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Lu P, Ruan D, Huang M, Tian M, Zhu K, Gan Z, Xiao Z. Harnessing the potential of hydrogels for advanced therapeutic applications: current achievements and future directions. Signal Transduct Target Ther 2024; 9:166. [PMID: 38945949 PMCID: PMC11214942 DOI: 10.1038/s41392-024-01852-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/02/2024] [Accepted: 04/28/2024] [Indexed: 07/02/2024] Open
Abstract
The applications of hydrogels have expanded significantly due to their versatile, highly tunable properties and breakthroughs in biomaterial technologies. In this review, we cover the major achievements and the potential of hydrogels in therapeutic applications, focusing primarily on two areas: emerging cell-based therapies and promising non-cell therapeutic modalities. Within the context of cell therapy, we discuss the capacity of hydrogels to overcome the existing translational challenges faced by mainstream cell therapy paradigms, provide a detailed discussion on the advantages and principal design considerations of hydrogels for boosting the efficacy of cell therapy, as well as list specific examples of their applications in different disease scenarios. We then explore the potential of hydrogels in drug delivery, physical intervention therapies, and other non-cell therapeutic areas (e.g., bioadhesives, artificial tissues, and biosensors), emphasizing their utility beyond mere delivery vehicles. Additionally, we complement our discussion on the latest progress and challenges in the clinical application of hydrogels and outline future research directions, particularly in terms of integration with advanced biomanufacturing technologies. This review aims to present a comprehensive view and critical insights into the design and selection of hydrogels for both cell therapy and non-cell therapies, tailored to meet the therapeutic requirements of diverse diseases and situations.
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Affiliation(s)
- Peilin Lu
- Nanomedicine Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, PR China
- Department of Minimally Invasive Interventional Radiology, and Laboratory of Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, PR China
| | - Dongxue Ruan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Department of Respiratory and Critical Care Medicine, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, PR China
| | - Meiqi Huang
- Department of Minimally Invasive Interventional Radiology, and Laboratory of Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, PR China
| | - Mi Tian
- Department of Stomatology, Chengdu Second People's Hospital, Chengdu, 610021, PR China
| | - Kangshun Zhu
- Department of Minimally Invasive Interventional Radiology, and Laboratory of Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, PR China.
| | - Ziqi Gan
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, 510055, PR China.
| | - Zecong Xiao
- Nanomedicine Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, PR China.
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Park JH, Park AR, Kim K, Shin SH, Jeon Y, Lee WK, Lee D, Baek JH. Prediction of the minimum amount of anti-adhesive agent required for entire intra-abdominal cavity using fluorescent dye. KOREAN JOURNAL OF CLINICAL ONCOLOGY 2024; 20:18-26. [PMID: 38988015 PMCID: PMC11261179 DOI: 10.14216/kjco.24004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/19/2024] [Accepted: 04/30/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE Studies on the appropriate amount of anti-adhesive agents for preventing postoperative adhesion are lacking. This animal study aimed to investigate the distribution of an anti-adhesive agent in the abdominal cavity and estimate the necessary amount to cover the entire cavity. METHODS Fluorescent dye Flamma-552 was conjugated to Guardix-sol to create Guardix-Flamma, which was laparoscopically applied to the abdominal cavity of two 10-kg pigs in different amounts: 15 mL for G1 and 35 mL for G2. After 24 hours, the distribution of Guardix-Flamma was examined under the near-infrared mode of the laparoscope, and the thickness was measured in tissues from the omentum, small, and large intestine by immunohistochemistry. RESULTS The average area of the abdominal cavity in 10 kg pigs was 2,755 cm2. Guardix-Flamma fluorescence was detected in the greater omentum, ascites in the pelvis, and right quadrant area in G1, whereas in G2, it was detected everywhere. On average, the total thickness of G1 and G2 were 12.68 ± 9.80 μm and 18.16 ± 15.57 μm, respectively. Guardix-Flamma thickness applied to the omentum, small, and large intestines of G2 were 1.31-, 1.45-, and 1.49-times thicker than those of G1, respectively, and were all statistically significant (P < 0.05). CONCLUSION The entire abdominal cavity of the 10 kg pig was not evenly covered with 15 mL of Guardix. Although 35 mL of Guardix is sufficient to cover the same area with an average thickness of 18 µm, further studies should evaluate the minimum thickness required for an effective anti-adhesive function.
