浩鼎 張念慈 幫Si2C 找新藥 (新藥召集人)

生技育成中心 張念慈挑樑 2015-10-29 04:48:44 經濟日報 記者黃文奇／台北報導行政院生技整合育成中心（Si2C）啟動大改組，延攬浩鼎生技董事長張念慈出任新藥召集人。張念慈昨（28）日表示，Si2C將「重新啟動、主動出擊」，規劃遴選逾十個新藥題材、廣納國際菁英、籌組生技小聯盟，打造台灣成為亞洲生技中心。張念慈將召集國內指標生技創投公司，共同參與早期重點個案注資，題材聚焦抗癌、代謝、中樞神經、抗感染四大領域，今年內完成首階段投資案，四年內孵育國際重點生技公司，希望創造百億美元市值的創新公司。Si2C現由中央研究院院長翁啟惠兼任總召集人，一般認為，張念慈具備新藥開發能力與經驗並有國際視野，出任召集人應是翁啟惠、行政院副院長張善政等人的推薦，加上生技界的共識，特別具有指標意義。張念慈表示，醫材領域召集人由益安生技總經理張有德出任。他擔任新藥召集人後，將化被動為主動，以鞏固生技的「四財」，即題材、人才、智財與錢財。題材方面，張念慈說，他引領團隊近期完成十多個國內外個案遴選，國內占比較多，主要來自學研界，部分已進入臨床，都是極具潛力的個案，要找錢不是問題。至於人才，張念慈第一個委員鎖定素有生技天王之稱的華生製藥創辦人、泰福生技董事長趙宇天；肺癌領域延請台大校長楊泮池；肝病領域則是中研院院士陳培哲；投資選案也有維梧創投共同合夥人孔繁建。

張念慈 幫Si2C 也幫浩鼎整併台灣生技業!!

張念慈：生技業…山上水姑娘 該露面了 2015-10-29 04:48:45 經濟日報 記者黃文奇／台北報導台灣生技產業還在發展初期，而兩岸新藥產品在全球的能見度差距仍大，Si2C新藥召集人張念慈比喻，台灣生技業與大陸相較，「像是漂亮的姑娘躲在山上的茅屋，該是時候出來與世界見面了」。張念慈說，台灣生技產業有競爭力，具備實力的創新公司現階段至少幾十家，但能見度太低，他願意接下Si2C前首席顧問蘇懷仁留下的棒子，協助產業往前走。他坦言，這工作雖然是當「義工」，實際上也能為自己的公司加分，一舉多得。說到能見度，張念慈說，台灣生技還沒真正浮出檯面，他才會找國際知名的專家，如趙宇天、孔繁建、陳培哲、楊泮池一起來加值，把台灣的美麗姑娘打扮一下，推到國際舞台上去選美。不過，要聘請專家不容易，張念慈指出，這些專家如果真正用商業標準來聘請，恐怕沒有幾百萬美元的年薪是請不來的，台灣應該珍惜這個機會，一起加把勁。相對於大陸生技業的發展，張念慈憂心，台灣不僅能見度低、進度也太慢，大陸許多小公司經過幾次整併已經大起來，即使是浩鼎目前的市值高達21.5億美元（約新台幣680億元），要與國際公司競爭仍差十倍以上，台灣還有一大段成長空間、還有一段路要走。

蔡英文生技政策利多股: 聯合/安克/商之器

遊戲生技領頭衝 櫃買夯 2015年10月29日 04:10 記者許庭瑜／台北報導 集中市場受到靜待FOMC會議變數影響，出現價跌量縮，不過櫃買市場卻完全未受影響，昨（28）日在遊戲及生技股這兩大族群大漲支撐下，櫃買市場成交值還擴大至257.03億元，且帶動指數上漲0.11％收125.58點。周三遊戲與生技族群股價向前衝，特別是周二民進黨總統候選人蔡英文開出的生技政策利多激勵下，讓櫃買生技指數開高，雖然盤中稍微震盪拉回，不過生技指數依舊上漲1.44％，反彈的生技股高達50家以上，聯合（4129）、安克（4188），商之器（8409）都以漲停作收，多頭氣勢旺盛。雖然近期美國那斯達克生技指數出現修正，不過台灣生技股在政策利多的期待心理，並沒有受到太大的衝擊。此外法人表示，過去十幾年在科技業大放異彩後，台灣也正在尋找新產業發展機會，而生技產業一直是有實力也相當被看好的族群，以長線來看，是有機會成為下一個主流產業。至於遊戲族群也在第三方支付開跑，及第四季旺季雙重利多加持，網龍（3083）、歐買尬（3687）、辣椒（4946）、智冠（5478），和橘子（6180）漲幅都超過3％以上，也是櫃買最熱門的族群之一。雖然整體看來，遊戲股9月營收並不亮眼，可是隨著第四季旺季到來，及第三方支付這個大利多的推出，跨足店商後可望再闢新藍海。但是觀察到目前台灣的遊戲產業、第三方支付市場其實都會面臨到其他國家的競爭，因此未來可以從中獲取多少利潤，還需要再觀察。此外，法人也提到，在加權指數於高檔震盪之際，不少內資、大戶轉入櫃買市場如魚得水，若新版證所稅未來可以順利過關，則可望激勵內資繼續點火櫃買市場。(工商時報)

新版食品添加物草案 2018年後施行

新版食品添加物草案 磷酸鹽含量大放寬 醫生憂「洗腎人口恐大幅增加」 2015-10-29 03:31:59 聯合報 記者陳雨鑫／台北報導 食藥署參考國際新趨勢，重新擬定食品添加物分類項目，並調整使用範圍及標準。衛福部於今年四月推出新版「食品添加物使用範圍及限量標準」草案，但其中問題重重，被學者揪出磷酸鹽含量竟大幅放寬，與現行規定相差三倍以上，且計算母數也放寬，醫師憂心此舉「完全是開大門讓業者任意添加」，若草案真的上路，未來洗腎人口恐會大幅增加。 衛福部食品藥物管理署食品組科長高怡婷表示，去年參考聯合國食品法典委員會（Codex）標準，發現台灣食品添加物分類跟不上國際腳步，推出新版「食品添加物使用範圍及限量標準」草案，將現有的十七項分類新增成廿八類。文化大學推廣教育部食品技師班講師陳俊成表示，新版草案中對於「磷酸鹽」的使用限制大幅放寬，若這份草案通過，台灣食品會愈來愈「好吃」，洗腎的人卻會愈來愈多。林口長庚臨床毒物科主任顏宗海表示，食品添加磷酸鹽有保水、黏著等作用，槓丸、重組肉、麵條都需要用到磷酸鹽，會讓食品更Q彈，也能延長食品保存的時間。陳俊成表示，現行法規規定，磷酸鹽類添加物每公斤最多使用三千毫克，且計算方式是以「磷酸根」九十六個分子量來計算，但現在磷酸鹽的添加限量，最高可以到每公斤四萬四千毫克，且計算方式是以「磷」的卅二個分子量來計算。陳俊成說，姑且不論計算方式用的分子量已相差三倍，光四萬四千毫克與過去的三千毫克相比就已相差近十五倍，「未來業者怎麼加都不會違法」。顏宗海表示，若以國人常吃的麵包來看，新版食品添加物草案，磷酸鹽加在麵包中所規範的限量標準為每公斤可用九千三百毫克，遠超過舊規定的三千毫克。他說，根據國人膳食營養素參考攝取量，一般成人每日建議磷酸鹽的攝取量為八百毫克，而目前已知吃太多磷酸鹽會有高血磷症、併發心血管疾病、血管鈣化、腎病等多重危機。輔仁大學食品系教授陳炳輝表示，提升食品添加物限量是為了與國際接軌，但民眾還是要有知的權利，建議食藥署在食品包裝上做標示，讓民眾減少重複暴露的機會。食藥署食品組長潘志寬表示，該草案到十一月廿日前都還在廣納意見，磷酸鹽的部分仍可以討論，若能取得各方共識，希望能在三年後通過預告及公告施行。

