Patient description: The patient is a 16-year-old girl recently diagnosed with myasthenia gravis, class IIa. She complains of diplopia and weakness affecting in her upper extremities. She had a positive anti-AChR antibody test, and her single fiber electromyography (SFEMG) was positive. She is on acetylcholinesterase inhibitor treatment combined with immunosuppressants. But she still has some symptoms. She does not smoke or use illicit drugs. She is not sexually active, and her menses are regular. Her physical exam and lab studies are not remarkable for any other abnormalities. BP: 110/75 Hgb: 11 g/dl WBC: 8000 /mm3 Plt: 300000 /ml Creatinine: 0.5 mg/dl BUN: 10 mg/dl Beta hcg: negative for pregnancy

Clinical trial eligibility criteria: eligible ages (years): 0.0-999.0,  Acquired Immunodeficiency Syndrome HIV Infection to 60 years of age, HIV-1 negative by HIV-1 ELISA, HIV PCR and Western Blot analysis. Subjects in good health with no evidence of underlying disease based on history, physical exam and laboratory analysis. Must have normal organ function as characterized by the following: Hematopoietic: absolute granulocyte count of at least 1500/mm(3); platelet count of at least 150, 000/mm(3); hematocrit within normal range. Renal: BUN less than 23 mg/dl; creatine less than 1.6 mg/dl. Hepatic: serum total bilirubin less than 1.5 mg%. Metabolic: ALT less than or equal to 1.5 x upper limit of normal range; serum calcium within normal range; serum lactate within normal range; total serum CPK within normal range. Endocrine: serum glucose - within normal range. Immunologic: CD4 count greater than or equal to 500 cells/mm(3); total serum immunoglobulin (IgM, IgG and IgA) levels within normal ranges. No other clinically significant laboratory abnormalities. All subjects must understand the basis of transmission of HIV and other common sexual and blood borne infections and agree to practice abstinence or clinically accepted methods of prevention, including barrier protection during intercourse for the duration of the study. Female subjects of child bearing potential must have a negative pregnancy test. Must be available for active follow-up. Able to give informed consent by signing the Institutional Review Board (IRB)-approved consent form(s). Must not have previous immunization with any experimental vaccine directed against HIV or receipt of any experimental agent within 30 days prior to enrollment. Must not receive any blood product or immunoglobulin within 6 months prior to enrollment. Must not be exposed to potentially infective HIV fluids within the prior 6 months or tested positive for HIV at any time. No history of any prior disease or therapy which would affect immune function including: Prior malignancy, except curatively-treated basal cell or squamous cell carcinoma of the skin or carcinoma in situ of the cervix; Radiation therapy or cytotoxic/cancer chemotherapy; immunodeficiency or auto-immune disease; Acute infection or a recent (within 6 months) history of chronic infection. Female subjects must not be nursing a child. Must not be taking any medication which may affect immune function, with the following exceptions: subjects may be taking low doses of nonprescription strength (e.g. ibuprofen or aspirin) or acetaminophen. No known hypersensitivity to bupivacaine or any amide-type local anesthetic (such as lidocaine, dibucaine, mepivacaine, and prilocaine) or a history of anaphylaxis or of any serious adverse reactions to vaccines. No evidence of active drug or alcohol abuse or uncontrolled (unstable) psychiatric disorders which would interfere with study participation. Must not be engaging in HIV-related high-risk behavior such as unprotected sex, sex with multiple partners, or intravenous drug use. No evidence of infection with HBV, HIV-1, HCV or HTLV-1 using standard testing procedures. Must not have any positive result for anti-DNA antibodies as measured by standard testing procedures (anti-DNA antibody and anti-nuclear antibody (ANA) assays. This study does permit enrollment of volunteers with a low positive ANA (less than or equal to 1:160) titers, if there is no clinical evidence of underlying disorders that are associated with a positive ANA, if no first degree relative has an autoimmune disease, and if anti-DNA and ENA are negative