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Affiliation(s)
- Ji-Hyeon Park
- Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - A Reum Park
- Department of Biomedical Engineering, Graduate School of Gachon University, Seongnam,
Korea
| | - Kiwon Kim
- Department of Technical Support, BioActs Co., Ltd., Incheon,
Korea
| | - Seo Hyun Shin
- Department of Testing and Research, KNOTUS Co., Ltd., Incheon,
Korea
| | - Youngbae Jeon
- Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - Woon Kee Lee
- Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - Donghyuk Lee
- Department of Premedicine, Gachon University, Seongnam,
Korea
| | - Jeong-Heum Baek
- Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
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Suter B, Anthis AHC, Zehnder A, Mergen V, Rosendorf J, Gerken LRH, Schlegel AA, Korcakova E, Liska V, Herrmann IK. Surgical Sealant with Integrated Shape-Morphing Dual Modality Ultrasound and Computed Tomography Sensors for Gastric Leak Detection. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2301207. [PMID: 37276437 PMCID: PMC10427398 DOI: 10.1002/advs.202301207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/26/2023] [Indexed: 06/07/2023]
Abstract
Postoperative anastomotic leaks are the most feared complications after gastric surgery. For diagnostics clinicians mostly rely on clinical symptoms such as fever and tachycardia, often developing as a result of an already fully developed, i.e., symptomatic, surgical leak. A gastric fluid responsive, dual modality, electronic-free, leak sensor system integrable into surgical adhesive suture support materials is introduced. Leak sensors contain high atomic number carbonates embedded in a polyacrylamide matrix, that upon exposure to gastric fluid convert into gaseous carbon dioxide (CO2 ). CO2 bubbles remain entrapped in the hydrogel matrix, leading to a distinctly increased echogenic contrast detectable by a low-cost and portable ultrasound transducer, while the dissolution of the carbonate species and the resulting diffusion of the cation produces a markedly reduced contrast in computed tomography imaging. The sensing elements can be patterned into a variety of characteristic shapes and can be combined with nonreactive tantalum oxide reference elements, allowing the design of shape-morphing sensing elements visible to the naked eye as well as artificial intelligence-assisted automated detection. In summary, shape-morphing dual modality sensors for the early and robust detection of postoperative complications at deep tissue sites, opening new routes for postoperative patient surveillance using existing hospital infrastructure is reported.
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Affiliation(s)
- Benjamin Suter
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
- Particles‐Biology InteractionsDepartment of Materials Meet LifeSwiss Federal Laboratories for Materials Science and Technology (Empa)Lerchenfeldstrasse 5St. Gallen9014Switzerland
| | - Alexandre H. C. Anthis
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
- Particles‐Biology InteractionsDepartment of Materials Meet LifeSwiss Federal Laboratories for Materials Science and Technology (Empa)Lerchenfeldstrasse 5St. Gallen9014Switzerland
| | - Anna‐Katharina Zehnder
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
| | - Victor Mergen
- Diagnostic and Interventional RadiologyUniversity Hospital ZurichUniversity of ZurichRämistrasse 100Zürich8091Switzerland
| | - Jachym Rosendorf
- Department of SurgeryFaculty of Medicine in PilsenCharles UniversityAlej Svobody 923/80Pilsen32300Czech Republic
- Biomedical CenterFaculty of Medicine in PilsenCharles UniversityAlej Svobody 1655/76Pilsen32300Czech Republic
| | - Lukas R. H. Gerken
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
- Particles‐Biology InteractionsDepartment of Materials Meet LifeSwiss Federal Laboratories for Materials Science and Technology (Empa)Lerchenfeldstrasse 5St. Gallen9014Switzerland
| | - Andrea A. Schlegel
- Department of Surgery and TransplantationSwiss HPB CentreUniversity Hospital ZurichRämistrasse 100Zurich8091Switzerland
- Fondazione IRCCS Ca' GrandaOspedale Maggiore PoliclinicoCentre of Preclinical ResearchMilan20122Italy
- Transplantation Center, Digestive Disease and Surgery Institute and Department of Immunity and Inflammation, Lerner Research InstituteCleveland Clinic9620 Carnegie AveClevelandOH44106United States
| | - Eva Korcakova
- Biomedical CenterFaculty of Medicine in PilsenCharles UniversityAlej Svobody 1655/76Pilsen32300Czech Republic
- Department of Imaging MethodsFaculty of Medicine in Pilsen, Charles UniversityAlej Svobody 80Pilsen30460Czech Republic
| | - Vaclav Liska
- Department of SurgeryFaculty of Medicine in PilsenCharles UniversityAlej Svobody 923/80Pilsen32300Czech Republic
- Biomedical CenterFaculty of Medicine in PilsenCharles UniversityAlej Svobody 1655/76Pilsen32300Czech Republic
| | - Inge K. Herrmann
- Nanoparticle Systems Engineering LaboratoryInstitute of Energy and Process Engineering (IEPE)Department of Mechanical and Process Engineering (D‐MAVT)ETH ZurichSonneggstrasse 3Zürich8092Switzerland
- Particles‐Biology InteractionsDepartment of Materials Meet LifeSwiss Federal Laboratories for Materials Science and Technology (Empa)Lerchenfeldstrasse 5St. Gallen9014Switzerland
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Nadri S, Rahmani A, Hosseini SH, Habibizadeh M, Araghi M, Mostafavi H. Prevention of peritoneal adhesions formation by core-shell electrospun ibuprofen-loaded PEG/silk fibrous membrane. ARTIFICIAL CELLS, NANOMEDICINE, AND BIOTECHNOLOGY 2022; 50:40-48. [PMID: 35296208 DOI: 10.1080/21691401.2021.1883043] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 01/15/2021] [Accepted: 01/24/2021] [Indexed: 06/14/2023]
Abstract
Adhesion bands are pathological fibrous tissues that create in the middle of tissues and organs, often reasons of intestinal obstruction, and female infertility. Here, we explored the anti-adhesive and inflammatory capacities of PEG/silk and Ibuprofen-loaded PEG/Silk core-shell nanofibrous membranes, respectively. The ibuprofen-loaded Silk Fibroin-Poly ethylene Glycol (SF-PEG) core-shell membrane was fabricated by electrospinning and considered in terms of morphology, surface wettability, drug release, and degradation. To reveal the membrane capability for adhesion bands inhibition, the membrane was stitched among the abdominal partition and peritoneum and then evaluated using two scoring adhesion systems. According to results, the fibrous membrane hindered cell proliferation, and the scoring systems and pathology showed that in a rat model, Ibuprofen-loaded PEG/Silk core-shell membrane caused a lightening in post-operative adhesion bands and the low-grade inflammatory reaction in animal models. Collectively, we fabricated new ibuprofen-loaded PEG/SF membranes with anti-adhesion and anti-inflammation properties. Moreover, this core-shell electrospun fibrous membrane has not even now been used to prevent peritendinous adhesion generation.