小辭典／磷酸鹽 磷酸鹽類化合物在台灣為合法食品添加物，目前開放16種可用於加工肉品，包含多磷酸鹽、偏磷酸鹽、焦磷酸鹽等，主要有保水、黏著、抗氧化、防腐、抑菌、增加風味、抗結塊等作用，常用於加工肉品、麵條、餅乾等食品等。磷雖然是人體必要礦物質，且天然食物中也有磷，但是，攝取過多會出現高血磷症、低血鈣症狀、腎衰竭，並增加心血管疾病風險。資料來源／林口長庚臨床毒物科主任顏宗海整理／陳雨鑫

晟德 擬全額認購澳優乳業 未繳款部分 (港幣約2.5億元)

晟德：公告本公司董事會決議參與子公司澳優乳業(股)公司現金增資案 鉅亨網／鉅亨網新聞中心-2015年10月29日 上午09:10 第二條　第20款1.證券名稱:澳優乳業股份有限公司普通股2.交易日期:104/11/1~104/12/313.交易數量、每單位價格及交易總金額:本公司除依原股東認股比例認購外，擬全額認購原股東未繳款之特定人部分，預估認購最高總股數為113,430,230股，每股港幣2.2元，總金額為港幣249,546,506元。4.處分利益（或損失）（取得有價證券者不適用）:不適用。5.與交易標的公司之關係:澳優乳業為本公司之子公司。6.迄目前為止，累積持有本交易證券（含本次交易）之數量、金額、持股比例及權利受限情形（如質押情形）:累積(含本次)數量:417754551股(晟德估) 20838268股(玉晟管顧)123355375股(玉晟生技)；累計(含本次)金額：4680541375元(晟德估)233518508元(玉晟管顧) 1493216814元(玉晟生技)；累計(含本次)持股比例：33.48%(晟德估)1.67%(玉晟管顧) 9.89%(玉晟生技)；權利受限情形：無7.迄目前為止，依「公開發行公司取得或處分資產處理準則」第三條所列之有價證券投資（含本次交易）占公司最近期財務報表中總資產及歸屬於母公司業主之權益之比例暨最近期財務報表中營運資金數額:有價證券投資(含本次交易)/總資產:123.13 %有價證券投資(含本次交易)/母公司業主權益:200.77%營運資金:-236,170 仟元8.取得或處分之具體目的:長期投資。9.本次交易表示異議董事之意見:無。10.本次交易為關係人交易:否11.董事會通過日期:不適用12.監察人承認或審計委員會同意日期:不適用13.其他敘明事項:本公司將以銀行借款支應，無資金不足情況。

外科醫師 擁 ”槍” 罪嫌送辦

醫生改槍練射擊 拗有助開刀穩定 2015-10-29 〔記者許國楨、蔡淑媛／台中報導〕在中部某醫院任職的陳姓醫師熱愛射擊，斥資5、60萬元買空氣槍，還在家中設簡易靶場，警方前天找上門，起出1把改造過具殺傷力的空氣長槍。陳男說，因射擊有助開刀的穩定專注及靈敏度，才會在住處練槍，未料因此觸法，懊惱不已。

醫界說沒聽過 練槍維繫開刀穩定及靈敏度？中國附醫整型外科醫師陳信翰昨說，還是第一次聽到。他說，曾有外科醫師為專心開刀，會在手術時聽古典音樂，或是不愛旁人說話，認為與個人嗜好比較有關。打靶要專心力及手部穩定，可能對他有幫助，但無助訓練手部靈敏度。外科醫師訓練手部靈巧，會在小瓶子裡練習穿針引線、夾取物品，和左右手並用的技巧。台中市刑大偵四隊執行網路巡邏，發現42歲陳男多次在拍賣網站買空氣槍及改造零件，唯恐衍生治安事故，前天前往陳男住處搜索，找到5把空氣槍，經逐一試射，發現其中1把德國製「華瑟」空氣槍，能輕易穿透2片鋁板（超過20焦耳），具殺傷力。

觸法直說很後悔 警方查出陳男是名專業醫師，他供稱，因工作需要常動刀，為幫助開刀時穩定專注度與靈敏度，才會網購空氣槍，利用閒暇在家中進行射擊練習，並不影響他人，未料觸法。 但警方調查，陳姓醫師玩空氣槍約5年，都是透過拍賣網站挑選空氣槍，國外生產的空氣槍威力雖大，礙於台灣法令，進口時須降低威力，因射擊威力不足，達不到訓練目的，陳男購買套件還原成國外原廠設定，日前他用4萬5000元買1把空氣獵槍及狙擊瞄準鏡，為還原槍枝原有火力，還上網站，將槍枝動能出氣孔，以尖銳鐵製工具加大提升射速，訊後依槍砲罪嫌送辦。

臨床研究模式銷售! 中國衛計委支持 合富乾眼症治療/檢測儀

合富攻大陸眼科 傳利多 2015-10-29 05:29:51 經濟日報 記者高行／台北報導分享大陸醫材代理龍頭F-合富（4745）布局大陸眼科市場有成，近期獲大陸衛計委支持，旗下最新乾眼症檢測及治療儀器搶進大陸26家大型醫療院所。董事長王瓊芝表示，該項結合官方資源的策略具指標意義，有利完成市場全覆蓋，促使眼科業務出貨進入起飛期。 合富年初首度切入眼科領域，獨家代理美國Tear Science乾眼症檢測及治療儀器，搶攻兩岸市場；其中，檢測儀器已獲兩岸銷售許可，治療儀器部分僅獲台灣許可，大陸許可預計明年取得。不過，由於近期獲得大陸衛計委支持，治療儀器以臨床研究名義順利打進當地26家權威眼科醫院，已啟動實質銷售。王瓊芝表示，供對岸醫療院所臨床試驗使用的乾眼症檢測及治療儀器總計出貨26套，其中七套9月底前已出貨完畢，預計第4季出貨10套以上，剩餘九套預計明年第1季出貨。法人預估，對岸眼科業務對合富第4季貢獻近5,000萬元；明年出貨持續放大，將挑戰2億元規模。合富股價昨（28）日收77.5元，上漲1.7元。王瓊芝指出，乾眼症為現代人文明病，除公司獨家代理的治療儀器外，並無妥善治療方式，因此獲得大陸衛計委高度支持，頒布「瞼板腺功能障礙臨床診治多中心研究計畫」，以大陸權威眼科同仁醫院為首，總計26家知名醫院共同參與，有助將乾眼症治療推廣至大陸各區域，有利對岸市場的全覆蓋。合富最大營收來源檢驗試劑方面，今年大陸反腐雷厲風行，儘管導致各大醫院層峰統包代理簽約遞延，但整體營收將維持小幅成長。公司表示，今年統包標案將遞延到明年，客戶陸續恢復簽約後，將帶動業績回復雙位數成長。法人預估，合富由於第4季眼科業務大幅進帳，營收表現可望較第3季佳，檢驗試劑也有持穩表現，全年EPS力拚4元以上。

