Repair of renal artery aneurysm with stent angiography and coil embolization.

Renal artery aneurysms (RAAs) are rare and are frequently discovered incidentally during the workup for other renal issues. Open surgery has been a popular approach to managing RAAs; however, endovascular techniques have recently emerged as a less invasive option. Endovascular therapy involves stent angiography and coil embolization of the aneurysm. RAA classification (type 1, 2, and 3) is determined by its anatomical location and shape, which has been demonstrated to affect whether an open or an endovascular method is most suitable. We report two patients with type 1 RAAs and a history of hypertension who were successfully repaired endovascularly using VBX stents.

Cross-reactive carbohydrate determinant interference in cellulose-based IgE allergy tests utilizing recombinant allergen components.

BACKGROUND: Cross-reactive carbohydrate determinant (CCD) structures found in plant and insect glycoproteins are commonly recognized by IgE antibodies as epitopes that can lead to extensive cross-reactivity and obscure in vitro diagnostic (IVD) serology results. With the introduction of component resolved diagnosis (CRD), recombinant non-glycosylated components have been utilized to mitigate the risk of CCD-specific IgE (sIgE) detection. However, a recent study has shown that CCD-sIgE may bind directly to the cellulose solid phase matrix used in certain in vitro diagnostic assays, eliminating the advantage of CRD over traditional extract-based testing. The aim of this study is to further investigate the prevalence of CCD-sIgE interference on a commonly-used in vitro sIgE automated platform which employs a cellulose-based matrix to immobilize CCD-free recombinant components. METHODS: Sera from patients sensitized to peanut, silver birch, and/or timothy grass were analyzed for CCD-sIgE reactivity on ImmunoCAP/Phadia and NOVEOS autoanalyzers against the MUXF3 carbohydrate component. Positive CCD-sIgE sera were further analyzed against non-glycosylated recombinant components bound to the ImmunoCAP solid phase in the absence and presence of a soluble CCD inhibitor. For comparison, sera were then analyzed on NOVEOS, a non-cellulose based automated sIgE assay. RESULTS: Sera from 35% of the sensitized population tested in this study were positive (≥0.35 kU/L) for CCD-sIgE. Of those positives, 17% resulted in CCD-sIgE-positive (false positive) results on ImmunoCAP using non-glycosylated allergosorbents that were negative on NOVEOS. Sera producing false-positive results on ImmunoCAP had varying levels of CCD-sIgE from 0.67 kU/L to 36.52 kU/L. The incidence of CCD interference was predominantly delimited to low-positive IgE results (0.35 kUA/L- 3.00 kUA/L). CONCLUSION: Falsely elevated diagnostic allergen-sIgE results can commonly occur due to the presence of CCD-sIgE using assays that employ a carbohydrate matrix-based allergosorbent. Even the use of non-glycosylated recombinant allergenic components coupled to cellulose matrices do not reduce their risk of detection. The risk of CCD interference that compromises quantitative IgE results can be mitigated by the addition of a soluble CCD inhibitor to positive CCD-sIgE containing sera or by alternatively using a non-cellulose based sIgE assay, such as the NOVEOS assay.

Dehydrative cyclocondensation mechanisms of hydrogen thioperoxide and of alkanesulfenic acids.

Structural features of hydrogen thioperoxide (oxadisulfane, H-S-O-H) and of alkanesulfenic acids (R-S-O-H; R = CH3, CH2CH3, CH2CH2CH3, CH(CH3)2, C(CH3)3, CF3, CCl3) and the mechanisms of their dehydrative cyclocondensation to the respective sulfinothioic acid (H-(S═O)-S-H) and alkyl alkanethiosulfinates (R-(S═O)-S-R) have been studied using coupled cluster theory with single and double and perturbative triple excitations [CCSD(T)] and quadratic configuration interaction with single and double and perturbative triple excitations [QCISD(T)] with the cc-pVDZ basis set and also using second-order Møller-Plesset perturbation theory (MP2) and the hybrid density functionals B3LYP, B3PW91, and PBE1PBE with the 6-311+G(d,p) basis set. The concerted cyclodehydration mechanisms include cyclic five-center transition states with relatively long distance sulfur-sulfur bonding interactions. Attractive and repulsive nonbonding interactions are predicted in the sulfenic acids, transition states, and thiosulfinates. In the alkyl alkanethiosulfinates attractive cyclic C-H----O═S nonbonding interactions are predicted. CCSD(T) and QCISD(T) predict similar values for the relative energies and CCSD(T) predicts the barrier to the cyclocondensation of H-S-O-H to sulfinothioic acid (H-(S═O)-S-H) to be 41.8 kcal/mol, and barriers in the range of 37.5 to 39.6 kcal/mol are predicted for the condensation of alkanesulfenic acids to alkyl alkanethiosulfinates.