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Affiliation(s)
- Samad Nadri
- Department of Medical Nanotechnology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
- Zanjan Pharmaceutical Nanotechnology Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ali Rahmani
- Department of Medical Nanotechnology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Seyed Hojjat Hosseini
- Department of Pharmacology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mina Habibizadeh
- Department of Pharmacy Biomaterial, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahmood Araghi
- Department of Pathology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hossein Mostafavi
- Department of Physiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Anthis AHC, Abundo MP, Neuer AL, Tsolaki E, Rosendorf J, Rduch T, Starsich FHL, Weisse B, Liska V, Schlegel AA, Shapiro MG, Herrmann IK. Modular stimuli-responsive hydrogel sealants for early gastrointestinal leak detection and containment. Nat Commun 2022; 13:7311. [PMID: 36437258 PMCID: PMC9701692 DOI: 10.1038/s41467-022-34272-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/19/2022] [Indexed: 11/28/2022] Open
Abstract
Millions of patients every year undergo gastrointestinal surgery. While often lifesaving, sutured and stapled reconnections leak in around 10% of cases. Currently, surgeons rely on the monitoring of surrogate markers and clinical symptoms, which often lack sensitivity and specificity, hence only offering late-stage detection of fully developed leaks. Here, we present a holistic solution in the form of a modular, intelligent suture support sealant patch capable of containing and detecting leaks early. The pH and/or enzyme-responsive triggerable sensing elements can be read out by point-of-need ultrasound imaging. We demonstrate reliable detection of the breaching of sutures, in as little as 3 hours in intestinal leak scenarios and 15 minutes in gastric leak conditions. This technology paves the way for next-generation suture support materials that seal and offer disambiguation in cases of anastomotic leaks based on point-of-need monitoring, without reliance on complex electronics or bulky (bio)electronic implantables.
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Affiliation(s)
- Alexandre H C Anthis
- Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, CH-8092, Zurich, Switzerland
- Laboratory for Particles Biology Interactions, Department Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
| | - Maria Paulene Abundo
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA, 91125, USA
| | - Anna L Neuer
- Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, CH-8092, Zurich, Switzerland
- Laboratory for Particles Biology Interactions, Department Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
| | - Elena Tsolaki
- Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, CH-8092, Zurich, Switzerland
- Laboratory for Particles Biology Interactions, Department Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
| | - Jachym Rosendorf
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Thomas Rduch
- Laboratory for Particles Biology Interactions, Department Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
- Department of Gynaecology, Cantonal Hospital St Gallen (KSSG), Rorschacherstrasse 95, CH-9007, St Gallen, Switzerland
| | - Fabian H L Starsich
- Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, CH-8092, Zurich, Switzerland
- Laboratory for Particles Biology Interactions, Department Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland
| | - Bernhard Weisse
- Laboratory for Mechanical Systems Engineering, Department of Engineering Sciences, Empa - Swiss Laboratories for Materials Science and Technology, Ueberlandstrasse 129, CH-8600, Dübendorf, Switzerland
| | - Vaclav Liska
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Andrea A Schlegel
- Department of Visceral Surgery and Transplantation, University Hospital Zurich, CH-8091, Zurich, Switzerland
- Swiss HPB and Transplant Center, Zurich, Rämistrasse 100, CH-8091, Zurich, Switzerland
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Centre of Preclinical Research, Milan, 20122, Italy
| | - Mikhail G Shapiro
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA, 91125, USA
- Howard Hughes Medical Institute, Pasadena, CA, 91125, USA
| | - Inge K Herrmann
- Nanoparticle Systems Engineering Laboratory, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, CH-8092, Zurich, Switzerland.
- Laboratory for Particles Biology Interactions, Department Materials Meet Life, Swiss Federal Laboratories for Materials Science and Technology (Empa), Lerchenfeldstrasse 5, CH-9014, St. Gallen, Switzerland.
