The Technological Basis of a Balloon-Expandable TAVR System: Non-occlusive Deployment, Anchorage in the Absence of Calcification and Polymer Leaflets.

Leaflet durability and costs restrict contemporary trans-catheter aortic valve replacement (TAVR) largely to elderly patients in affluent countries. TAVR that are easily deployable, avoid secondary procedures and are also suitable for younger patients and non-calcific aortic regurgitation (AR) would significantly expand their global reach. Recognizing the reduced need for post-implantation pacemakers in balloon-expandable (BE) TAVR and the recent advances with potentially superior leaflet materials, a trans-catheter BE-system was developed that allows tactile, non-occlusive deployment without rapid pacing, direct attachment of both bioprosthetic and polymer leaflets onto a shape-stabilized scallop and anchorage achieved by plastic deformation even in the absence of calcification.

Preclinical evaluation of a transcatheter aortic valve replacement system for patients with rheumatic heart disease.

Aims: Cardiac surgery in middle-income countries differs significantly from that in high-income countries regarding prevailing heart valve pathologies and access to cardiac surgery. Typically, rheumatic aortic regurgitation in the absence of calcification by far outweighs stenosis. As such, entirely different transcatheter aortic valve implantation (TAVI) concepts are required for these regions.

Transcatheter valve with a hollow balloon for aortic valve insufficiency.

During the past decade transcatheter aortic valve implantation (TAVI) has revolutionized our approach to heart valve disease. Although largely applied to patients with calcific aortic valve stenosis, there is an unmet clinical need to also treat patients with aortic valve insufficiency in patients with non-calcific aortic valve disorders. The following Techno-College tutorial demonstrates our pre-clinical experience with a novel non-occlusive, self-homing TAVI system, developed with Strait Access Technologies, that we hope will improve outcomes for treatment of non-calcific aortic valve insufficiency.

Robotic versus laparoscopic distal pancreatectomy: an up-to-date meta-analysis.

Background: Laparoscopic distal pancreatectomy (LDP) reduces postoperative morbidity, hospital stay and recovery as compared with open distal pancreatectomy. Many authors believe that robotic surgery can overcome the difficulties and technical limits of LDP thanks to improved surgical manipulation and better visualization. Few studies in the literature have compared the two methods in terms of surgical and oncological outcome.

Clinical evaluation of a hyaluronan-based gel following microsurgical reconstruction of peripheral nerves of the hand.

A controlled clinical trial was performed to investigate the safety and efficacy of the hyaluronate-based gel polymer Hyaloglide after microsurgical reconstruction of peripheral nerves of the hand. Thirty patients were randomized to receive either no postsurgical treatment (n = 16) or Hyaloglide (n = 14) and were clinically evaluated at various intervals for 1 year. The application of Hyaloglide posed no safety concerns.

Evaluation of the EYTEX(TM) system in the COLIPA eye irritation program.

In the context of the 6th Amendment of the European Directive on Cosmetics, several cosmetic companies concentrate their basic research on the development of the best adapted battery of in vitro tests able to be incorporated in the ocular risk assessment process. Consequently, the European Cosmetic Toiletry and Perfumery Association (COLIPA) has initiated an international multicentric study with the main purpose to validate available alternatives in vitro methods for assessing the eye irritation potential of cosmetic raw materials and formulations. The alternative methods assessed in this validation study were chosen since all of these tests had already been used and continue to be conducted in the risk assessment process.

Photosensitization of wild and mutant strains of Escherichia coli by meso-tetra (N-methyl-4-pyridyl)porphine.

Wild type Escherichia coli cells as well as some mutant strains lacking specific DNA repair systems are efficiently killed upon visible light-irradiation after 5 min-incubation with meso-tetra(4N-methyl-pyridyl)porphine (T4MPyP). The presence of oxygen is necessary for cell photoinactivation. The porphyrin appears to exert its phototoxic activity largely by impairing some enzymic and transport functions at the level of both the outer and cytoplasmic membrane.

