Haptic Guidance in Comanipulated Laser Surgery for Fetal Disorders

The current techniques in minimal invasive surgery allow to treat fetal disorders. In fetal interventions very precise instrument manipulation is required from the surgeon. For instance in the treatment of the twin-to-twin transfusion syndrome (TTTS) it is crucial that the surgeon maintains a specific distance between the tip of the employed instrument and the placenta, while lasering target sites on the placenta. To facilitate this procedure, we suggest a new approach where the surgeon comanipulates the instruments together with a robotic stabilizer arm. The stabilizer arm provides haptic guidance to the surgeon, augmenting the surgeon's dexterity and precision. The first results show that this approach is promising

Evaluation of Haptic Feedback on Bimanually Teleoperated Laparoscopy for Endometriosis Surgery

Robotic minimal invasive surgery is gaining acceptance in surgical care. In contrast with the appreciated 3D vision and enhanced dexterity, haptic feedback is not offered. For this reason robotics is not considered beneficial for delicate interventions such the endometriosis. Overall, haptic feedback remains debatable and yet unproven except for some simple scenarios such as Fundamentals of Laparoscopic Surgery exercises. OBJECTIVE: The present work investigates the benefits of haptic feedback on more complex surgical gestures, manipulating delicate tissue through coordination between multiple instruments. Methods: A new training exercise, “Endometriosis Surgery Exercise” (ESE) has been devised approximating the setting for monocular robotic endometriosis treatment. A bimanual bilateral teleoperation setup was designed for laparoscopic laser surgery. Haptic guidance and haptic feedback are respectively offered to the operator. User experiments have been conducted to i) assess the validity of ESE and to ii) examine possible advantages of haptic technology during execution of bimanual surgery. RESULTS: i) Content and face validity of ESE was established by participating surgeons. Surgeons suggested ESE also as a means to train lasering skills, ii) interaction forces on endometriotic tissue were found to be significantly lower when a bilateral controller is used. Collisions between instruments and the environment were less frequent and so were situations marked as potentially dangerous. CONCLUSION: This study provides some promising results suggesting that haptics may offer a distinct advantage in complex robotic interventions were fragile tissue is manipulated. SIGNIFICANCE: Patients need to know whether it should be incorporated. Improved understanding of the value of haptics is important as current commercial surgical robots are widely used but do not offer haptics

Transcriptional and genomic parallels between the monoxenous parasite Herpetomonas muscarum and Leishmania

Trypanosomatid parasites are causative agents of important human and animal diseases such as sleeping sickness and leishmaniasis. Most trypanosomatids are transmitted to their mammalian hosts by insects, often belonging to Diptera (or true flies). These are called dixenous trypanosomatids since they infect two different hosts, in contrast to those that infect just insects (monoxenous). However, it is still unclear whether dixenous and monoxenous trypanosomatids interact similarly with their insect host, as fly-monoxenous trypanosomatid interaction systems are rarely reported and under-studied–despite being common in nature. Here we present the genome of monoxenous trypanosomatid Herpetomonas muscarum and discuss its transcriptome during in vitro culture and during infection of its natural insect host Drosophila melanogaster. The H. muscarum genome is broadly syntenic with that of human parasite Leishmania major. We also found strong similarities between the H. muscarum transcriptome during fruit fly infection, and those of Leishmania during sand fly infections. Overall this suggests Drosophila-Herpetomonas is a suitable model for less accessible insect-trypanosomatid host-parasite systems such as sand fly-Leishmania

Induction and transmission of oncogene-induced senescence

Senescence is a cellular stress response triggered by diverse stressors, including oncogene activation, where it serves as a bona-fide tumour suppressor mechanism. Senescence can be transmitted to neighbouring cells, known as paracrine secondary senescence. Secondary senescence was initially described as a paracrine mechanism, but recent evidence suggests a more complex scenario involving juxtacrine communication between cells. In addition, single-cell studies described differences between primary and secondary senescent end-points, which have thus far not been considered functionally distinct. Here we discuss emerging concepts in senescence transmission and heterogeneity in primary and secondary senescence on a cellular and organ level

