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Absorption, distribution, metabolism and excretion of the biomaterials used in Nanocarrier drug delivery systems. Adv Drug Deliv Rev 2019; 143:97-114. [PMID: 31255595 DOI: 10.1016/j.addr.2019.06.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/16/2019] [Accepted: 06/25/2019] [Indexed: 12/13/2022]
Abstract
Nanocarriers (NCs) are a type of drug delivery system commonly used to regulate the pharmacokinetic and pharmacodynamic properties of drugs. Although a wide variety of NCs has been developed, relatively few have been registered for clinical trials and even fewer are clinically approved. Overt or potential toxicity, indistinct mechanisms of drug release and unsatisfactory pharmacokinetic behavior all contribute to their high failure rate during preclinical and clinical testing. These negative characteristics are not only due to the NCs themselves but also to the materials of the drug nanocarrier system (MDNS) that are released in vivo. In this article, we review the main analytical techniques used for bioassay of NCs and MDNS and their pharmacokinetics after administration by various routes. We anticipate our review will serve to improve the understanding of MDNS pharmacokinetics and facilitate the development of NC drug delivery systems.
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Freytag C, Odermatt EK. Standard Biocompatibility Studies Do Not Predict All Effects of PVA/CMC Anti-Adhesive Gel in vivo. Eur Surg Res 2016; 56:109-22. [DOI: 10.1159/000443235] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 12/09/2015] [Indexed: 11/19/2022]
Abstract
Purpose: PVA/CMC (polyvinyl alcohol/carboxymethyl cellulose) hydrogel fulfills various physiochemical properties required for an adhesion barrier and has shown good anti-adhesion properties in previous in vivo studies. In this investigation, we assessed the in vitro and in vivo biocompatibility of PVA/CMC gel and compared this to the functionality and promotion of wound healing for two surgical indications. Methods: Standardized ISO10993 in vitro and in vivo biocompatibility studies, comprising cytotoxicity, genotoxicity, acute systemic toxicity, delayed contact and maximization sensitization test, intracutaneous reactivity and local muscle implantation, were performed on PVA/CMC gel. In the functional studies, PVA/CMC gel was applied - on the one hand - to a rabbit abdominal wall model enforced with a polypropylene mesh for testing the anti-adhesion properties and - on the other hand - to an end- to-end anastomosis model that was selected for surveying potential influences of different dosages of PVA/CMC gel on anastomotic wound healing. Results: The ISO10993 methods indicated generally good biocompatibility properties, such as the absence of cytotoxic and mutagenic effects as well as no signs of systemic toxicity and sensitization potentials. No irritation effects were observed after the intracutaneous injection of lipophilic PVA/CMC sesame oil extract. However, the injection of hydrophilic PVA/CMC physiologic saline extract induced slight irritation. Following rabbit muscle implantation of the PVA membrane for 2, 4, 12, 26 and 52 weeks, a slight irritant effect was observed at 12 weeks due to the peak of phagocytosis. In the functionality tests, PVA/CMC gel showed good anti-adhesive effects in the abdominal wall model enforced with the mesh, with significantly lower and less tense adhesions compared to the untreated control. However, moderate signs of inflammation, especially in the spleen were observed after the intra-abdominal implantation of 3.3 ml PVA/CMC gel per kg body weight. In the end-to-end anastomosis model, PVA/CMC gel had no influence on wound healing. For dosages of 1-6 ml gel per treatment, no signs of intestinal leaks were detected, and tensile strength was equal to that of the untreated control, but again more moderate signs of inflammation in the spleen were observed at a dosage >3 ml. Conclusion: Comparing the standardized ISO10993 methods, anti-adhesive PVA/CMC gel displays good biocompatibility. However, those methods do not seem to be sensitive enough because the rabbit abdominal wall and the end-to-end anastomosis models display more effects with respect to the dosage and routes of the intra-abdominal resorption of PVA/CMC gel - with the recommended <2 ml PVA/CMC gel per kg body weight as a secure dosage.