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Zhang R, Zhang D, Sun X, Song X, Yan KC, Liang H. Polyvinyl alcohol/gelatin hydrogels regulate cell adhesion and chromatin accessibility. Int J Biol Macromol 2022; 219:672-684. [PMID: 35952815 DOI: 10.1016/j.ijbiomac.2022.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 12/24/2022]
Abstract
Cell adhesion has a critical influence on various processes such as cancer metastasis and wound healing. Many substrates have been used for studying cell adhesion and its related biological processes, it is still highly desirable to have a simply prepared and low-cost substrate suitable for regulating cell adhesion. In this study, we produced a series of polyvinyl alcohol/gelatin hydrogels with different gelatin concentrations via dry-annealing method. Our data showed that the protein adsorbing capability was enhanced and cell adhesion area and the ratio of non-spherical cells were increased with the increment of gelatin concentration. We also observed that varying cell adhesion conditions induced by polyvinyl alcohol /gelatin hydrogels resulted in expression level changes of genes involved in mechanotransduction from extracellular matrices (ECM) to the nucleus. In particular, we detected a widespread increase in chromatin accessibility under poor cell adhesion condition. This work provides a useful hydrogel system for regulating cell adhesion and opens up new possibilities for the design of biomaterials for cell adhesion study.
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Affiliation(s)
- Ran Zhang
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, University of Science and Technology of China, Hefei, China
| | - Duo Zhang
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, University of Science and Technology of China, Hefei, China
| | - Xingyue Sun
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, University of Science and Technology of China, Hefei, China
| | - Xiaoyuan Song
- MOE Key Laboratory for Cellular Dynamics, CAS Key Laboratory of Brain Function and Disease, School of Life Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Karen Chang Yan
- Mechanical Engineering and Biomedical Engineering, The College of New Jersey, Ewing, NJ, USA.
| | - Haiyi Liang
- CAS Key Laboratory of Mechanical Behavior and Design of Materials, Department of Modern Mechanics, University of Science and Technology of China, Hefei, China; School of Civil Engineering, Anhui Jianzhu University, Hefei, China; IAT-Chungu Joint Laboratory for Additive Manufacturing, Anhui Chungu 3D printing Institute of Intelligent Equipment and Industrial Technology, Wuhu, China.
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Dong J, Feng C, Dang J, Yang X, Zhang T, Wang B. Preparation of healing promotive alanyl-glutamine-poly(p-dioxanone) electrospun membrane integrated with gentamycin and its application for intestinal anastomosis in rats. BIOMATERIALS ADVANCES 2022; 139:212977. [PMID: 35882134 DOI: 10.1016/j.bioadv.2022.212977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/23/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
Anastomosis surgery at the intestinal site is performed on millions of individuals every year. However, several persistent complications, such as anastomotic leakage, abnormal adhesion, and anastomotic stenosis, have been observed after the surgery. For promoting anastomotic healing and to overcome the challenges mentioned above, re-epithelialization at anastomotic sites is crucial. In this study, an epithelialization-promoting macromolecular prodrug Ala-Gln-PPDO was prepared and processed into fibrous membranes by electrospinning. Ala-Gln and gentamicin were sustainably released from the electrospun membranes with degradation of these membranes to promote the proliferation of rat intestinal epithelial cells and suppress the proliferation of Staphylococcus aureus and Escherichia coli. The comprehensive repair effects of Ala-Gln-PPDO membranes have been evaluated in rat models of intestinal anastomosis in this study. Application of Ala-Gln-PPDO membranes, especially the gentamicin-incorporated Ala-Gln-PPDO ones, could prevent adhesion between the injured intestine and surrounding intestinal tissues. In addition, they did not affect the healing strength of anastomotic stoma negatively and could promote re-epithelialization at the anastomotic sites. Furthermore, the gentamicin-incorporated Ala-Gln-PPDO membranes could relieve stenosis at anastomotic sites. The gentamicin-incorporated Ala-Gln-PPDO electrospun membrane is a promising, comprehensive implantable material for promoting healing after gastrointestinal anastomosis owing to its effects involving the promotion of re-epithelialization, prevention of adhesion, and relieving of anastomotic stenosis.
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Affiliation(s)
- Jun Dong
- Department of Chemistry, School of Pharmacy, North Sichuan Medical College, Nanchong, China
| | - Chengmin Feng
- Department of Otolaryngology & Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jiafeng Dang
- Gynecology and Obstetrics, Department of Clinical Medicine, The Third Affiliated Hospital of Chengdu Medicine College, Pidu District People's Hospital, Chengdu, China
| | - Xiaomei Yang
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Ting Zhang
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, China
| | - Bing Wang
- Department of Chemistry, School of Pharmacy, North Sichuan Medical College, Nanchong, China; Medical Imaging Key Laboratory of Sichuan Province, North Sichuan Medical College, Nanchong, China.
