This dissertation analyses the use of the Leiden anatomical collections in the nineteenth century. It investigates what happened to anatomical preparations after they were added to institutional... Show moreThis dissertation analyses the use of the Leiden anatomical collections in the nineteenth century. It investigates what happened to anatomical preparations after they were added to institutional collections. Four chapters discuss the four main audiences of the Leiden collections: students, researchers, lay visitors, and university governors. The medical audiences (students and researchers) kept using the collections throughout the nineteenth century; the non-medical audiences (visitors and governors) stopped using the collections in the second half of the century. The dissertation argues that, to understand these developments, we need to see anatomical collections as dynamic entities: intended for active, hands-on use and containing objects that, as philosopher of biology Hans-J_rg Rheinberger has put it, are made of what they represent. These properties enabled researchers and students to continuously reinterpret the preparations as medical theories and practices changed. In the new medicine, the collections were placed in a closed laboratory environment, and the reinterpretations disconnected the preparations from their past and the moral stories once attached to them. Hence, they became hard to access and use for lay visitors and university governors. Even today, old preparations linger in hospitals and laboratories, waiting for new uses __ as do newly built collections of bodily material. Show less
Myasthenia gravis (MG) is hallmarked by acquired and fluctuating weakness of voluntary muscles. In the majority of patients, weakness is caused by autoantibodies to the postsynaptic acetylcholine... Show moreMyasthenia gravis (MG) is hallmarked by acquired and fluctuating weakness of voluntary muscles. In the majority of patients, weakness is caused by autoantibodies to the postsynaptic acetylcholine receptor (AChR) in the neuromuscular junction. Approximately 10% of MG patients are seronegative (SNMG). In 2001, antibodies to muscle-specific kinase (MuSK) were discovered within this group. This dissertation describes the epidemiology, clinical characteristics and immunological aspects of this new disease. In the Netherlands, MuSK MG is rare. Incidence was 0.17 per million person-years. Prevalence was 2.8 per million on January 1st 2004. Weakness was more often bulbar, and lead to frequent respiratory crises. MuSK MG was linked to the HLA-DR14-DQ5 haplotype and the disease severity was associated to antigen-specific IgG4 antibodies instead of IgG1. This is in contrast to AChR MG in which autoantibodies are mainly of the IgG1 and IgG3 subclass, and the disease is linked to HLA-B8-DR3. In SNMG patients, no antibodies to postsynaptic ErbB receptors were found. A case-report describes the transmission of MuSK autoantibodies from mother to her newborn child, causing transient weakness in the infant. A second case-report illustrates the effect of MuSK antibodies on both pre- and postsynaptic signal transmission in the neuromuscular junction. Show less