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Lang R, Baumann P, Schmoor C, Odermatt EK, Wente MN, Jauch KW. A-Part Gel, an adhesion prophylaxis for abdominal surgery: a randomized controlled phase I-II safety study [NCT00646412]. ANNALS OF SURGICAL INNOVATION AND RESEARCH 2015; 9:5. [PMID: 26336510 PMCID: PMC4557926 DOI: 10.1186/s13022-015-0014-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 08/13/2015] [Indexed: 11/25/2022]
Abstract
Background Intra-abdominal surgical intervention can cause the development of intra-peritoneal adhesions. To reduce this problem, different agents have been tested to minimize abdominal adhesions; however, the optimal adhesion prophylaxis has not been found so far. Therefore, the A-Part® Gel was developed as a barrier to diminish postsurgical adhesions; the aim of this randomized controlled study was a first evaluation of its safety and efficacy. Methods In this prospective, controlled, randomized, patient-blinded, monocenter phase I–II study, 62 patients received either the hydrogel A-Part-Gel® as an anti-adhesive barrier or were untreated after primary elective median laparotomy. Primary endpoint was the occurrence of peritonitis and/or wound healing impairment 28 ± 10 days postoperatively. As secondary endpoints anastomotic leakage until 28 days after surgery, adverse events and adhesions were assessed until 3 months postoperatively. Results A lower rate of wound healing impairment and/or peritonitis was observed in the A-Part Gel® group compared to the control group: (6.5 vs. 13.8 %). The difference between the two groups was −7.3%, 90 % confidence interval [−20.1, 5.4 %]. Both treatment groups showed similar frequency of anastomotic leakage but incidence of adverse events and serious adverse events were slightly lower in the A-Part Gel® group compared to the control. Adhesion rates were comparable in both groups. Conclusion A-Part Gel® is safe as an adhesion prophylaxis after abdominal wall surgery but no reduction of postoperative peritoneal adhesion could be found in comparison to the control group. This may at least in part be due to the small sample size as well as to the incomplete coverage of the incision due to the used application. Trial Registration: NCT00646412
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Affiliation(s)
- Reinhold Lang
- Department of Surgery, University Munich-Großhadern, Marchioninistrasse 15, 81377 Munich, Germany
| | - Petra Baumann
- Aesculap AG, Am Aesculap Platz, 78532 Tuttlingen, Germany
| | - Claudia Schmoor
- Clinical Trials Unit, University Medical Center Freiburg, Elsässer Strasse 2, 79110 Freiburg, Germany
| | | | - Moritz N Wente
- Aesculap AG, Am Aesculap Platz, 78532 Tuttlingen, Germany
| | - Karl-Walter Jauch
- Department of Surgery, University Munich-Großhadern, Marchioninistrasse 15, 81377 Munich, Germany
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Slieker JC, Ditzel M, Harlaar JJ, Mulder IM, Deerenberg EB, Bastiaansen-Jenniskens YM, Kleinrensink GJJ, Jeekel J, Lange JF. Effects of new anti-adhesion polyvinyl alcohol gel on healing of colon anastomoses in rats. Surg Infect (Larchmt) 2012; 13:396-400. [PMID: 23240723 DOI: 10.1089/sur.2011.114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Adhesions follow abdominal surgery with an incidence as high as 95%, resulting in invalidating complications such as bowel obstruction, female infertility, and chronic pain. Searches have been performed for a safe and effective adhesion barrier; however, such barriers have impaired anastomotic site healing. The primary aim of this study was to investigate the effect of a new adhesion barrier, polyvinyl alcohol gel, on healing of colonic anastomoses using a rat model. METHODS Thirty-two Wistar rats were divided in two groups. In all animals, an anastomosis was constructed in the ascending colon. The first group received no adhesion barrier, whereas in the second group, 2 mL of polyvinyl alcohol gel (A-Part Gel(®); Aesculap AG, Tuttlingen, Germany) was applied circularly around the anastomosis. All animals were sacrificed on the seventh post-operative day, and the abdomen was inspected for signs of anastomotic leakage. The anastomotic bursting pressure, the adhesions around the anastomosis, and the collagen content of the excised anastomosis were measured. RESULTS No significant differences were observed between the two groups in the incidence of anastomotic leakage, the anastomotic bursting pressure (p=0.08), or the collagen concentration (p=0.91). No significant reduction in amount of adhesions was observed in the rats receiving polyvinyl alcohol gel. CONCLUSIONS This experimental study showed no significant differences in anastomotic leakage, anastomotic bursting pressure, or collagen content of the anastomosis when using the adhesion barrier polyvinyl alcohol around colonic anastomoses. The barrier did not prevent adhesion formation.
