Synthetic carriers: sequential oligopeptide carriers SOCn-I and SOCn-II as an innovative and multifunctional approach.

Nowadays, the use of synthetic carriers as biochemical reagents and immunogens is entering a new phase. The multimeric nature of these constructs, the unambiguous composition and the ease, reliability and versatility of their production, make this type of carriers well-suited to various biotechnological and biochemical applications for diagnostic purposes, protein mimetics, antiviral agents, vaccines, drug and gene delivery vehicles. This review aims to briefly summarize the different types of synthetic carriers currently in use and will be focused on an innovative type of multifunctional helicoid carrier-foldamer, named SOC(n)-I, II, which was successfully developed in our laboratory. Our concept was to construct an artificial template with structural rigidity and regularity, so as the peptide epitopes/pharmacophore groups could be anchored without any conformational restriction and steric hindrance as demonstrated by conformational studies using (1)H-NMR, CD and FT-IR. SOC(n)-I,II were used as antigenic substrates in developing immunoassays of high sensitivity, specificity and reproducibility, as well as potent immunogens to generate site-specific antibodies. To this end, we emphasize on the application of SOC(n) carriers covalently bearing a 'built-in' adjuvant, for the preparation of totally synthetic peptide-based vaccines for human use.

Torsion of a non-gravid leiomyomatous uterus in a patient with myotonic dystrophy complaining of acute urinary retention: anaesthetic management for total abdominal hysterectomy.

Torsion of a pregnant uterus is rare, but torsion of a non-pregnant uterus is extremely rare. Abdominal pain is the major symptom. Other symptoms include vaginal bleeding, urinary tract symptoms and gastro-intestinal manifestations. We present a case of a 37-year-old white nullipara who presented at the emergency room with acute urinary retention. Medical history revealed that the patient carried the disease of myotonic dystrophy, which was diagnosed two years before. Physical examination revealed a tender, distended bladder, which was easily catheterized, draining 900 ml of clear urine. The abdomen was soft with no muscle guarding or rebound tenderness. A palpable large dense mass occupying the cul-de-sac was found during bimanual examination. Abdominal ultrasound examination revealed a large intramural leiomyoma approximately 10 cm in diameter, in the posterior wall of the uterus, which repelled the bladder. In neurological examination the muscular tone and reflexes were reduced in the lower extremities. Myotonic phenomenon was not found. The patient was thought to suffer from myotonic dystrophy and therefore the possibilities for pulmonary and cardiac complications or malignant hyperthermia had to be kept in mind during the anaesthetic management. The patient underwent an exploratory laparotomy and the uterus was found to have undergone a 60 degrees rotation along the corpus and the cervix uteri transition line. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was perfomed. The intra- and postoperative course of the patient was uneventful. In conclusion, in this patient the uterine pathology (large leiomyoma) in combination with the disease of myotonic dystrophy seemed to be the predisposing factors for the torsion of the non-pregnant uterus. Also, the anaesthetic implications for total abdominal hysterectomy in myotonic dystrophy are discussed and the international literature is reviewed.