RESUMO
We evaluated left hand function with or without obstruction of left subclavian artery for 29 cases of thoracic endovascular aortic repair (TEVAR). 18 cases of distal true aortic aneurysm were undergone surgery with simple direct closure of left subclavian artery (LSCA). The other 11 cases of true arch aneurysm were revascularized by axilla-carotid-axilla bypass grafting with TEVAR. Later 26 cases were evaluated by blood pressure, maximal grasping power, persisting duration of 60% maximal grasping power, circumferential length of upper and forearms, and simple test for evaluating hand function (STEF). Left hand blood pressure was significantly reduced than right side in obstruction group. But left hand function was not reduced in any other test. We concluded that no relationship between the obstruction of LSCA and the left hand function, and the influence of late survival and mobidity.
Assuntos
Aneurisma da Aorta Torácica/cirurgia , Procedimentos Endovasculares , Mãos/fisiologia , Artéria Subclávia/cirurgia , Idoso , Feminino , Humanos , Masculino , StentsRESUMO
Nanotechnology is an innovative method of freely controlling nanometre-sized materials. Recent outbreaks of mucosal infectious diseases have increased the demands for development of mucosal vaccines because they induce both systemic and mucosal antigen-specific immune responses. Here we developed an intranasal vaccine-delivery system with a nanometre-sized hydrogel ('nanogel') consisting of a cationic type of cholesteryl-group-bearing pullulan (cCHP). A non-toxic subunit fragment of Clostridium botulinum type-A neurotoxin BoHc/A administered intranasally with cCHP nanogel (cCHP-BoHc/A) continuously adhered to the nasal epithelium and was effectively taken up by mucosal dendritic cells after its release from the cCHP nanogel. Vigorous botulinum-neurotoxin-A-neutralizing serum IgG and secretory IgA antibody responses were induced without co-administration of mucosal adjuvant. Importantly, intranasally administered cCHP-BoHc/A did not accumulate in the olfactory bulbs or brain. Moreover, intranasally immunized tetanus toxoid with cCHP nanogel induced strong tetanus-toxoid-specific systemic and mucosal immune responses. These results indicate that cCHP nanogel can be used as a universal protein-based antigen-delivery vehicle for adjuvant-free intranasal vaccination.
Assuntos
Géis/química , Nanopartículas/química , Nanotecnologia/métodos , Administração Intranasal , Animais , Toxinas Botulínicas Tipo A/química , Encéfalo/metabolismo , Clostridium botulinum/metabolismo , Sistemas de Liberação de Medicamentos , Feminino , Sistema Imunitário , Teste de Materiais , Camundongos , Camundongos Endogâmicos BALB C , Bulbo Olfatório/metabolismo , Vacinas/químicaRESUMO
Rice-expressed cholera toxin B (CTB) subunit is a cold-chain-free oral vaccine that effectively induces enterotoxin-neutralising immunity. We created another rice-based vaccine, MucoRice, expressing nontoxic double-mutant cholera toxin (dmCT) with CTA and CTB subunits. Western-blot analysis suggested that MucoRice-dmCT had the shape of a multicomponent vaccine. Oral administration of MucoRice-dmCT induced CTB- but not CTA-specific serum IgG and mucosal IgA antibodies, generating protective immunity against cholera toxin without inducing rice-protein-specific antibody responses. The potency of MucoRice-dmCT was equal to that of MucoRice-CTB vaccine. MucoRice has the potential to be used as a safe multicomponent vaccine expression system.