中國863計劃: 3D列印生產心臟/ 藍光英諾 投資2.15億元

幫你列印一顆心臟吧 解密「3D生物列印」 北京新浪網 (2015-10-29 01:51)一群「科學怪人」正執著於製造人體器官。西部科技重鎮成都10月25日舉行了一場特別發佈會，叫作「國家高技術研究發展計劃(863計劃)」3D生物列印血管項目獲得重要突破」。兩名「千人計劃」國家特聘專家，加上成都最大的地產商人，是這個項目的幕後推手。具有生物活性的血管3D列印只是起步，距離真正的人體器官3D列印尚需時日。3D生物列印，曾獲得四川省政府創業創新推薦。科學家們試圖證明，如果按照他們說的方法行進，終有一天，人們可以為自己量身定製一隻備用心臟。

如何實現3D生物列印 簡單來說，3D生物列印技術是把細胞培養液當作「墨汁」，通過特製的3D印表機列印出人體器官、組織，比如內臟、四肢。這是不是不著邊際的不靠譜行為？這背後的科學家團隊陣容倒是十分強大：首席科學家、藍光英諾3D生物列印產業技術研究院院長康裕建教授，他參與了全球第一例換心手術，製造併為試驗豬安裝了全球第一隻3D列印豬心臟。負責藍光英諾3D生物印表機製造的周惠興教授，是中國農業大學3D列印工程技術研究中心主任。康裕建、周惠興均是「千人計劃」國家特聘專家;「3D生物列印血管項目」進入了國家863計劃。作為唯一有機會進入藍光英諾3D生物列印實驗室的媒體記者，本報記者有幸第一時間目睹兩台3D生物印表機真容，分別是血管印表機、表皮組織印表機。初看頗不覺為奇，血管印表機有兩個噴頭，噴頭口流出的液體滴到下面一條中空細管(類似於飲料吸管)表面，細管旋轉一圈，液體完全覆蓋細管表面。不久，據說血管列印成功了。但這裏面其實有很多學問。比如經康裕建解釋，細管中空，是因為裏面灌裝了培養液，保證細胞在成為血管組織過程中保持生物活性。也就是說，印表機里是正在生長髮育的活細胞。

細胞液也很有講究 在一次轉基因老鼠試驗中，康裕建受到啟發：當胚胎的器官產生以前，母體子宮中某一微環境限定了胚胎某組幹細胞和另一組幹細胞向不同方向的分化。也就是說，如果發現了影響某種器官表達的微環境，就有可能通過引導幹細胞分化，形成想要的器官。而研究導致某種器官表達的幹細胞微環境構成，可能窮盡一名頂尖科學家一生精力。「在過去15年中，我只做了一件事——專注於再生醫學和幹細胞研究。」康裕建總結說。而其15年沉澱，成就了「生物磚」技術。康裕建不僅要研究幹細胞向血管轉化的微環境，還需要提供一種結構，使得處於該微環境的幹細胞可以列印成為器官、組織，具備正常人體器官、組織功能。「生物磚」是「Biosynsphere」的中文意譯，實際上是一種具有生物活性的合成球體。康裕建向《第一財經日報》記者表示，它擁有一個生物可降解、有力學強度和抗機械損傷能力的外殼，外殼裡是細胞生長因子和營養成分，以及幹細胞。和普通磚石是建築物基礎同理，康裕建團隊構建的技術體系中，「生物磚」正是用來建造組織、器官「大廈」的磚石。

技術突破點3D列印血管，乃至於3D血管印表機(3D血管旋生儀)，實際上都不是此次科學突破的重點。相對於單個仍有待臨床試驗驗證產品發佈，康裕建團隊通過發佈3D列印血管、印表機，實際是建立了一套3D生物列印平台體系和技術路線，這包括醫療影像雲平台、生物墨汁、3D生物印表機、列印后處理系統四大核心部分。如果繼續沿著上述路線研發，3D生物列印將可能在包括「生物磚」系統基礎上，從血管列印延伸至肝臟、脾胃列印。「『生物磚』是我們提供的開發平台，我們需要很多應用開發者。」康裕建說。包含不同微環境的「生物磚」，在藍光英諾製備的「血管『生物磚』」以外，還可能形成「心臟『生物磚』」、「肝臟『生物磚』」……繼而通過對應3D列印模塊，列印出生物心臟、生物肝臟，真正實現人體器官定製。「我們的團隊在做血管，兩年內可以把血管放到人的身體內，但這並不等於說我們血管的任務就完成了，因為每一寸血管都不一樣，對我們來說血管研究就是無休止的工作。」康裕建對本報記者說。至於如何滿足不同「生物磚」、不同組織器官的列印，周惠興對本報記者表示：「總的來說，我們的思路是模塊化設計，印表機的基本平台是可以通用的，列印血管的時候就加上血管的附件。」而也有「器官再造」懷疑論者認為，人類對幹細胞分化微環境模擬難以窮盡，或者複雜器官的3D生物列印難以實現。事實上，現在3D生物列印距離臨床試驗確有一段距離。不過康裕建對3D生物列印出器官非常自信，「我可以負責任地告訴你，我們可以列印血管，我們就認為用生物磚打任何器官這條路都可以走得通。」

商業運作遇考驗 發佈會期間，《第一財經日報》記者也注意到一個小插曲。10月24日，量子基金創始人之一羅傑斯也訪問了藍光英諾實驗室，羅傑斯坦言，對於藍光英諾3D生物列印技術，從開始懷疑到了解后震驚。不過，羅傑斯的溢美之詞始終加之於康裕建團隊的技術成就，而對於藍光英諾如何運營、其用戶是誰、現金流如何保障提出尖銳的疑問。本報記者向羅傑斯提問稱，會不會因為對藍光英諾的考察而考慮買入藍光發展(600466.SH)，羅傑斯的回答模稜兩可，「因為藍光發展停牌，我也買不了。」而一旦藍光發展復牌，羅傑斯稱，會再詳細加以研究。藍光英諾成立於2014年，藍光發展曾公告投入2.15億元用於3D生物列印技術研發和科研團隊建設。作為上市公司，藍光發展如投資需要持續資金投入短期不見盈利的項目，雖然其有利於藍光發展向大健康領域長遠戰略布局，但短期業績仍有可能受到拖累，這也正是投資者擔心所在。「從我們的醫療影像轉換，到以『生物磚』為核心的生物墨汁技術，到印表機載體，再到后處理階段，我們未來的商業模式，就是『把我的技術和你的技術合作。』」藍光英諾董事長任東川稱。「實際上，藍光英諾是個平台。英諾下面每個產品、每個具體的項目可能是一個科學家小組、是一個公司，藍光會投資，大康資本會投資，它是一個股份制公司。」藍光發展董事局主席楊鏗說。正是楊鏗最初接觸以及最後敲定投資與康裕建開展合作。他們一方是急於尋求轉型的地產企業家，一方是急需資本推動研究的科學家。中短期內，通過3D列印技術解決方案和技術合作，藍光英諾獲得盈利較為困難。不過在研發過程中產生的副產品，全息信息技術、精準製藥技術，可能是英諾更為現實的盈利點。對於藍光英諾的市場表現，任東川稱2016年或許有數據可以公佈。

中研院 謝清河 4個 microRNA 抑制ErbB4心肌成熟 !

