The ectoderm gives rise not only to the skin but also to the entire CNS. This common embryonic lineage suggests that some molecular isoforms might serve analogous functions in both tissues. Indeed, not only are laminins important components of dermal adhesion mechanisms, but they also regulate some aspects of synaptic development in both the CNS and the PNS. In the skin, laminins are part of a hemidesmosome complex essential for basal keratinocyte adhesion that includes collagen XVII (BP180) and BPAG1 (dystonin/BP230). Here, we show that CNS neurons also express collagen XVII and BPAG1 and that these molecules are expressed in the adult and developing retina. In the retina, isoforms of collagen XVII and BPAG1 are colocalized with laminins at photoreceptor synapses and around photoreceptor outer segments; both molecules are expressed by rods, whereas cones express collagen XVII but not BPAG1. Moreover, biochemical data demonstrate that collagen XVII complexes with retinal laminins. We propose that collagen XVII and BPAG1 isoforms may help to anchor elements of the rod photoreceptor cytomatrix to the extracellular matrix.
BackgroundPatients who have undergone cardiac surgery are generally mechanically ventilated postoperatively. Early postoperative extubation is currently recommended in anesthesia guidelines. No current technology can accurately, non-invasively, measure respiratory competence after extubation. Pulse oximetry has been helpful, but this is a late indicator of respiratory compromise. A novel, non-invasive, respiratory volume monitor (RVM) has been shown to deliver accurate continuous, real-time minute ventilation (MV), tidal volume (TV) and respiratory rate (RR) measurements and provide an objective measure of respiratory competence. The RVM will accurately reflect MV, TV and RR in cardiac surgery patients before and after extubation.MethodsRVM traces were recorded from patients before and after cardiac surgery. Continuous monitoring began on admission to the unit and was ended at 24 h after extubation. RVM-based MV, TV and RR were calculated from 30-s segments. MV, TV and RR were also continuously recorded from the ventilator prior to extubation. The RVM was calibrated to each patient using the readings from the ventilator.ResultsDuring mechanical ventilation, the RVM measured TVs strongly correlated with the ventilator TVs (r = 0.97). Following extubation, the patient’s breathing became more erratic and TVs and MVs decreased. Within 1 h, all patients studied showed a marked recovery of MV and TV.ConclusionsRVM-based MV, TV and RR correlated well with similar data collected from ventilators. After extubation, RVM shows promise as a means to monitor respiratory competence of non-intubated patients, and has implications for use in other settings and improving patient safety.
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