A retrospective review of our prospectively maintained database identified all PMCAA treated in our institution. GSKJ4 The clinical charts, procedural data, and angiographic results were reviewed.
From April 2004 to December 2011, 17 patients were identified including six
who presented with subarachnoid hemorrhage (SAH) and 11 with an unruptured PMCAA. All aneurysms were small (< 6 mm) and had a branch arising from the neck or the sac, and 15/17 were wide-necked. All patients were successfully treated by balloon-assisted coiling (n = 10), stent-assisted coiling (n = 5), and coiling (n = 2). No technical or clinical complication occurred. Fifteen patients showed an excellent clinical outcome, and two kept a slight or a significant deficit that were both SAH-related. Immediate anatomical outcome includes nine complete occlusions and eight neck remnants. Imaging follow-up in 11 patients (mean = 21, range, 6 to 60 months) showed stable or improved results in all cases.
Our study is the first reported series of patients with PMCAA treated by selective embolization. It suggests that EVT is a safe and effective alternative to surgery for the management
of PMCAA. Balloon- or stent-assisted coiling are needed in most cases because of PMCAA morphological characteristics.”
“Induction of specific immunological unresponsiveness by oral autoantigens such as glutamic acid decarboxylase 65 (GAD65) is termed oral tolerance and may be a potential therapy for autoimmune diabetes. However, the requirement PD0332991 Acetophenone for large amounts of protein will limit clinical testing of autoantigens, which are difficult to produce.
Mucosal adjuvants such as cholera toxin B subunit (CTB) may lower the level of autoantigens required. Here we describe cloning, expression, purification and identification study of the CTB and triple GAD(531-545) epitopes fusion gene. The fusion gene was ligated via a flexible hinge tetrapeptide and expressed as a soluble protein in Escherichia coli BL21 (DE3) driven by the T7 promoter. We purified the recombination protein from the cell lysate and obtained approximately 2.5 mg of CrB-GAD((531-545)3) per liter of culture with greater than 90% purity by a Ni-NTA resin column. The bacteria produced this protein as the pentameric form, which retained the GM1-ganglioside binding affinity and the native antigenicity of CTB and GAD65. Further studies revealed that oral administration of bacterial CT13GAD((531-545)3) fusion protein showed the prominent reduction in pancreatic islet inflammation in nonobese diabetic mice. The results presented here demonstrate that the bacteria bioreactor is an ideal production system for an oral protein vaccine designed to develop immunological tolerance against autoimmune diabetes. Crown Copyright (C) 2009 Published by Elsevier Inc. All rights reserved.