心臟病福音！ 中研院找出加速修補心肌關鍵 2015-10-28 記者吳欣恬／台北報導 心肌梗塞發作，會使大量心肌細胞在缺血數小時後壞死，因心肌細胞難以再生，即使接受藥物或手術治療，也無法讓心肌恢復功能，最後導致心律不整或心臟衰竭而死。中研院生醫所研究員謝清河領導的研究團隊領先全球，找出以刺激4個「微型核醣核酸（microRNA）」的方式，就能成功加速心肌細胞生長。 這項發現不僅讓未來心肌修補成為可能，也使治療心臟疾病、開發新藥、幹細胞療法等，有突破性進展；該研究9月底登上國際學術期刊「細胞報告（Cell Report）」，並選為封面論文，獲國際相當重視。 過去的研究，能以胚胎幹細胞和「誘導式多潛能幹細胞（iPS cell）」分化出心肌細胞，但因不具肌節構造，收縮力微弱且無法共同跳動，植入心臟反可能導致心律不整，生醫界一直希望找出使心肌細胞成熟的更好技術。 經9年研究，謝清河的研究團隊發現人體心肌細胞和內皮細胞一起培養21天，能發育出肌節構造成熟的心肌細胞，再從內皮細胞的5千種「微型核醣核酸（microRNA）」中篩選出4個表現明顯的microRNA，進一步發現這4種能抑制ErbB4分子，所以能使心肌成熟。其中ErbB4分子是可幫助心肌細胞分化增生，但當心肌細胞到一定數量，相對也需抑制ErbB4分子，才能使心肌細胞更成熟。 這項技術已初步實驗證實，老鼠心肌細胞可於3天成熟，人類心肌細胞則可於21天成熟。預計2019年就將進行人體試驗。 由於心臟病高居全球死亡率第一位，在台灣也排名國人十大死因第二位，這項研究讓相關醫療研究有了更多可能 。

葡萄王 曾盛麟: 公司組織過於老舊/改革難上加難 !

葡萄王生技 如何為老品牌注入新生命？ 2015-10-28 17:00:40【文／邱品瑜 動腦編輯部】「康貝特，喝了再上！Come Best！」耳熟能詳的廣告標語，是不少四、五年級生的共同回憶，也是葡萄王46年前一戰成名的產品。當時康貝特在機能性飲品中，穩坐市場龍頭寶座多年，但隨著後起之秀的激烈競爭，讓康貝特的銷售量逐年衰退，葡萄王如何幫助昔日明星商品，重新振作？動腦俱樂部2015年9月23日，第433次午餐演講例會，邀請葡萄王生技董事長暨總經理曾盛麟，以「精彩每一刻——葡萄王的品牌回春術」為題，分享葡萄王46年來，品牌翻新、組織再造，以及行銷創新的過程。

第二代想創新 起步不如預期順遂 曾盛麟在演講一開始，就用輕鬆的態度坦言，自己在2010年回台灣加入葡萄王時，遇到的種種困境，例如：公司組織過於傳統、企業識別老舊、資源沒有有效整合等。即便身為企業第二代，革新之路，並沒有想像中的順利。2010年的葡萄王辦公室裡，使用的是3.5吋的磁碟片，多數以紙本文書作業，也沒有整合型事務機，公司只有三分之一的人用E-Mail對外溝通，平均員工年齡46歲。更特別的是，當時的葡萄王沒有行銷部門，行銷工作是掛在營業單位底下，如果沒有達到營業目標，就會節省行銷預算，但往往愈節省行銷預算，營業額只會愈不見起色。這是為什麼過去十年裡，葡萄王除了靈芝王、樟芝王、益菌王以外，一直沒有新產品的原因，因為只有這三項產品的營收，能負擔得起行銷費用。這些陳年的問題，牽一髮而動全身，對一個剛從英國回來，37歲的年輕人，進公司沒多久，想要改革，簡直難上加難。

急事緩辦 先從修改企業識別著手不過，曾盛麟決定急事緩辦，對於組織再造的部分，先放慢腳步，從品牌重塑（Rebranding）著手。在經過市調統計結果發現，葡萄王給生活者的品牌印象，較為本土、老舊，許多人覺得舊的葡萄王商標，不好看；例如：藍、紅、橘的配色沒有活力、整體設計看起來像一個哭臉，有點邪惡的感覺。但所謂的品牌重塑，不只是單純的換新商標而已，曾盛麟找了顧問公司和公司高層，經過長達9個月的討論，訂製出品牌整體的未來走向以及理念，才進行商標Logo的修改。最後從15個新Logo中，選出3個，由全公司員工票選，才決議出現在新的企業識別。 新Logo為了國際化，所以加入了葡萄王的英文Grape King Bio，且取其首字「G」包裹整個商標，讓品牌Logo看起來像在微笑一樣；另外，重新修改配色，以藍、綠、橘，分別詮釋葡萄王生技的核心價值：「科技、健康、希望」。八顆葡萄中間的一顆，與主視覺葉脈連起來，讓它看起來像生物科技的滴管，象徵企業以「生物科技」為命脈，開枝散葉凝聚為纍纍果實。

了解現在資源 先從整合開始緊接著，曾盛麟更著手將公司的官網及兩個購物網站，三網合一。將舊有分歧的網站，全部整合起來，減少一般大眾對企業服務的混淆。藉此時機，了解公司既有資源加以利用，並合併目標相同的部門。另外，曾盛麟把所有旗下的保健食品統一包裝規格，區分為四大類：健康調節、漢方保養、女性美妍、學齡保健。有效減少過去特殊包裝，所造成的多餘成本支出，提高產品在通路上的辨識度，這項計畫預計於2016年中正式執行完畢。從品牌重塑的過程，漸漸的讓曾盛麟取得父親、資深員工、合作夥伴，對他的專業信任，於是溝通上愈來愈順利，這讓曾盛麟在推動行銷的創新時，有更大的發揮空間。

Amarantus : Eltoprazine(5HT1A/1B partial agonist) 重生三部曲(Solvay /Abbott / PsychoGenics) !