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Affiliation(s)
- Juliette C Slieker
- Department of Surgery, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
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Deerenberg EB, Mulder IM, Ditzel M, Slieker JC, Bemelman WA, Jeekel J, Lange JF. Polyvinyl alcohol hydrogel decreases formation of adhesions in a rat model of peritonitis. Surg Infect (Larchmt) 2012; 13:321-5. [PMID: 22789109 DOI: 10.1089/sur.2011.108] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Adhesion formation after surgery for peritonitis-related conditions, with such associated complications as intestinal obstruction, pain, and infertility, remains an important problem. Applying a liquid barrier intra-peritoneally might reduce initial adhesion formation. METHODS A combination of the cecal ligation and puncture model of peritonitis with the side-wall defect (SWD) model of adhesion formation was performed. Forty rats were assigned randomly to receive no barrier or 1 mL or 2 mL of the cross-linked polyvinyl alcohol and carboxymethylcellulose (PVA/CMC) hydrogel A-Part(®) Gel (B. Braun Aesculap AG, Tuttlingen, Germany). After 14 days, the animals were sacrificed, and adhesion formation and abscess formation were scored. RESULTS Thirty animals survived, distributed equally among the groups. There were significantly fewer adhesions to the SWD in the PVA/CMC groups (median 0) than in the control group (median 26%-50%) (p<0.05). The median tenacity of the adhesions was significantly higher in the control group (Zühlke score 2) than in the PVA/CMC groups (Zühlke score 0) (p<0.05). The amount and size of intra-abdominal abscesses were not significantly different in the three groups. CONCLUSION In this experiment, PVA/CMC hydrogel reduced the amount of adhesions to the SWD and between viscera significantly with equal risk of abscess formation.
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Affiliation(s)
- Eva B Deerenberg
- Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
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Schädlich A, Naolou T, Amado E, Schöps R, Kressler J, Mäder K. Noninvasive in Vivo Monitoring of the Biofate of 195 kDa Poly(vinyl alcohol) by Multispectral Fluorescence Imaging. Biomacromolecules 2011; 12:3674-83. [DOI: 10.1021/bm200899h] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Andreas Schädlich
- Martin Luther University Halle-Wittenberg, Department of Pharmaceutical Technology and Biopharmaceutics, Wolfgang-Langenbeck-Strasse 4, D-06120 Halle (Saale), Germany
| | - Toufik Naolou
- Martin Luther University Halle-Wittenberg, Department of Chemistry/Physical Chemistry of Polymers, Von-Danckelmann-Platz 4, D-06120 Halle (Saale), Germany
| | - Elkin Amado
- Martin Luther University Halle-Wittenberg, Department of Chemistry/Physical Chemistry of Polymers, Von-Danckelmann-Platz 4, D-06120 Halle (Saale), Germany
| | - Regina Schöps
- Martin Luther University Halle-Wittenberg, Department of Chemistry/Physical Chemistry of Polymers, Von-Danckelmann-Platz 4, D-06120 Halle (Saale), Germany
| | - Jörg Kressler
- Martin Luther University Halle-Wittenberg, Department of Chemistry/Physical Chemistry of Polymers, Von-Danckelmann-Platz 4, D-06120 Halle (Saale), Germany
| | - Karsten Mäder
- Martin Luther University Halle-Wittenberg, Department of Pharmaceutical Technology and Biopharmaceutics, Wolfgang-Langenbeck-Strasse 4, D-06120 Halle (Saale), Germany
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Alves MH, Jensen BEB, Smith AAA, Zelikin AN. Poly(Vinyl Alcohol) Physical Hydrogels: New Vista on a Long Serving Biomaterial. Macromol Biosci 2011; 11:1293-313. [DOI: 10.1002/mabi.201100145] [Citation(s) in RCA: 166] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Indexed: 12/16/2022]