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8
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Waldron MG, Judge C, Farina L, O’Shaughnessy A, O’Halloran M. Barrier materials for prevention of surgical adhesions: systematic review. BJS Open 2022; 6:6602139. [PMID: 35661871 PMCID: PMC9167938 DOI: 10.1093/bjsopen/zrac075] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/07/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Postoperative surgical adhesions constitute a major health burden internationally. A wide range of materials have been evaluated, but despite constructive efforts and the obvious necessity, there remains no specific barrier widely utilized to prevent postoperative adhesion formation. The aim of this study was to highlight and characterize materials used for prevention of postoperative surgical adhesions in both animal and human studies. METHODS A systematic review was performed of all original research articles presenting data related to the prevention of postoperative adhesions using a barrier agent. All available observational studies and randomized trials using animal models or human participants were included, with no restrictions related to type of surgery. PubMed and Embase databases were searched using key terms from inception to August 2019. Standardized data collection forms were used to extract details for each study and assess desirable characteristics of each barrier and success in animal and/or human studies. RESULTS A total of 185 articles were identified for inclusion in the review, with a total of 67 unique adhesion barrier agents (37 natural and 30 synthetic materials). Desirable barrier characteristics of an ideal barrier were identified on review of the literature. Ten barriers achieved the primary outcome of reducing the incidence of postoperative adhesions in animal studies followed with positive outputs in human participants. A further 48 materials had successful results from animal studies, but with no human study performed to date. DISCUSSION Multiple barriers showed promise in animal studies, with several progressing to success, and fulfilment of desirable qualities, in human trials. No barrier is currently utilized commonly worldwide, but potential barriers have been identified to reduce the burden of postoperative adhesions and associated sequelae.
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Affiliation(s)
- Michael Gerard Waldron
- Correspondence to: Michael Gerard Waldron, Translational Medical Device Lab, Galway University Hospital, Newcastle Road, Galway, Ireland H91YR71 (e-mail: )
| | - Conor Judge
- Translational Medical Device Laboratory, National University of Ireland Galway, Galway, Ireland
| | - Laura Farina
- Translational Medical Device Laboratory, National University of Ireland Galway, Galway, Ireland
| | - Aoife O’Shaughnessy
- Translational Medical Device Laboratory, National University of Ireland Galway, Galway, Ireland
| | - Martin O’Halloran
- Translational Medical Device Laboratory, National University of Ireland Galway, Galway, Ireland
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Bi-layered carboxymethyl cellulose-collagen vitrigel dual-surface adhesion-prevention membrane. Carbohydr Polym 2022; 285:119223. [DOI: 10.1016/j.carbpol.2022.119223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/12/2021] [Accepted: 02/01/2022] [Indexed: 11/21/2022]
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10
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Fatehi Hassanabad A, Zarzycki AN, Jeon K, Dundas JA, Vasanthan V, Deniset JF, Fedak PWM. Prevention of Post-Operative Adhesions: A Comprehensive Review of Present and Emerging Strategies. Biomolecules 2021; 11:biom11071027. [PMID: 34356652 PMCID: PMC8301806 DOI: 10.3390/biom11071027] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
Post-operative adhesions affect patients undergoing all types of surgeries. They are associated with serious complications, including higher risk of morbidity and mortality. Given increased hospitalization, longer operative times, and longer length of hospital stay, post-surgical adhesions also pose a great financial burden. Although our knowledge of some of the underlying mechanisms driving adhesion formation has significantly improved over the past two decades, literature has yet to fully explain the pathogenesis and etiology of post-surgical adhesions. As a result, finding an ideal preventative strategy and leveraging appropriate tissue engineering strategies has proven to be difficult. Different products have been developed and enjoyed various levels of success along the translational tissue engineering research spectrum, but their clinical translation has been limited. Herein, we comprehensively review the agents and products that have been developed to mitigate post-operative adhesion formation. We also assess emerging strategies that aid in facilitating precision and personalized medicine to improve outcomes for patients and our healthcare system.
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Affiliation(s)
- Ali Fatehi Hassanabad
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
| | - Anna N. Zarzycki
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
| | - Kristina Jeon
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R7, Canada;
| | - Jameson A. Dundas
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
| | - Vishnu Vasanthan
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
| | - Justin F. Deniset
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Paul W. M. Fedak
- Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2N9, Canada; (A.F.H.); (A.N.Z.); (J.A.D.); (V.V.); (J.F.D.)