Amarantus seeks US FDA orphan drug status for eltoprazine to treat levodopa-induced dyskinesia  Saturday, October 24, 2015, Amarantus Bioscience Holdings, Inc., a biotechnology company, has submitted a request to the US FDA for orphan drug designation (ODD) for eltoprazine in the treatment of levodopa-induced dyskinesia (PD-LID)."A successful application to the US FDA for ODD for eltoprazine in PD LID would complete the transition of our therapeutics portfolio into the orphan drug arena, thereby squarely positioning Amarantus as an orphan drug company," said Gerald E. Commissiong, President & CEO of Amarantus. The FDA Orphan Drug designation programme provides a special status to drugs and biologics intended to treat, diagnose or prevent so-called orphan diseases and disorders that affect fewer than 200,000 people in the US. This designation provides for a seven-year marketing exclusivity period against competition, as well as certain incentives, including federal grants, tax credits and a waiver of PDUFA filing fees. Parkinson's disease is a chronic, progressive motor disorder that causes tremors, rigidity, slowed movements and postural instability. The Parkinson's Disease Foundation estimates that there were approximately one million people living with Parkinson's disease in the United States in 2011. The most commonly-prescribed treatments for Parkinson's disease are levodopa-based therapies. In the body, levodopa is converted to dopamine to replace the dopamine loss caused by the disease. The therapeutic efficacy of levodopa is gradually lost over time, and abnormal involuntary movements, dyskinesias, gradually emerge as a prominent side-effect in response to previously beneficial doses of the drug. Levodopa-induced dyskinesia can be severely disabling, rendering patients unable to perform routine daily tasks.  Eltoprazine is a small molecule 5HT1A/1B partial agonist in clinical development for the treatment of Parkinson's disease levodopa-induced dyskinesia (PD-LID), adult attention deficit hyperactivity disorder (ADHD) and Alzheimer's aggression. Eltoprazine has been evaluated in over 680 human subjects to date, and has a well-established safety profile. Eltoprazine was originally developed by Solvay Pharmaceuticals for the treatment of aggression. Upon Solvay's merger with Abbott Pharmaceuticals, the eltoprazine programme was out-licensed to PsychoGenics. PsychoGenics licensed eltoprazine to Amarantus following successful proof-of-concept trials in PD-LID and adult ADHD.

GEORGETOWN ASSAY  The Georgetown Assay is a blood-based approach to diagnosing Alzheimer's disease (AD). Its validated 10 lipid panel provides up to 90% specificity with a 90% sensitivity in predicting those at risk of developing prodromal or manifest AD. According to the Alzheimer's Association, it is estimated that over 5.4 million people in the United States suffer from Alzheimer's disease. Over 500,000 patients are diagnosed annually, with nearly one-in-eight older Americans affected by the disease. Alzheimer's disease is the third leading cause of death in the United States. The cost of unpaid care in the United States is estimated at over $210 billion annually. Total payments for care are estimated at over $200 billion annually, including $140 billion in cost to Medicare and Medicaid. Alzheimer's expenditures in the United States are expected to exceed $1.2 trillion by 2050. There is no cure or effective treatment for Alzheimer's disease. Worldwide, about 35.6 million individuals have the disease and, according to the World Health Organization, the number will double every 20 years to 115.4 million people with Alzheimer's by 2050. On January 15, 2015 Amarantus executed a one-year, exclusive option agreement with Georgetown University to enter into a license for the patent rights related to certain blood based biomarkers for memory loss that Georgetown University and University of Rochester jointly own. Amarantus will be required to achieve timely milestones including providing Georgetown with development and commercialization plans for the biomarkers, share information related to Amarantus' diagnostic assets, CLIA validation of biomarkers, recruitment of a senior executive to lead Amarantus' diagnostics division and other requirements as defined in the agreement.

The Lymphocyte Proliferation Test (LymPro Test®) is a diagnostic blood test that determines the ability of peripheral blood lymphocytes to withstand an exogenous mitogenic stimulation that induces them to enter the cell cycle. It is believed that certain diseases, most notably Alzheimer's disease, are the result of compromised cellular machinery that leads to aberrant cell cycle re-entry by neurons. LymPro is unique in the use of peripheral blood lymphocytes (PBLs) as a surrogate for neuronal cell function, suggesting a common immune-based relationship between PBLs and neurons in the brain.

TRAUMATIC BRAIN INJURY / CHRONIC TRAUMATIC ENCEPHALOPATHY  Traumatic brain injury (TBI) occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism (closed or penetrating head injury), or other features). Head injury and concussions usually refers to TBI, but is a broader category because it can involve damage to structures other than the brain, such as the scalp and skull. TBI is a major cause of death and disability worldwide, especially in children and young adults. Causes include falls, vehicle accidents, and violence. Prevention measures include use of technology to protect those suffering from automobile accidents, such as seat belts and sports or motorcycle helmets, as well as efforts to reduce the number of automobile accidents, such as safety education programs and enforcement of traffic laws. In addition to the damage caused at the moment of injury, brain trauma causes secondary injury, a variety of events that take place in the minutes and days following the injury. These processes, which include alterations in cerebral blood flow and the pressure within the skull, contribute substantially to the damage from the initial injury. Chronic Traumatic Encephalopathy (CTE) is a brain disorder caused by multiple Traumatic Brain Injuries. CTE is a neurological degenerative disease found in individuals who have been subjected to repetitive traumatic brain injuries by way of the acceleration of the head on impact and the subsequent damage to axons. While repetitive brain trauma is thought to be necessary to cause CTE, it is not sufficient, meaning that not everyone exposed to repetitive brain trauma will get the disease. Professional level athletes are the largest demographic to suffer from CTE due to frequent concussions from play in contact-sport. These contact-sports include American football, ice hockey, rugby, boxing, and wrestling. Other individuals that have been diagnosed with CTE were involved in military service, had a previous history of chronic seizures, victims of domestic abuse, and or were involved in activities resulting in repetitive head collisions. Reports of CTE have steadily increased in younger athletes, most likely due to increased awareness of the issue and perhaps due in part to athletes becoming bigger and stronger producing greater magnitudes of force in collision. The primary physical manifestations of CTE include a reduction in brain weight, associated with atrophy of the frontal and temporal cortices and medial temporal lobe. The lateral ventricles and the third ventricle are often enlarged, with rare instances of dilation of the fourth ventricle. Other physical manifestations of CTE include anterior cavum septi pellucidi and posterior fenestrations, pallor of the substantia nigra and locus ceruleus, and atrophy of the olfactory bulbs, thalamus, mammillary bodies, brainstem and cerebellum. As CTE progresses, there may be marked atrophy of the hippocampus, entorhinal cortex, and amygdala.

