Stability of lyophilized Meningococcal A conjugate vaccine, (MenAfriVac™) at elevated temperatures to support controlled temperature chain (CTC) claim

Meningococcal A Conjugate Vaccine (MenAfriVac) is the world's first Monovalent Conjugate Vaccine against Neisseria Meningitidis serogroup A which has obtained Controlled Temperature Chain (CTC) label claim of "stable upto 40°C for 4 days prior to reconstitution" developed by Serum Institute of India Pvt. Ltd. Pune, India and the vaccine was granted permission from World health Organization. This paper elucidates and talks about the layout of various studies performed to characterize the product to declare as CTC at the time when the knowledge and mechanism to describe CTC was not fully known which in term helped to design the CTC guidelines. Product stability was assessed using clinical, consistency and regular lots released by NRA. The critical stability indicating parameters like free polysaccharide, molecular size distribution along with Potency and safety tests were carried out to support the product stability making sure it also qualifies for Vaccine Vial Monitor label claim of VVM30. An additional in use stability (reconstitution) was also performed. All studies indicated that the product remains stable at real time as well as elevated temperatures and well within the specifications approved by NRA and formed the strong basis for CTC claim which is now recommended by WHO.

"Raking-in Technique:" Removal Of Brachiocephalic Vein Thrombus Using AngioVac® Device Within A Stented Venous Segment

Introduction

A case is reported of left brachiocephalic vein thrombus removal using the Angiovac device within a stented venous segment via a through-and-through access technique.

Report

This novel technique involves obtaining through-and-through access from the left basilic vein to the right femoral vein, which then facilitates the advancement of the Angiovac device to successfully remove in a stepwise fashion the thrombus present within a stented region of the left brachiocephalic vein.

Discussion

The Angiovac device has been shown to be very useful and effective at removing large amounts of thrombus, tumor, and foreign bodies within arterial and venous systems successfully. This novel technique uses the through-and-through venous access approach to allow for this device to remain close to the targeted area of thrombus burden and prevent damage of the already existing stents in this region.

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Novel technique to extract thrombus in a stented segment of vessel.

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Through-and-through access technique from the left basilica vein to the right femoral vein.

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Central venous thrombectomy using angioplasty balloon.

Electroporative transfection with KGF-1 DNA improves wound healing in a diabetic mouse model

We recently demonstrated that electroporation enhances transfection in a mouse wound-healing model. Keratinocyte growth factor (KGF) is an inducer of epithelial cell proliferation and differentiation and has been shown to be under expressed in the wounds of diabetic individuals. We hypothesized that KGF delivered into an excisional wound via naked DNA injection with subsequent electroporation would be a novel and potentially effective method to enhance wound closure in a diabetic mouse model. ELISA assays confirmed production of KGF protein in cultured mouse cells and RT-PCR assays confirmed KGF mRNA in skin samples taken from mice. In all, 32 genetically diabetic mice were given two identical excisional wounds of their dorsum and split into two groups with one group receiving KGF DNA injection and electroporation with the other group receiving no treatment. Over 90% of wounds healed in the presence of KGF and electroporation versus 40% in the untreated group by day 12. Histological analysis of the wounds demonstrated that untreated wounds contained microulcers with thin or incomplete epithelium with unresolved inflammation as compared to treated wounds where intact and mature epithelium was observed. Taken together these findings suggest that a single injection of KGF DNA encoded on a plasmid coupled with electroporation improves and accelerates wound closure in a delayed wound-healing model.

Endoscopic vein harvest: early results of a prospective trial with open vein harvest

BACKGROUND

Conventional open long saphenous vein harvest (OVH) is often associated with significant wound pain and serious morbidity in some patients with a resultant extended treatment period. Endoscopic vein harvest (EVH) in theory should alleviate wound pain, be less predisposed towards leg wound infection and lead to greater patient satisfaction. This study aims to compare the two techniques on this basis and determine whether EVH is a viable technique within normal operative time.

METHODS

During September and December 2000, 60 saphenous vein harvests were prospectively randomised to EVH (n=30) and OVH (n=30); all performed by one surgeon with the Clearglide(r) endoscopic vein harvest system (Ethicon Inc). End points were impaired wound healing (ASEPSIS score) and postoperative pain (Visual analogue scale) and operative variables. Statistical analysis done using Fisher s exact test and Mann-Whitney U test as appropriate.

RESULTS

The groups were well matched demographically. Patients in the EVH group had significantly lower ASEPSIS scores (p<0.001) and postoperative pain (p<0.001). The vein was harvested at 0.96cm/min (0.43-1.5+/-0.33) in the OVH group compared to 0.81cm/min (0.41-1.13+/-0.19) in the EVH group (p=0.09). The new procedure did not prolong the overall operative time (p=0.53). Two patients needed to be converted to open technique. There was no difference found in the vein quality by histological analysis.

CONCLUSIONS

These data clearly demonstrate that endoscopic vein harvest results in significantly reduced post-operative pain, better impaired wound healing, allows earlier ambulation and does not prolong the operative time significantly with no compromise in vein quality.