- Correspondence:
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11
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Liu KS, Kao CW, Tseng YY, Chen SK, Lin YT, Lu CJ, Liu SJ. Assessment of Antimicrobial Agents, Analgesics, and Epidermal Growth Factors-Embedded Anti-Adhesive Poly(Lactic-Co-Glycolic Acid) Nanofibrous Membranes: In vitro and in vivo Studies. Int J Nanomedicine 2021; 16:4471-4480. [PMID: 34234437 PMCID: PMC8257070 DOI: 10.2147/ijn.s318083] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/15/2021] [Indexed: 02/05/2023] Open
Abstract
Background Postoperative tissue adhesion is a major concern for most surgeons and is a nearly unpreventable complication after abdominal or pelvic surgeries. This study explored the use of sandwich-structured antimicrobial agents, analgesics, and human epidermal growth factor (hEGF)-incorporated anti-adhesive poly(lactic-co-glycolic acid) nanofibrous membranes for surgical wounds. Materials and Methods Electrospinning and co-axial electrospinning techniques were utilized in fabricating the membranes. After spinning, the properties of the prepared membranes were assessed. Additionally, high-performance liquid chromatography and enzyme-linked immunosorbent assays were utilized in assessing the in vitro and in vivo liberation profiles of the pharmaceuticals and the hEGF from the membranes. Results The measured data suggest that the degradable anti-adhesive membranes discharged high levels of vancomycin/ceftazidime, ketorolac, and hEGF in vitro for more than 30, 24, and 27 days, respectively. The in vivo assessment in a rat laparotomy model indicated no adhesion in the peritoneal cavity at 14 days post-operation, demonstrating the anti-adhesive capability of the sandwich-structured nanofibrous membranes. The nanofibers also released effective levels of vancomycin, ceftazidime, and ketorolac for more than 28 days in vivo. Histological examination revealed no adverse effects. Conclusion The outcomes of this study implied that the anti-adhesive nanofibers with sustained release of antimicrobial agents, analgesics, and growth factors might offer postoperative pain relief and infection control, as well as promote postoperative healing of surgical wounds.
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Affiliation(s)
- Kuo-Sheng Liu
- Department of Thoracic and Cardiovascular Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Wei Kao
- Department of Anesthesiology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yuan-Yun Tseng
- Department of Neurosurgery, New Taipei Municipal Tu-Cheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan
| | - Shih-Kuang Chen
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Ting Lin
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Jung Lu
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.,Department of Orthopedic Surgery, Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Jung Liu
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.,Department of Orthopedic Surgery, Bone and Joint Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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12
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Aksakal N, Goksoy B, Onder SY, Dogan S, Gok AFK, Barbaros U. A New Cross-Linked Hyaluronic Acid Gel for Preventing Adhesion After Thyroid Surgery: An Animal Study. J Surg Res 2021; 265:147-152. [PMID: 33940237 DOI: 10.1016/j.jss.2021.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/18/2021] [Accepted: 03/25/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Revision of any neck surgeries is usually associated with increased rate of complications compared to the initial surgery due to adhesions. Especially, recurrent laryngeal nerve injury and hypoparathyroidism are most important postoperative complications of thyroid revision surgery. This study aimed to reveal anti-adhesive effects of cross-linked hyaluronic acid gel (NCHAG) in thyroid surgery. MATERIALS AND METHODS This study was performed in 16 adult male rats who underwent hemithyroidectomy in the right lobe and randomized into two experimental groups: Group I (control group) was given any substance and Group II (NCHA group) received NCHA spray into their perithyroidal area. The rats were sacrificed after three weeks of thyroidectomy for assessment. RESULTS Gross adhesions score (x̄ = 2.500) was significantly higher in Group I than Group II (x̄=1.750; P = 0.031). Group II showed significantly less fibrosis compared to the Group I (P = 0.002). The rate of inflammation was found to be significantly higher in group I (P = 0.008). Vascular proliferation was not different between two groups (p=0.083). CONCLUSIONS Our study showed that NCHA can reduce postoperative adhesion and might be effective in preventing fibrosis after the thyroidectomy. Although this study could not demonstrate that application of NCHA is able to reduce complication rate in revision neck surgery, it could be safely used after thyroidectomy and neck surgeries to prevent adhesions.
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Affiliation(s)
- Nihat Aksakal
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Beslen Goksoy
- Department of General Surgery, Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Semen Yesil Onder
- Department of Pathology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Selim Dogan
- Department of General Surgery, Health Sciences University, Turkish Ministry of Health, Istanbul Research and Training Hospital, Istanbul, Turkey
| | - Ali Fuat Kaan Gok
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Umut Barbaros
- Department of General Surgery, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
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13
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Chandel AKS, Shimizu A, Hasegawa K, Ito T. Advancement of Biomaterial-Based Postoperative Adhesion Barriers. Macromol Biosci 2021; 21:e2000395. [PMID: 33463888 DOI: 10.1002/mabi.202000395] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/28/2020] [Indexed: 01/16/2023]
Abstract
Postoperative peritoneal adhesion (PPA) is a prevalent incidence that generally happens during the healing process of traumatized tissues. It causes multiple severe complications such as intestinal obstruction, chronic abdominal pain, and female infertility. To prevent PPA, several antiadhesion materials and drug delivery systems composed of biomaterials are used clinically, and clinical antiadhesive is one of the important applications nowadays. In addition to several commercially available materials, like film, spray, injectable hydrogel, powder, or solution type have been energetically studied based on natural and synthetic biomaterials such as alginate, hyaluronan, cellulose, starch, chondroitin sulfate, polyethylene glycol, polylactic acid, etc. Moreover, many kinds of animal adhesion models, such as cecum abrasion models and unitary horn models, are developed to evaluate new materials' efficacy. A new animal adhesion model based on hepatectomy and conventional animal adhesion models is recently developed and a new adhesion barrier by this new model is also developed. In summary, many kinds of materials and animal models are studied; thus, it is quite important to overview this field's current progress. Here, PPA is reviewed in terms of the species of biomaterials and animal models and several problems to be solved to develop better antiadhesion materials in the future are discussed.
