for myasthenia gravis were reviewed from the point of view of respiratory disturbances. In the group of patients requiring mechanical ventilation for over 24 hours after operation the incidence of high preoperative cholinesterase inhibitor intake, severe bulbar symptoms and severe myasthenia gravis with anamnestic respiratory crisis and cardiorespiratory disease were much higher than in the group of patients who could have their trachea extubation within 24 hours. The presence of a thymic tumour, patients' age over 50 years and the so-called precrisis have revealed differences between the two groups, while the patient groups were identical in mean age, duration of myasthenia gravis and sex distribution. The above clinical data are recommended to be considered in the evaluation of the need for postoperative mechanical ventilation or extubation and preparation of preventive tracheotomy.     

Ventral spondylodesis: basic method in the treatment of cervical spine injuries

Ventral spondylodesis or ventrofixation is the most important surgical method for the treatment of severe cervical spine injuries accompanied by instability. Its wide indications include fracture-dislocations, compression fractures of the vertebral body, injuries to the disc, luxations, 'tear drop fractures' as well as "hangman's fractures". The essential parts of its technique: previous reduction by traction, anterior cervical approach, removal of the injured parts of vertebral body and disc(s), replacement by corticocancellous bone graft with subsequent plate-screw fixation. The authors performed in their Institute nearly 100 operations of this type, in a 10-year period of which; detailed account is given. Good results of surgery can be expected only by ensuring adequate technical conditions and professional knowledge, performing the operations in centres having sufficient experience.     

An anti-GD2 single chain Fv selected by phage display and fused to Pseudomonas exotoxin A develops specific cytotoxic activity against neuroblastoma derived cell lines

Since the disialoganglioside GD2 is abundantly present on the surface of neuroblastoma cells, we constructed a new recombinant immunotoxin for possible clinical use in patients with neuroblastoma. A functional 14.18 scFv-phage was obtained by selection of an anti-GD2 hybridoma derived phage antibody mini-library on the neuroblastoma-derived, GD2-expressing cell line IMR5. By insertion into the bacterial expression vector pBM1.1 the selected scFv was fused to a deletion mutant of Pseudomonas exotoxin A (ETA'). Periplasmically expressed 14.18(scFv)-ETA' bound to the GD2 expressing cell line IMR5, but not to the GD2 negative Hodgkin-derived cell line L540Cy as documented by ELISA and flow cytometry. The recombinant immunotoxin (rIT) inhibited cell viability of IMR5 cells by 50% at concentrations (IC(50)) of 0.326 microg/ml. This recombinant immunotoxin will be further investigated in vivo for its value as a new immunotherapeutic agent for the treatment of patients with neuroblastoma.     

Modified technique for Handsewn anastomosis following abdominoperineal pull-through operation

A modified technique for handsewn anastomosis after abdominoperineal pull-through resection is described. The technique is a continuous locked modification of the Gambee suture. Simplicity, rapidity, reliability, and firmness are the advantages of this technique.     

Effects of passive smoking on lung function tests in preschool children born late-preterm: a preventable health priority

Objective: Late-preterm delivery is known to be associated with potential adverse effects on lung development. Passive smoking may result in alterations of pulmonary function in infants born late-preterm. Impulse oscillometry (IOS) is a noninvasive, rapid, and practicable technique that can assess lung function. This study aimed to evaluate the effect of passive smoking on lung function tests in preschool children born late-preterm using IOS.

Methods: The study population consisted of a total of 139 children between 3 and 7 years of age born late-preterm who were being followed-up at our outpatient unit at the time of study period. Late-preterms were subcategorized according to presence or absence of exposure to passive smoking (PS). Those with and without exposure to passive smoking were referred to as PS group (56.1%, n?=?78) and non-PS group (43.9%, n?=?61), respectively. Resistance (R5–R20), reactance (X5–X20), and resonant frequency were measured by impulse oscillometry (IOS) at 5–20?Hz.

Results: Median R5-R20 and Z5 were significantly higher and median X10 was significantly lower in PS group compared to non-PS group (p?Conclusions: This study demonstrated that passive smoking significantly increases peripheral airway resistance and seems to adversely affect lung function in children born late-preterm.     

Peak oxygen uptake and ventilatory anaerobic threshold in fibromyalgia

OBJECTIVE: To compare maximum oxygen uptake and anaerobic threshold in patients with fibromyalgia (FM) and healthy sedentary controls matched by sex, age, weight, and body mass index. METHODS: Fifty women with FM aged 18-60 years and 50 healthy sedentary controls were studied. All were submitted to a maximum treadmill incremental test. Expired gas, ventilatory anaerobic threshold, and maximum oxygen uptake (VO2max) were evaluated. The influence of FM on quality of life was evaluated by questionnaires: the Fibromyalgia Impact Questionnaire and the Medical Outcomes Study Short-Form (SF-36). RESULTS: In patients with FM, the anaerobic threshold and peak oxygen uptake were significantly reduced. Maximum heartbeat rate was significantly lower in FM, indicating submaximum effort. Linear regression data showed a correlation between peak VO2 and the "Role-physical" domain of the SF-36. No such correlations were noted with anaerobic threshold. CONCLUSION: These results confirm the hypothesis of lower physical fitness in patients with FM. Considering that patients with FM do not achieve a maximum effort, ventilatory anaerobic threshold should be considered as a better fitness index than VO2max.