Measurement of epidermal moisture content by magnetic resonance imaging: assessment of a hydration cream.

The moisture content of the epidermis was measured by magnetic resonance imaging (MRI), using transverse relaxation time. The spatial resolution was 86 microns, allowing a quantitative, accurate and localized determination of variations in epidermal hydration. The wrists of 15 volunteers were studied before and after application of a hydration cream.

[Primary lymphoma of the breast (apropos of a clinical case)].

Taking as their starting point the observation of a case of primary lymphoma of the breast, the Authors point out that this tumour constitutes a rare disease in the context of non-Hodgkin lymphomas arising in sites other than the lymph nodes. They emphasize the clinical and instrumental diagnostic difficulties which the disease poses, as well as the uselessness of radical surgical therapy and the need for radio-chemotherapeutic management along with periodic follow-up. The Authors go on to explain how difficult it is to formulate a reliable prognosis for this type of tumour in view of the lack of homogeneity and the limited numbers of cases reported in the literature.

[Clinical results after proximal selective vagotomy (considerations on 42 cases)].

The authors report the results of a 6-8 year follow-up of 42 patients treated by selective proximal vagotomy with pyloroplasty for gastric or duodenal ulcer disease. On the basis of Visick's classification, the patients broke down into the following categories: Cat. 1: 66.

[Esophagogastroplasty in the treatment of squamous carcinoma of the esophagus (our experience)].

The authors report on their experience with 42 cases of squamous carcinoma of the oesophagus subjected to oesophagectomy and oesophagogastroplasty. The patients' mean age was 55.2 years (range: 41-70) with a 13:1 male/female ratio.

[Epithelial splenic cysts].

The authors describe a case of an epithelial cyst of the spleen treated successfully by splenectomy. Diagnostic techniques and the principles adopted in treatment this rare disease are discussed.

[Gastric metastasis of melanoma (report of a clinical case)].

The Authors report a case of gastric metastasis from melanoma of the skin, occurring 6 years after removal of the primary neoplasm. The metastasis, which was characterized by conspicuous alimentary tract haemorrhage, called for emergency surgery consisting in a total gastrectomy with oesophago-jejunal anastomosis according to Roux. The Authors then go on to review the literature on the subject, stressing the frequency of gastrointestinal metastases in skin melanomas with an incidence affecting up to 60% of cases in autopsy series.

[Pancreas transplant today: review of the literature].

The authors, after analysing the world literature concerning the pancreatic transplantation, dwell in considering the problems involved in the indications and techniques of the transplantation itself. Among the several problems expecting an ultimate solution, the improvement of prophylaxis, diagnosis and treatment of rejection seems to heavily affect the future of this surgery.

[Benign pathology of the breast. Diagnostic protocol and therapeutic indications].

The frequency of benign mammary disease and the need to differentiate between benign and malignant tumors without the indiscriminate use of instrumental examinations and biopsies have prompted the Cooperative Interdisciplinary Group on Mammary Neoplasms to adopt the diagnostic protocol and propose a number of therapeutic indications. Though involving a progressive reduction in biopsies, the use of the protocol has not led to failure to recognize carcinomas, the number of identified malignancies being maintained within the anticipated limits.

[Nd-YAG laser disobstruction of esophageal endoprostheses occluded by neoplastic development in the palliative treatment of esophageal cancer].

Since August 1984 18 patients suffering from inoperable esophageal cancer have been treated by Nd. Yag Laser therapy under endoscopic control in the Verona University Institute of Clinical Surgery. Three patients, all males ranging in age from 68 to 80 years, had endo-esophageal prostheses which were occluded as a result of the neoplasms.

[The ND-Yag laser in the treatment of non-resectable esophageal neoplasms: evaluation and results].

The Authors show a set of 9 cases of patients suffering from oesophagus flaky carcinoma, judged radically non-operable, and treated with endoscopic laser-therapy by N.D. Yag Laser.