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Affiliation(s)
- Arvind K Singh Chandel
- Center for Disease Biology and Integrative Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Atsushi Shimizu
- Department of Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Kiyoshi Hasegawa
- Department of Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan
| | - Taichi Ito
- Center for Disease Biology and Integrative Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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14
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Arjmand MH, Zahedi-Avval F, Barneh F, Mousavi SH, Asgharzadeh F, Hashemzehi M, Soleimani A, Avan A, Fakhraie M, Nasiri SN, Mehraban S, Ferns GA, Ryzhikov M, Jafari M, Khazaei M, Hassanian SM. Intraperitoneal Administration of Telmisartan Prevents Postsurgical Adhesion Band Formation. J Surg Res 2020; 248:171-181. [PMID: 31923833 DOI: 10.1016/j.jss.2019.10.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Angiotensin II receptor blockers (ARBs) have a potential role in reducing inflammation and fibrosis. We have integrated systems and molecular biology approaches to investigate the therapeutic potential of ARBs in preventing postsurgical adhesion band formation. MATERIAL AND METHODS we have followed the ARRIVE guidelines point by point during experimental studies. Telmisartan (1 and 9 mg/kg), valsartan (1 and 9 mg/kg), and losartan (1 and 10 mg/kg) were administered intraperitoneally in different groups of male albino Wistar rat. After 7 d of treatment, macroscopic evidence and score of fibrotic bands based on scaling methods was performed. Moreover, the anti-inflammatory and antifibrosis effects of telmisartan on reduction of fibrotic bands were investigated by using histopathology, ELISA, and real-time polymerase chain reaction methods. RESULTS Telmisartan, but not losartan or valsartan, prevented the frequency as well as the stability of adhesion bands. Telmisartan appears to elicit anti-inflammatory responses by attenuating submucosal edema, suppressing proinflammatory cytokines, decreasing proinflammatory cell infiltration, and inhibiting oxidative stress at the site of peritoneal surgery. We also showed that telmisartan prevents fibrotic adhesion band formation by reducing excessive collagen deposition and suppression of profibrotic genes expression at the peritoneum adhesion tissues. CONCLUSIONS These results support the potential application of telmisartan in preventing postsurgical adhesion band formation by inhibiting key pathologic responses of inflammation and fibrosis in postsurgery patients.
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Affiliation(s)
- Mohammad-Hassan Arjmand
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farnaz Zahedi-Avval
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farnaz Barneh
- Genetics Research Center, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Seyed Hadi Mousavi
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshteh Asgharzadeh
- Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Milad Hashemzehi
- Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Atena Soleimani
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee and Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Maryam Fakhraie
- Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyedeh Najibeh Nasiri
- Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Mehraban
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Brighton, Sussex, UK
| | - Mikhail Ryzhikov
- Division of Pulmonary and Critical Care Medicine, Washington University, School of Medicine, Saint Louis, Missouri
| | - Mohieddin Jafari
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Majid Khazaei
- Department of Medical Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Seyed Mahdi Hassanian
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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15
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Kao CW, Tseng YY, Liu KS, Liu YW, Chen JC, He HL, Kau YC, Liu SJ. Anesthetics and human epidermal growth factor incorporated into anti-adhesive nanofibers provide sustained pain relief and promote healing of surgical wounds. Int J Nanomedicine 2019; 14:4007-4016. [PMID: 31213812 PMCID: PMC6549740 DOI: 10.2147/ijn.s202402] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/11/2019] [Indexed: 12/16/2022] Open
Abstract
Background: This study exploited sheath-core-structured lidocaine/human EGF (hEGF)-loaded anti-adhesive poly[(d,l)-lactide-co-glycolide] (PLGA) nanofibrous films for surgical wounds via a co-axial electrospinning technique. Materials and methods: After spinning, the properties of the co-axially spun membranes were characterized by scanning electron microscopy, laser-scanning confocal microscopy, Fourier Transform Infrared spectrometry, water contact angle measurements, and tensile tests. Furthermore, a HPLC analysis and an ELISA evaluated the in vitro and in vivo release curves of lidocaine and hEGF from the films. Results: PLGA anti-adhesion nanofibers eluted high levels of lidocaine and hEGF for over 32 and 27 days, respectively, in vitro. The in vivo evaluation of post-surgery recovery in a rat model demonstrated that no adhesion was noticed in tissues at 2 weeks after surgery illustrating the anti-adhesive performance of the sheath-core-structured nanofibers. Nanofibrous films effectively released lidocaine and hEGF for >2 weeks in vivo. In addition, rats implanted with the lidocaine/hEGF nanofibrous membranes exhibited greater activities than the control demonstrating the pain relief efficacy of the films. Conclusion: The empirical outcomes suggested that the anti-adhesive nanofibrous films with extended release of lidocaine and hEGF offer post-operative pain relief and wound healing.