Presbyopia(老花眼,遠視眼) 矯正用Corneal Inlays or Corneal Onlays

Tackling presbyopia with an inlay Study with corneal inlay finds good visual quality and patient satisfaction September 15, 2015        By Vanessa Caceres, Jeffrey Whitman MD Take-home message: An investigational corneal inlay for presbyopia called the Raindrop had good near visual acuity results and patient satisfaction in a group of active patients. By Vanessa Caceres; Reviewed by Jeffrey Whitman, MD Dallas—The Raindrop Near Vision Inlay (ReVision Optics) to treat presbyopia provided good near visual acuity without glasses in a study conducted and presented by Jeffrey Whitman, MD. The inlay, which is still an investigational device in the U.S., is inserted under a LASIK flap. It is a microscopic hydrogel inlay that creates a central steepening of the cornea to give a greater depth of focus, said Dr. Whitman, Key-Whitman Eye Center, Dallas. "It's an easy procedure for anyone who knows how to make a flap for LASIK surgery," he said. Dr. Whitman's study included 81 patients and focused on quality of vision and patient satisfaction after a yearlong follow up. He collected visual acuity information at one week and other follow-ups at 1, 3, 6, 9, and 12 months. Patients reported information on visual symptoms, visual task performance, and patient satisfaction with the use of National Eye Institute Refractive Error Quality of Life questionnaire. At 1 year binocularly, 98% of patients had 20/20 or better uncorrected near visual acuity (UNVA), and 100% had 20/20 uncorrected distance visual acuity (UDVA). In the Raindrop Eye, 98% had 20/25 or better UNVA, and 96% had 20/32 or better UDVA. Dr. Whitman found few moderate or worse visual symptoms after Raindrop Inlay implantation. There were no reports of glare, and only 2% of patients had halos at 1 year. There was no increased difficulty for driving at night. Six percent of patients reported dryness. Looking at long reading—in other words, reading for more than 45 minutes, as someone might do with a book—the inlay made a difference in the percentage of patients who used glasses. Ninety six percent used glasses all of the time preoperatively, compared with 62% who said they did not use glasses for long reading after Raindrop Inlay implantation. Nine percent of patients still used glasses all the time for long reading after inlay implantation, while some patients used glasses only occasionally.

Performance analysis The inlay also helped with the performance of work or hobbies at near. Ninety one percent said they had little or no difficulty with these tasks 1 year after inlay implantation, compared with 29% preoperatively. "Whether it be coin collecting or computer work or reading, the majority did well," Dr. Whitman said. Previous trials have found a one-line decrease in uncorrected distance visual acuity with the Raindrop, Dr. Whitman said. However, when asked about playing active sports—which tend to be more distance predominant—14% had less difficulty after inlay insertion. "It's probably from a wider range of vision," Dr. Whitman said. Although patients may experience a slight decrease in distance vision, it appears to be minimal enough to not affect visual quality or satisfaction, he explained. Ninety six percent of patients were satisfied or very satisfied with their visual results. Dr. Whitman concluded by noting that the inlay could be an option for presbyopic patients with an active lifestyle. A number of patients in the study said they felt better about themselves with the inlay as they didn't feel they had the stigma of taking glasses on and off in a group of mixed-age coworkers, or it made them feel younger. The company that makes the inlay continues to study the device and are working toward eventual U.S. FDA approval. The inlay may help both patients with good distance vision who have lost their near vision and possibly patients with previous cataract surgery who still have to use glasses, Dr. Whitman said. A second study is under way with pseudophakes. Recently, the KAMRA cornea inlay (AcuFocus) for presbyopia was approved by the FDA in the United States. Jeffrey Whitman, MD E: Jeffrey.whitman@keywhitman.com This article was adapted from Dr. Whitman's presentation at the 2015 meeting of the American Society of Cataract and Refractive Surgery. He did not indicate any financial interest in the subject matter.

Corneal Inlays and Corneal Onlays  By Vance Thompson, MD  Corneal inlays and corneal onlays are tiny lenses or other optical devices that are inserted into the cornea to improve reading vision. Some of these devices resemble very small contact lenses. The primary purpose of these devices is to improve near vision and reduce the need for reading glasses in older adults who have presbyopia. As their names suggest, corneal inlays and onlays differ in where they are implanted within the cornea: corneal onlays are placed near the surface of the eye, directly under the thin outer layer of the cornea called the epithelium; inlays are placed deeper in the cornea — in the thicker middle layer called the stroma. A magnified section of the cornea showing all layers of the cornea in cross-section. Corneal inlays are placed within the central stromal layer of the cornea; corneal onlays are positioned just beneath the outer epithelium. Because they are implanted deeper in the cornea, corneal inlays may be more stable and deliver more predictable and long-lasting results than corneal onlays. For these reasons, it appears corneal inlays will likely be the preferred device for doctors and patients interested in this refractive surgery option. Corneal inlay surgery sometimes can be combined with LASIK surgery to correct both presbyopia and nearsightedness, farsightedness and/or astigmatism. (This is considered an "off-label" use of the procedure in the United States, meaning the U.S. Food and Drug Administration (FDA) will allow an eye surgeon to perform the combined procedure, even though it has not yet been officially approved by the FDA.) Corneal inlay surgery is less invasive and may have fewer risks than phakic IOL procedures, which involve implanting lenses further back inside the eye, either directly behind or in front of the pupil. Also, because no corneal tissue is removed during inlay surgery, this procedure may be a good alternative for people whose corneas are too thin for LASIK or PRK.

Kamra Corneal Inlay Developed by AcuFocus, the Kamra corneal inlay received FDA approval for use in the United States in April 2015. The device also has received a CE mark for the European Economic Area, allowing it to be marketed in over 30 countries across Europe. The Kamra inlay is designed to reduce or eliminate the need for reading glasses among people over age 40 who have good distance vision without glasses but have problems seeing up close due to presbyopia.

AcuFocus ACI 7000 corneal inlay The Kamra corneal inlay (left) is used for presbyopia correction. Here it is shown next to a typical contact lens. (Image: AcuFocus) The Kamra device is very small and thin — just 3.8 millimeters (about 0.15 inch) in diameter and 6 microns thick (about half the thickness of plastic wrap used to store food). It consists of an opaque outer ring and a tiny (1.6 mm) central opening that is placed directly in front of the center of the pupil. This creates a pinhole camera effect that extends the natural range of vision, making near objects appear clearer without significant loss of distance vision. The Kamra inlay typically is implanted in the non-dominant eye, so the distance vision of the patient's dominant eye is completely unaffected. The procedure takes less than 15 minutes and can be performed in the eye surgeon's office. The eye heals quickly without the need for stitches.

Raindrop Near Vision Inlay The Raindrop Near Vision Inlay is a corneal inlay for presbyopia being developed by Revision Optics. Formerly known as PresbyLens in the U.S. and Vue+ in Europe, the tiny (2.0 mm diameter) inlay is made of medical-grade hydrogel plastic similar to that used for soft contact lenses and has optical characteristics that are almost identical to the human cornea, according to the company. The Raindrop Near Vision Inlay typically is placed within the cornea of the non-dominant eye under a LASIK-style flap created with a femtosecond laser. When in position, the inlay changes the curvature of the cornea so the front of the eye acts much like a multifocal contact lens.

Procedure time: about 15 minutes per eye Typical results: clear vision at all distances without glasses or contact lenses  Recovery time: several days to several weeks In a recent study of 38 people (ages 45 to 56) who underwent the Raindrop Near Vision Inlay procedure: Six months after receiving the implant, most people could perform near vision tasks such as reading a newspaper without the need for eyeglasses. Most subjects also did not require eyeglasses for intermediate tasks such as reading a computer screen. All study participants had 20/25 or better distance vision in both eyes. Only one adverse event was reported, when an inlay needed to be repositioned. Though ReVision Optics states on their website that the company is actively pursuing regulatory approvals and market opportunities for the Raindrop Near Vision Inlay worldwide, the product is still considered an investigational device in the United States and has not yet received FDA approval for routine use.