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Preparation and characterization of poly(lactic-co-glycolic acid) microspheres loaded with a labile antiparkinson prodrug. Int J Pharm 2011; 409:289-96. [DOI: 10.1016/j.ijpharm.2011.02.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 01/27/2011] [Accepted: 02/21/2011] [Indexed: 11/23/2022]
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Müller SA, Weis C, Odermatt EK, Knaebel HP, Wente MN. A hydrogel for adhesion prevention: characterization and efficacy study in a rabbit uterus model. Eur J Obstet Gynecol Reprod Biol 2010; 158:67-71. [PMID: 21146281 DOI: 10.1016/j.ejogrb.2010.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2009] [Revised: 08/08/2010] [Accepted: 11/08/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Postoperative peritoneal adhesions following gynaecological surgery remain a clinically relevant problem. One approach to prevent adhesion formation is to apply physical barriers such as hydrogels. STUDY DESIGN A physically crosslinked polyvinyl alcohol and carboxymethylcellulose (PVA/CMC) hydrogel (A-Part) was characterized in vitro. Three different traumatization methods were evaluated in a rabbit uterine study. To determine its anti-adhesion efficacy, the hydrogel was first tested in an in vivo pilot study and then in a larger trial to compare it with icodextrin 4% solution (Adept) and controls. RESULTS Rheological measurements showed an increased elasticity of the hydrogel after freezing. In vivo experiments revealed a clear reduction in incidence, extent and severity of adhesions compared to the icodextrin 4% solution and the untreated control group. CONCLUSIONS These results warrant further investigation of the PVA/CMC A-Part hydrogel in clinical trials focused on gynaecological procedures.
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Affiliation(s)
- Sascha A Müller
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
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Mohan N, Nair PD. A synthetic scaffold favoring chondrogenic phenotype over a natural scaffold. Tissue Eng Part A 2010; 16:373-84. [PMID: 19566439 DOI: 10.1089/ten.tea.2009.0314] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The three-dimensional scaffolds play a very important role in regulating cell adhesion and the production of extracellular matrix molecules in in vitro regeneration of cartilage. This study evaluates how the three-dimensional structure and physicochemical properties of the polymeric scaffolds influence in vitro regeneration of cartilage tissue. A synthetic poly(vinyl alcohol)-poly(caprolactone) semi-interpenetrating polymer network (IPN) scaffold and gelatin-albumin, made of natural polymers, are used for the study. The polymers in the semi-IPN synthetic scaffold mimic the properties of collagen and glycosaminoglycans present in native cartilage. Its appropriate swelling and pore structure enabled cell-cell and cell-matrix interactions. This helped the chondrocytes to retain its spherical morphology and resulted in enhanced secretion of extracellular matrix components. In contrast, the biomimetic structure in gelatin-albumin scaffold induced chondrocytes to loose its phenotype by spreading and becoming fibroblastic in morphology. Its high swelling and the large pore size failed to recreate an appropriate microenvironment for chondrogenesis that resulted in less secretion of cartilage-specific molecules. Mesenchymal stem cell differentiation to chondrocytes in the presence of growth factors is also enhanced in the synthetic semi-IPN scaffold. The study thus indicates that the chemical composition and the physicochemical properties of the scaffolds play a very important role in providing appropriate niche in in vitro tissue regeneration.
