A total of 56 upper limbs from fetuses and adult cadavers were dissected to record anatomical variations in the musculocutaneous nerve (MC). A systematic literature review was performed to identify current classifications of MC variations. Communications were seen between the MC and median nerves in 53.6% of the dissections from which 84.6% were proximal, 7.7% distal, and 7.7% had one proximal and one distal communication to the point of entry of the MC into coracobrachialis muscle. In six out of 54 dissections where the MC was present, the nerve did not pierce the coracobrachialis muscle. In two cases, the MC was absent and in one case the MC and the median nerve had a distal origin. This article describes current classifications of MC variations and their problems. A new classification is proposed combining preexisting ones into an integrated and more detailed overview. Clinical manifestations of isolated MC injury with and without the presence of anatomical variations are thoroughly discussed. The knowledge of these variations will allow physicians to correctly interpret anomalous innervation patterns of the upper limb.

DNA vaccination has been of great interest since its discovery in the 1990s due to its ability to elicit both humoral and cellular immune responses. DNA vaccines consist of a DNA plasmid containing a transgene that encodes the sequence of a target protein from a pathogen under the control of a eukaryotic promoter. This revolutionary technology has proven to be effective in animal models and four DNA vaccine products have recently been approved for veterinary use. Although few DNA vaccines against bacterial infections have been tested, the results are encouraging. Because of their versatility, safety and simplicity a wider range of organisms can be targeted by these vaccines, which shows their potential advantages to public health. This article describes the mechanism of action of DNA vaccines and their potential use for targeting bacterial infections. In addition, it provides an updated summary of the methods used to enhance immunogenicity from codon optimization and adjuvants to delivery techniques including electroporation and use of nanoparticles.Keywords bacterial vaccine; cellular and humoral immune responses; DNA vaccine; molecular adjuvants Times have changed since Edward Jenner immunized James Phipps against smallpox in 1796 and created what years later became known as a vaccine [1]. From the first live-attenuated or killed vaccines to the era of DNA vaccines in the early 1990s, molecular biology and microbiology have aided medical research in the development of vaccines against infectious diseases, cancer, allergies and autoimmune diseases by inducing rapid and robust immune responses or by creating immune tolerance [2]. From the time of Jenner's first vaccine until the present day, there have been over 60 licensed vaccines in the USA. These vaccines come in many forms: killed microorganisms, live-attenuated microorganisms, subunits, conjugate vaccines or toxoids. Although there are no US FDA-approved DNA vaccines for use in humans, they are the newest vaccine platform currently in development and have already had success in veterinary medicine [3][4][5][6][7][8].© 2010 Expert Reviews Ltd † Author for correspondence: Tel.: +1 215 349 8591, Fax: +1 215 573 9436, dbweiner@mail.med.upenn.edu. Financial & competing interests disclosureThe authors declare possible commercial conflicts, which may include advising, consulting and collaboration, with Wyeth, Inovio, BMS, Virxsys, Ichor, Merck, Althea, Johnson & Johnson and Aldeveron. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript. NIH Public Access Author ManuscriptExpert Rev Vaccines. Author manuscript; available in PMC 2011 May 1. Published in final edited form as:Expert Rev Vaccines. 2010 July ; 9(7): 747-763. doi:10.1586/erv.10.57. NIH-PA Author ManuscriptNIH-PA Author Manuscript N...

PURPOSE: To assess the effectiveness and safety of an intravitreal injection of 1.25 mg bevacizumab (IVB) as a preoperative adjunct to small-gauge pars plana vitrectomy (PPV) compared with PPV alone in eyes with tractional retinal detachment secondary to proliferative diabetic retinopathy.METHODS: This prospective, double-masked, randomized, multicenter, active-controlled clinical trial enrolled 224 eyes of 224 patients between November 2013 and July 2015. All eyes underwent a baseline examination including best-corrected visual acuity, color photos, optical coherence tomography, and fluorescein angiography. Data were collected on intraoperative bleeding, total surgical time, early (<1 month) postoperative vitreous hemorrhage, and mean change in best-corrected visual acuity at 12 months. P < .05 was considered statistically significant. RESULTS: A total of 214 patients (214 eyes) were randomized in a 1:1 ratio to PPV plus IVB ([study group] 102 eyes) or PPV plus sham ([control] 112 eyes). Iatrogenic retinal breaks were noted intraoperatively in 35 eyes (34.3%) in the study group, and 66 eyes (58.9%) in the control group (P [ .001). Grade 2 intraoperative bleeding was noted in 32 (31.3%) eyes in the study group and 58 (51.7 %) eyes in the control group (P [ .001). Endodiathermy was necessary in 28 (27.4 %) eyes in the study group, compared with 75 (66.9%) eyes in the control group (P [ .0001). Mean surgical time was 71.3 ± 32.1 minutes in the study group and 83.6 ± 38.7 minutes in the control group (P [ .061). CONCLUSION: Preoperative IVB seems to reduce intraoperative bleeding, improving surgical field visualization, and reducing intraoperative and postoperative complications. NOTE: Publication of this article is sponsored by the

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