Presbia Flexivue Microlens Another innovative corneal inlay designed for the correction of presbyopia is the Presbia Flexivue Microlens, being developed by Ireland-based Presbia PLC. This device resembles a tiny bifocal intraocular lens like those used in cataract surgery. It measures just 3.2 mm in diameter and is available in a range of powers, depending on the patient's near vision needs. During the Presbia Flexivue Microlens procedure, small pocket is created in the corneal stroma with a femtosecond laser, and the inlay is inserted into this pocket with a special device. The pocket seals itself, and the entire procedure typically takes less than 10 minutes. The corneal inlay can be removed and replaced with a higher or lower power lens if needed. The Presbia Flexivue Microlens is not yet FDA-approved for use in the United States, but it has received a CE mark for the European Economic Area. In a 2012 study, patients in Italy and Greece who underwent the Flexivue Microlens procedure reported very high satisfaction rates one year after implantation, with 97 percent saying their uncorrected near vision in the implanted eye was either good or excellent, and 97 percent reporting that their uncorrected distance vision with both eyes open was either good or excellent. A clinical trial required for approval of the Presbia Flexivue Microlens in the U.S. commenced in 2014.

Corneal Onlays Corneal onlays are similar to corneal inlays, but are designed to be placed closer to the front surface of the cornea, just under the outer layer called the epithelium. The corneal epithelium comprises about 10 percent of the overall thickness of the cornea and acts as a protective barrier to keep bacteria, dust and other foreign substances from penetrating the eye. The epithelium also absorbs oxygen and nutrients from the tear film so they can nourish the rest of the cornea. Though some research in developing corneal onlays is ongoing in Europe, it appears that corneal inlays have become the preferred technology for corneal implants designed for vision correction, according to W. Bruce Jackson, MD, professor and chairman of ophthalmology at the University of Ottawa (Canada) and one of the early investigators of corneal onlays.

手機診測APP: Amblyopia (弱視,懶惰眼,Lazy eyes）/ GoCheck Kids

弱視就是要勤用眼看卡通能夠加速治療健康醫療網／實習記者朱姵慈報導-2015年10月25日上午09:51（健康醫療網／實習記者朱姵慈報導）你的孩子有弱視嗎？在美國，每一百名就有2到3位的兒童會受到弱視的影響，比例極高。一項研究顯示，看動畫電影可能成為簡易、孩童也不太會拒絕的治療弱視方法。弱視又俗稱為懶惰眼（Lazy eyes），成因是因為兒童在成長期間，視覺沒有正常的發展，在長期失去刺激的情況下，大腦最終會放棄了該部份的視力功能，視力減退，形成弱視。最常見的原因就是因為高度遠視或高度散光，或兩眼不等視等屈光不正所引起。其他如眼位不正，像內斜視或外斜視，或因先天性眼皮下垂，先天性白內障，也會造成弱視。時下治療弱勢最常見的方法是戴醫療眼罩，患者必須戴上眼罩數周到數月，它會迫使較弱的眼睛用眼，這種治療方式幫助大腦的相關視覺部分得以發展的更有效率，並穩定視力。然而，研究主持人德州大學達拉斯西南醫學中心的艾林博士（Eileen E. Birch）發現，目前的治療方法通常結合「知覺」學習任務，儘管有效，卻會讓孩子覺得厭倦，或是太複雜而容易放棄。如今，團隊研究了一個更有潛力且更生動有趣的治療方式－欣賞動畫電影。研究人員以八名4到10歲有弱視的孩童作為研究對象，要求孩子們需要連續兩週觀看3D電影，同時配戴3D眼鏡。兩週結束後，所有兒童的視力有顯著的改善。「僅僅觀看超過兩周6部的電影（9小時），孩子的視力已改善很多，視力檢查表能看清楚得多出1至4行。」原有療法在同樣時間只能改進1行左右，顯得有效的多。國內醫師也指出，弱視的孩童需要多從事耗眼力的工作，例如：打電動玩具，看電視，以持續加強刺激發育。總之，多用眼，治療效果才會更好更快。這和我們一般護眼觀念「多休息，少用眼」大相逕庭。

Amblyopia (from Greek αμβλυωπία, "blunt vision"), also called lazy eye.

Debut of World's First Comprehensive Vision Screening App Gobiquity showcases evolution of its flagship innovation, GoCheck Kids, to help prevent permanent vision loss in children October 23, 2015 10:48 AM Eastern Daylight Time WASHINGTON--(BUSINESS WIRE)--Gobiquity™ Mobile Health, a global leader at the forefront of digital health solutions, today announced the expanded accessibility and utility of its mobile health application, GoCheck Kids™. The world's first and only comprehensive vision screening app will be available on iTunes and unveiled during the American Academy of Pediatrics National Conference conference, on October 24th. GoCheck Kids offers a robust suite of mobile vision diagnostics, including mobile photoscreening, digital Visual Acuity screening, and personalized vision screening guidance, enabling clinically validated screenings from the palm of a physician's hand. "With this launch, we are expanding the utility and accelerating the distribution to allow more health professionals to utilize our reimbursable, HIPAA compliant vision screening system to improve care for all of their patients." The GoCheck Kids vision screening platform is now capable of effectively and efficiently identifying amblyopia risk factors for children 6 months to 6 years with mobile photoscreening, as well as obtaining a digital reading of a child's sharpness of vision or Visual Acuity (VA) for children ages 3 and older. Since its national launch earlier this year, GoCheck Kids™ mobile photoscreener has been used to complete over 36,000 pediatric vision screenings. "The new GoCheck Kids, now available on iOS, extends the ability of pediatricians and other primary care providers to effectively screen for amblyopia, the leading cause of vision loss in children," said Andrew Burns, CEO Gobiquity. "With this launch, we are expanding the utility and accelerating the distribution to allow more health professionals to utilize our reimbursable, HIPAA compliant vision screening system to improve care for all of their patients." With this release, physicians have access to a total vision solution, now including recommended screening protocols and validated VA measurements within a convenient and cost-effective mobile vision diagnostics suite. "We are excited to announce that the GoCheck Kids iOS application now offers threshold visual acuity assessments," said Pediatric Ophthalmologist and Cloudscaper co-founder James W. O'Neil, M.D., "GoCheck Kids incorporates the independently medically validated protocol developed by Cloudscaper, LLC. This clinically proven method has already assessed the vision of over 300,000 children via the desktop application, EyeSpy 20/20." In a study by Robert W. Arnold, MD, FAAP, featured in a 2014 edition of Journal of Pediatric Ophthalmology and Strabismus (JPOS), GoCheck Kids photoscreener was recognized for its "strong specificity, sensitivity and lower percentage inconclusive versus single-purpose devices." For pediatricians, GoCheck Kids has provided an effective, affordable and simple alternative for testing through photoscreening. With up to 25% of children at risk for developing visual disturbances that impair their ability to learn and lead healthy lives, yet fewer than 20% getting screened, there is a need for more comprehensive diagnostic tools. The American Academy of Pediatrics (AAP) and the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) endorse photoscreening to detect amblyopia risk factors, which, if left untreated, can lead to permanent vision loss. GoCheck Kids addresses these issues, while affording additional vision diagnostic tools and resources to support early detection.

