Month: July 2014

Airmen’s traumatic battlefield injuries may be more effectively treated by using a new light-activated technology developed as a result of research managed by Air Force Office of Scientific Research and supported by funds from the Office of the Secretary of Defense.

This new treatment for war injuries includes using a process or technology called Photochemical Tissue Bonding, which can replace conventional sutures, staples and glues in repairing skin wounds, reconnecting severed peripheral nerves, blood vessels, tendons and incisions in the cornea.

Harvard Medical School professor and Massachusetts General Hospital Wellman Center researcher, Dr. Irene Kochevar and her colleague at Wellman, Associate Professor Robert Redmond are both pleased with the initial lab bench experiments that led to a pilot clinical study.

“We have demonstrated that this technology is very helpful in medicine for the Air Force because it produces better healing and functional outcomes than the same wounds that were treated with conventional materials,” she said.

The process of creating the bonding or nanosutures is accomplished by applying a dye to the wound or damaged tissue and then exposing it briefly to green light. The dye absorbs the light and that helps it to molecularly bond proteins on the tissue surface.

“No glues, proteins or other materials are used that might stimulate an inflammatory response,” said Kochevar. “An immediate, water-tight seal is formed between the tissue surfaces leading to reduced inflammation in the near term and better scar formation in the long term.”

The researchers are planning to continue to evaluate the effectiveness of the new technology and how it can be even more effective in theater. Currently, they are seeking a shorter treatment time that yields an even stronger bond.

“We are approaching this challenge by identifying the basic molecular mechanisms responsible for light-activated crosslinking,” she said. “We believe that this information will show us how to improve the efficiency and effectiveness of the nanosuturing technology on the battlefield.”

Source:
Maria Callier
Air Force Office of Scientific Research

Could a simple eye scan detect early signs of diabetes-related nerve damage? Recent research toward developing such a test is the topic of a special article in Optometry and Vision Science, official journal of the American Academy of Optometry. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The article by Nathan Efron, Ph.D., D.Sc., FAAO, 2010 recipient of the prestigious Glenn A. Fry Lecture Award, presents a review of recent research on ophthalmic markers of diabetic peripheral neuropathy (DPN)-with the goal of developing a quick, painless test to screen for diabetes-related nerve damage at routine eye care appointments. “Looking to the future, this research may pave the way for an expanded role for the ophthalmic professions in diabetes management,” Dr. Efron writes.

High-Tech Advances May Lead to Simple Screening Test for Diabetic Nerve Damage

A diabetic himself, Dr. Efron’s interest in ophthalmic markers of DPN began more than a decade ago, when Dr. Efron was discussing his own symptoms with his diabetes specialist. Diabetic neuropathy is one of the major long-term complications of diabetes. Affecting about half of diabetic patients, DPN causes symptoms such as numbness, tingling, or pain in the arms and legs. “Patients with numbness may be unaware of foot trauma, which could develop into a foot ulcer,” Dr. Efron writes. “If left untreated, this may ultimately require amputation.”

In recent years, Dr. Efron has conducted extensive research into ways of detecting DPN by examining the eyes. The connection was made possible through “high-tech” techniques such as corneal confocal microscopy, which permits assessment of corneal nerve structure and function on the cellular level. Using this and other advanced techniques, Dr. Efron and his fellow researchers have discovered that diabetic neuropathy is linked to degradation of the corneal nerves, reduced corneal sensitivity, thinning of the retinal nerve fibers, and peripheral visual field loss.

The researchers hope to combine these four factors into a simple eye scan that can detect diabetic nerve damage in its early stages-even before the patient notices any symptoms. That’s important, because currently DPN can only be detected using painful nerve biopsies, or though indirect assessments like sensory testing.

The goal, according to Dr. Efron, is to develop a “rapid, painless, non-invasive, sensitive, reiterative, cost-effective, and clinically accessible means of screening for early detection, diagnosis, staging severity, and monitoring progression of DPN, as well as assessing the effectiveness of possible therapeutic interventions.”

A clinical trial, sponsored by the Juvenile Diabetes Research Foundation, is currently underway in Australia to evaluate the use of the simple eye scan for detection of DPN. If successful, the results will provide patients with diabetes and their physicians with an important new tool for early recognition and management of diabetes-related nerve damage. It may also pave the way to an expanded role for the eye care professions in diabetes screening, as well as monitoring the progression of DPN and the effects of clinical and treatment interventions.

Dr. Efron received the 2010 Glenn A. Fry Lecture Award in recognition of his research contributions. This prestigious award was established by the American Optometric Foundation, an affiliate of the American Academy of Optometry, to honor Dr. Glenn A. Fry, who contributed so much to the profession of optometry through his writings, teachings, and administrative duties at the Ohio State University.

Source:

Lippincott Williams & Wilkins