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Affiliation(s)
- Neethu Mohan
- Division of Tissue Engineering & Regeneration Technologies, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala, India
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Labruère R, Sicard R, Cormier R, Turos E, West L. Poly(vinyl benzoate) nanoparticles for molecular delivery: Studies on their preparation and in vitro properties. J Control Release 2010; 148:234-40. [PMID: 20728487 DOI: 10.1016/j.jconrel.2010.08.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 07/07/2010] [Accepted: 08/11/2010] [Indexed: 11/29/2022]
Abstract
The preparation and properties of poly(vinyl benzoate) nanoparticle suspensions as molecular carriers are described for the first time. These nanoparticles can be formed by nanoprecipitation of commercial poly(vinyl benzoate) in water using Pluronic F68 as surfactant, to create spherical nanostructures measuring 200-250nm in diameter. These nanoparticles are stable in phosphate buffer and blood serum, and only slowly degrade in the presence of esterases. Pluronic F68 stabilizes the nanoparticle and also protects it from enzymatic degradation. Up to 1.6% by weight of a lipid-soluble molecule such as coumarin-6 can be introduced into the nanoparticle during nanoprecipitation, compared to a water-soluble compound (5(6)-carboxyfluorescein) which gave almost no loading. Kinetics experiments in phosphate buffer indicate that 78% of the coumarin-6 was encapsulated within the polymer matrix of the nanoparticle, and the residual 22% of coumarin-6 was surface-bound and quickly released. The nanoparticles are non-toxic in vitro towards human epithelial cells (IC(50)>1000μg/mL) and primary bovine aortic endothelial cells (IC(50)>500μg/mL), and non-bactericidal against a selection of representative test microbes (MIC >250μg/mL). These properties suggest that the poly(vinyl benzoate) nanoparticles may be suitable carriers for molecular delivery of lipophilic small molecules such as pharmaceutical and imaging agents.
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Affiliation(s)
- Raphaël Labruère
- Center for Molecular Diversity in Drug Design, Discovery and Delivery, Department of Chemistry, University of South Florida, Tampa, FL 33620, USA
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A prospective, randomised, controlled, double-blind phase I-II clinical trial on the safety of A-Part Gel as adhesion prophylaxis after major abdominal surgery versus non-treated group. BMC Surg 2010; 10:20. [PMID: 20604918 PMCID: PMC2912830 DOI: 10.1186/1471-2482-10-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Accepted: 07/06/2010] [Indexed: 11/10/2022] Open
Abstract
Background Postoperative adhesions occur when fibrous strands of internal scar tissue bind anatomical structures to one another. The most common cause of intra-abdominal adhesions is previous intra-abdominal surgical intervention. Up to 74% of intestinal obstructions are caused by post surgical adhesions. Although a variety of methods and agents have been investigated to prevent post surgical adhesions, the problem of peritoneal adhesions remains largely unsolved. Materials serving as an adhesion barrier are much needed. Methods/Design This is a prospective, randomised, controlled, patient blinded and observer blinded, single centre phase I-II trial, which evaluates the safety of A-Part® Gel as an adhesion prophylaxis after major abdominal wall surgery, in comparison to an untreated control group. 60 patients undergoing an elective median laparotomy without prior abdominal surgery are randomly allocated into two groups of a 1:1- ratio. Safety parameter and primary endpoint of the study is the occurrence of wound healing impairment or peritonitis within 28 (+10) days after surgery. The frequency of anastomotic leakage within 28 days after operation, occurrence of adverse and serious adverse events during hospital stay up to 3 months and the rate of adhesions along the scar within 3 months are defined as secondary endpoints. After hospital discharge the investigator will examine the enrolled patients at 28 (+10) days and 3 months (±14 days) after surgery. Discussion This trial aims to assess, whether the intra-peritoneal application of A-Part® Gel is safe and efficacious in the prevention of post-surgical adhesions after median laparotomy, in comparison to untreated controls. Trial registration NCT00646412
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Jiang Y, Schädlich A, Amado E, Weis C, Odermatt E, Mäder K, Kressler J. In-vivostudies on intraperitoneally administrated poly(vinyl alcohol). J Biomed Mater Res B Appl Biomater 2010; 93:275-84. [DOI: 10.1002/jbm.b.31585] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Neffe AT, Tronci G, Alteheld A, Lendlein A. Controlled Change of Mechanical Properties during Hydrolytic Degradation of Polyester Urethane Networks. MACROMOL CHEM PHYS 2009. [DOI: 10.1002/macp.200900441] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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