AAP Annual Meeting Onsite Activities Gobiquity will be exhibiting on the showroom floor at booth

827. As well, Gobiquity is showcasing two presentations with DM Alcorn, MD, FAAP, Pediatric Ophthalmologist, and Natasha Burgert, MD, Pediatrician.

Preventing Permanent Vision Loss in Children Saturday, October 24th, 2015 Product Theater C, Booth

1763 1:15-1:30 PM: Importance of detecting and treating amblyopia risk factors as early as possible – Perspective from a pediatric ophthalmologist 1:30-1:45 PM: Photoscreening and visual acuity made easy and affordable with mobile applications Members of the company and its Medical Advisory Board will be onsite to answer questions and provide information about GoCheck Kids.

About Gobiquity Mobile Health Gobiquity Mobile Health (Gobiquity™) provides innovative mobile applications that bring specialty diagnostics to primary care providers so they can diagnose sooner and facilitate more efficient clinical decision-making. Their flagship mobile application, GoCheck Kids™, is a comprehensive vision screening solution. Gobiquity is committed to expanding their portfolio of pediatric vision diagnostics, followed by adult primary care that reaches a broader audience of healthcare constituents - establishing Gobiquity as the defacto vision solution for healthcare. (www.gobiquity.com | www.gocheckkids.com).

The demanding of sutureless wound management (ReSure Sealant) for pediatric cases

Ocular sealant helps ensure wound integrity in pediatric cases  Agent may be applied over suture, provides protection against complications, October 01, 2015 By M. Edward Wilson, MD, Take-home message: In pediatric cataract surgery, use of an ocular sealant not only also helps prevent wound leakage but also provides extra protection against eye rubbing and wound manipulation. By M. Edward Wilson, MD, Special to Ophthalmology Times/ In many cases the traditional clear corneal incisions in adult cataract surgeries are self-sealing and typically have minimal effect on astigmatism while requiring less healing time. If the wound does not seal sufficiently, sutures are generally used. Sutures, however, do not always seal as well as generally thought.1-4 This is true when discussing pediatric cataract surgery. Pediatric eyes present a unique challenge, as the tissue is very different from adult eyes. Children's eyes are naturally much smaller and have low scleral rigidity and thicker and softer corneas. Children are also much more likely to rub their eyes and are less compliant with activity restriction, putting them at increased risk of trauma and postoperative infection.

Complications in pediatric cataract surgery While postoperative infection and inflammation is concerning in any patient, this is compounded when dealing with pediatric patients. Children are especially prone to an additional variety of postoperative complications including axial growth after cataract extraction, secondary glaucoma, posterior-capsule opacification (PCO), and future vision loss due to amblyopia.5-7 All these factors increase the necessity for a truly closed and sealed wound, something a suture alone cannot always guarantee. With the increased scleral elasticity and soft corneas of pediatric tissue, even small wounds tend to leak. One study was able to demonstrate secure self-sealing wounds subsequent to pediatric extracapsular cataract extraction (ECCE) with posterior capsule preservation and IOL insertion.8 However, this does not seem to be the typical response as other surgeons attempting similar techniques still found it necessary to use a suture against leakage.9,10 A prospective study examining pediatric sutureless wounds illustrated a high leakage rate with 100% leakage in eyes of patients below 11 years of age who underwent ECCE, primary posterior capsulotomy, anterior vitrectomy with intraocular lens implantation (ECCE + PPC + AV + IOL). Consequently, suturing every pediatric wound is recommended. Most pediatric cataract surgeons utilize synthetic absorbable 10-0 polyglactin (Vicryl) suture but it does not have the same handling characteristics of conventional 10.0 nylon monofilament suture generally employed in adult surgery.11 Vicryl is more difficult to titrate and can easily be tied too tight, producing a lot of temporary astigmatism, or too loose, allowing a persistent wound leak.12

Adding an ocular sealant  Pediatric wounds often leak when the child rubs the eyes, even when sutured. To combat this, the use of a hydrogel ocular sealant can further prevent wound leakage, thus ensuring greater positive outcomes. In my practice, I use a certain sealant (ReSure Sealant, Ocular Therapeutix). This hydrogel sealant is comprised of polyethylene glycol (PEG), trilysine, buffering salts, and more than 89% water. It is tinted with FD&C Blue#1 to aid in visualization and placement. The tint dissipates quickly leaving behind a clear sealant, imperceptible to the naked eye but still visible under a scope. The sealant is packaged with a small tray with two wells and an applicator with which to reconstitute the gel. It is ready for use within seconds and can be used alone or in more complex procedures in children, as an adjunct to sutures. While the sealant provides significant advantages in terms of wound sealing in adults, challenges still arise in pediatric cases. With adult tissue, it is possible to completely dry the ocular surface, which allows the sealant to adhere. This is not the case with pediatric eyes. In the pediatric tissue, it is not usually possible to get the wound dry enough initially to apply the sealant. A suture must still be used to close the wound. However, the sealant can then be applied by simply brushing it over the sutured wound, making it useful as a secondary safety net, forming an air-tight barrier against infection and eliminating the need to sew the pediatric wounds quit so tight. It also provides extra protection against eye rubbing and wound manipulation, making the wound more stable.  For very small leaks, the sealant may work as a substitute for a suture. In most cases in young children though, a suture will still be needed with the sealant over the suture. I utilize this strategy in most of my recent cases and have used it to date in more than 50 pediatric procedures. While the surgery itself can be complicated and challenging it is essential that the integrity of the wound be not overlooked. Knowing the incision is truly sealed and that these young patients are as protected against post surgical-complications as possible offers great peace of mind.

References

1. Chee SP. Clear corneal incision leakage after phacoemulsification–detection using povidone iodine 5%. Case Report. Int. Ophthalmology. 2005;26:175-179.

2. Mifflin MD, Kinard, K, et al. Comparison of Stromal Hydration Techniques for Clear Corneal Cataract Incisions: Conventional Hydration versus Anterior Stromal Pocket Hydration. Journal of Refractive Surgery. 2012;38:933-937.

3. Herretes S, Stark WJ, et al. Inflow of ocular surface fluid into the anterior chamber after phacoemulsification through sutureless corneal cataract wounds. American Journal of Ophthalmology. 2005;140;737-740.

4. Masket S, Hovanesian J, et al. Use of a calibrated force gauge in clear corneal cataract surgery to quantify point-pressure manipulation. J Cataract Refract Surg. 2013 Feb 21.

5. Vasavada AR, Raj SM, Nihalani B. Rate of axial growth after congenital cataract surgery. Am J Ophthalmol. 2004;138:915–924.

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M. Edward Wilson, MD/ E: wilsonme@musc.edu  Dr. Wilson is the N. Edgar Miles Professor of Ophthalmology and Pediatrics at the Storm Eye Institute, Medical University of South Carolina, Charleston, SC. He also serves on the AAPOS Board of Directors, as the President-Elect of AAPOS, and is the incoming Chair of the governing Council of the American Ophthalmological Society. Dr. Wilson reports no financial interests relevant to this topic.