ESPRESSO: A novel device for laser-assisted surgery of the anterior eye segment.

INTRODUCTION: Merging robotics with laser eye surgery could enhance precision, repeatability and automation. During some eye laser procedures the patient is awake, thus eye stabilization is desired to avoid movements that could affect the treatment. MATERIAL AND METHODS: The ESPRESSO platform has a two-stage actuation system to position a stabilization tool on the eye, a proximity sensing unit to monitor the stabilization tool position, and a sensing unit to monitor the pressure exerted on the eye. The platform is tested in-vitro and ex-vivo with clinicians. A maximum pressure to be exerted on the eye is defined with expert ophthalmic surgeons to be 22 mmHg: physiological intraocular pressure (IOP) range is 10-21 mmHg. This pressure corresponds to a force of 0.3 N. RESULTS: The necessary contact force to have eye fixation (according to the clinicians' feedback) is evaluated: maximum values resulted always below 0.3 N. A maximum IOP increase of 4.67 mmHg is observed, that is a slight variation with respect to the performance of other platforms (IOP elevations up to 328 mmHg). CONCLUSION: Design and initial assessment of the platform is presented. Eye stabilization is performed without exceeding the critical contact force value and causing large/sudden IOP increases.

Photoinduced collagen cross-linking: a new approach to venous insufficiency.

BACKGROUND: What little research has been done on methods of venous valve function recovery with radiofrequency has had disappointing results. Valvuloplasty has some supporters, but the majority of physicians do not consider it a valid therapeutic option. OBJECTIVE: To test a new method of treating varicose veins based on their collagen structure. This procedure it is not a thermal treatment, but it is fast, with significant shrinking and preservation of the endothelium. MATERIALS & METHODS: In the laboratory, we subjected greater saphenous vein specimens to irradiation with a blue light-emitting diode generated (wavelength 450-480 nm) while a riboflavin solution (vitamin B2) was administered. The riboflavin acts as a cross-linking agent, and the blue light as the activator. In this photo-induced reaction, oxygen singlet is produced with oxidative deamination, forming new covalent bonds between collagen fibrils and water. RESULTS: In venous specimens, we demonstrated fast and significant shrinkaged without histologic evidence of endothelial damage and with evident change in mechanical properties of varicose veins. CONCLUSIONS: Photochemically induced collagen cross-linking to restructure varicose veins is only a research field but may become an important tool for recovery of vein diameter and valve function.

Hemodynamic 3D Infrared Thermal Stereoscopic Imaging (TSI) Investiga- tion in Chronic Vascular Leg Ulcers: A Feasibility Study.

UNLABELLED: Hemodynamic 3D infrared thermal stereoscopic imaging (TSI) was tested as a new non-invasive diagnostic method for studying chron- ic vascular leg ulcers. The aim was to test this new diagnostic approach in investigating mixed arterio-venous wounds. Duplex ultrasonography is the most useful test for investigating hemodynamic alterations in patients with vascular cutaneous ulcers; however, it fails to provide any information about microvascular dysfunctions, which could play a sig- nificant role in the development of skin wounds. The study of thermal patterns at the wound site represents a method of investigating cu- taneous microcirculation-temperature gradients indicating abnormal blood flow in the margins and bed of wounds with vascular disorders are well correlated with clinical findings. METHODS: In order to evaluate the predominance of the arterial or venous component in vascular mixed ulcers of the leg and to understand the underlying pathology of the ulcers, 3D thermography was tested in three different hemodynamic positions. A total of 20 physiological and 20 pathological patients were assessed standing, supine, or in a discharging position (legs raised above heart level). RESULTS: A relatively constant temperature trend was observed in healthy subjects, while a different reaction was recorded in those with ulcerated legs. Moreover, a different temperature trend was noted among the varying hemodynamic positions and a trend differ- ence was also observed between arterial and venous ulcers in clinical investigation tests. CONCLUSION: TSI appears to be a safe, user-friendly, rapid, and promising procedure for distinguishing both arterial and ve- nous involvement in mixed arterio-venous leg ulcers. .

Therapeutic vaccination against Helicobacter pylori in the beagle dog experimental model: safety, immunogenicity, and efficacy.

Helicobacter pylori is a gram-negative bacterium that colonizes the human gastric mucosa causing gastritis and peptic ulcer and increasing the risk of gastric cancer. The efficacy of current antibiotic-based therapies can be limited by problems of patient compliance and increasing antibiotic resistance; the vaccine approach can overcome these limits. The present study describes the therapeutic vaccination of experimentally H. pylori-infected beagle dogs, an animal model that reproduces several aspects of the human infection with H. pylori. The vaccine consisted of three recombinant H. pylori antigens, CagA, VacA, and NAP, formulated at different doses (10, 25, or 50 microg each) with alum and administered intramuscularly either weekly or monthly. No adverse effects were observed after vaccination and a good immunoglobulin G response was generated against each of the three antigens. Bacterial colonization and gastritis were decreased after the completion of the vaccination cycle, especially in the case of the monthly immunization schedule. In conclusion, therapeutic vaccination in the beagle dog model was safe and immunogenic and was able to limit H. pylori colonization and the related gastric pathology.