Adherence issues related to sublingual immunotherapy as perceived by allergists

Objectives: Sublingual immunotherapy (SLIT) is a viable alternative to subcutaneous immunotherapy to treat allergic rhinitis and asthma, and is widely used in clinical practice in many European countries. The clinical efficacy of SLIT has been established in a number of clinical trials and meta-analyses. However, because SLIT is self-administered by patients without medical supervision, the degree of patient adherence with treatment is still a concern. The objective of this study was to evaluate the perception by allergists of issues related to SLIT adherence. Methods: We performed a questionnaire-based survey of 296 Italian allergists, based on the adherence issues known from previous studies. The perception of importance of each item was assessed by a VAS scale ranging from 0 to 10. Results: Patient perception of clinical efficacy was considered the most important factor (ranked 1 by 54% of allergists), followed by the possibility of reimbursement (ranked 1 by 34%), and by the absence of side effects (ranked 1 by 21%). Patient education, regular follow-up, and ease of use of SLIT were ranked first by less than 20% of allergists. Conclusion: These findings indicate that clinical efficacy, cost, and side effects are perceived as the major issues influencing patient adherence to SLIT, and that further improvement of adherence is likely to be achieved by improving the patient information provided by prescribers. © 2010 Scurati et al, publisher and licensee Dove Medical Press Ltd

SIRT1-metabolite binding histone macroH2A1.1 protects hepatocytes against lipid accumulation.

Item does not contain fulltextNon-alcoholic-fatty-liver-disease (NAFLD) encompasses conditions associated to fat deposition in the liver, which are generally deteriorated during the aging process. MacroH2A1, a variant of histone H2A, is a key transcriptional regulator involved in tumorigenic processes and cell senescence, and featuring two alternatively splicing isoforms, macroH2A1.1 and macroH2A1.2. MacroH2A1.1 binds with high affinity O-acetyl ADP ribose, a small metabolite produced by the reaction catalysed by NAD+-dependent deacetylase SIRT1, whereas macroH2A1.2 is unable to do so. The functional significance of this binding is unknown. We previously reported that the hepatic levels of macroH2A1.1 and macroH2A1.2 are differentially expressed in mice models of NAFLD. Here we show that over-expression of macroH2A1.1, but not of macroH2A1.2, is able to protect hepatocytes against lipid accumulation. MacroH2A1.1 over-expressing cells display ameliorated glucose metabolism, reduced expression of lipidogenic genes and fatty acids content. SIRT1/macroH2A1.1-dependent epigenetic regulation of lipid metabolism may be relevant to NAFLD development.1 januari 201

SIRT1-metabolite binding histone macroH2A1.1 protects hepatocytes against lipid accumulation

Item does not contain fulltextNon-alcoholic-fatty-liver-disease (NAFLD) encompasses conditions associated to fat deposition in the liver, which are generally deteriorated during the aging process. MacroH2A1, a variant of histone H2A, is a key transcriptional regulator involved in tumorigenic processes and cell senescence, and featuring two alternatively splicing isoforms, macroH2A1.1 and macroH2A1.2. MacroH2A1.1 binds with high affinity O-acetyl ADP ribose, a small metabolite produced by the reaction catalysed by NAD+-dependent deacetylase SIRT1, whereas macroH2A1.2 is unable to do so. The functional significance of this binding is unknown. We previously reported that the hepatic levels of macroH2A1.1 and macroH2A1.2 are differentially expressed in mice models of NAFLD. Here we show that over-expression of macroH2A1.1, but not of macroH2A1.2, is able to protect hepatocytes against lipid accumulation. MacroH2A1.1 over-expressing cells display ameliorated glucose metabolism, reduced expression of lipidogenic genes and fatty acids content. SIRT1/macroH2A1.1-dependent epigenetic regulation of lipid metabolism may be relevant to NAFLD development.1 januari 201

Host-parasite relationship of ticks (Acari: Ixodidae and Argasidae) and feral pigs (Sus scrofa) in the Nhecolândia region of the Pantanal wetlands in Mato Grosso do Sul.

Feral pigs (S. scrofa) were introduced to the Pantanal region around 200 years ago and the population appears to be in expansion. Its eradication is considered to be impossible. The population of feral pigs in the Pantanal wetlands is currently estimated at one million. Two scientific excursions were organized. The first was conducted during the dry season, when 21 feral pigs were captured and the second was during the wet season, when 23 feral pigs were captured. Ticks were collected and the oviposition and hatching process were studied to confirm the biological success of each tick species. Three tick species were found to be feeding on feral pigs: Amblyomma cajennense, A. parvum, and Ornithodoros rostratus. During the dry season, 178 adult A. cajennense were collected, contrasting with 127 A. cajennense specimens in the wet season. This suggests that the seasonality of these ticks in the Brazilian Pantanal wetlands could be different from other regions. The results indicate that A. parvum and A. cajennense are biologically successful parasites in relation to feral pigs. A. cajennense appears to have adapted to this tick-host relationship, as well as the areas where feral pigs are abundant, and could play a role in the amplification of this tick population.201