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Affiliation(s)
- Ching-Wei Kao
- Department of Anesthesiology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Yuan-Yun Tseng
- Division of Neurosurgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Sheng Liu
- Department of Thoracic and Cardiovascular Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yen-Wei Liu
- Department of Thoracic and Cardiovascular Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jin-Chung Chen
- Graduate Institute of Biomedical Science, Chang Gung University, Taoyuan, Taiwan
| | - Hong-Lin He
- Department of Pathology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Yi-Chuan Kau
- Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Jung Liu
- Department of Mechanical Engineering, Chang Gung University, Taoyuan, Taiwan.,Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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16
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Pharmacological Mobilization and Recruitment of Stem Cells in Rats Stops Abdominal Adhesions After Laparotomy. Sci Rep 2019; 9:7149. [PMID: 31073167 PMCID: PMC6509124 DOI: 10.1038/s41598-019-43734-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/25/2019] [Indexed: 12/12/2022] Open
Abstract
Adhesions are a very common complication in the abdominal surgery. Animal studies and human trials have evaluated strategies designed to reduce and prevent postsurgical adhesions but few have an evidence base that justifies routine use. A strategy to prevent adhesions effectively remains an urgent need. We studied a reproducible model of intra-peritoneal adhesion formation in rats using laparotomy with several peritoneal sutures to produce the adhesions. Here we show that entraining endogenous stem cells into injury sites using the combined effect of AMD3100 and low-dose FK-506 (AF) can reduce the adhesion score significantly and abolish peritoneal adhesions in 45% of animals in a rat model of severe postsurgical intra-abdominal adhesions, compared with saline controls. Searching for mechanisms, we found AF treatment dramatically increased SDF-1 expressing cells, HGF expressing Ym1+ M2 macrophages and CD133+ stem cells in the injury sites of peritoneal surface at day 5 post-operation. Our results demonstrate that medically induced recruitment of autologous stem cells using AF significantly reduced postsurgical intra-abdominal adhesions. These findings suggest a novel effective therapeutic approach to preventing adhesions in patients.
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17
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Sultana T, Van Hai H, Abueva C, Kang HJ, Lee SY, Lee BT. TEMPO oxidized nano-cellulose containing thermo-responsive injectable hydrogel for post-surgical peritoneal tissue adhesion prevention. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 102:12-21. [PMID: 31146982 DOI: 10.1016/j.msec.2019.03.110] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 12/13/2022]
Abstract
The objective of this study was to present an effective injectable adhesion barrier comprised of TEMPO-oxidized cellulose nanofiber (TOCN), methyl cellulose, carboxymethyl cellulose, and polyethylene glycol. Hydrogels with different concentrations (0.2, 0.5, 0.8, 1% w/v) of bio compatible TOCN were investigated to determine their abilities to prevent post-surgical peritoneal adhesion using a rat cecal wall abrasion model. Sol-gel transition at body temperature (37 °C) was optimized by adjusting concentration of sodium ions (Na+), with a gelation time of 45 ± 7 s. These TOCN containing hydrogels showed non cytotoxicity to rat bone marrow mesenchymal stem cells (RBMSCs) and L929 fibroblast cells as cell models during in vitro assessment. Degradation studies revealed that, TOCN concentration in hydrogel was inversely proportional to hydrolytic degradation rate. From in vivo evaluations, TOCN 0.2 hydrogel significantly reduced peritoneal adhesion in rat (n = 8) compared to untreated controls based on gross observation, histological analysis, and expression analysis of marker proteins. By taking advantages of thermo gelling, high stability, non-invasive way of application and rapid recovery potential, TOCN containing bio compatible hydrogel could be used as a cost-effective barrier to efficiently inhibit post-surgical peritoneal adhesions.
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Affiliation(s)
- Tamanna Sultana
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea
| | - Ho Van Hai
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea
| | - Celine Abueva
- Institute of Tissue Regeneration, Soonchunhyang University, Cheonan 31151, Republic of Korea
| | - Hoe Jin Kang
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea
| | - Sun-Young Lee
- Division of Environmental Material Engineering, Department of Forest Products, Korea Forest Research Institute, Seoul, Republic of Korea
| | - Byong-Taek Lee
- Department of Regenerative Medicine, College of Medicine, Soonchunhyang University, Cheonan 31151, Republic of Korea; Institute of Tissue Regeneration, Soonchunhyang University, Cheonan 31151, Republic of Korea.
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18
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Logun MT, Dowling MB, Raghavan SR, Wallace ML, Schmiedt C, Stice S, Karumbaiah L. Expanding Hydrophobically Modified Chitosan Foam for Internal Surgical Hemostasis: Safety Evaluation in a Murine Model. J Surg Res 2019; 239:269-277. [PMID: 30884383 DOI: 10.1016/j.jss.2019.01.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 12/19/2018] [Accepted: 01/25/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND A novel injectable expanding foam based on hydrophobically modified chitosan (HM-CS) was developed to improve hemostasis during surgeries. HM-CS is an amphiphilic derivative of the natural biopolymer chitosan (CS); HM-CS has been shown to improve the natural hemostatic characteristics of CS, but its internal safety has not been systematically evaluated. The goal of this study was to compare the long-term in vivo safety of HM-CS relative to a commonly used fibrin sealant (FS), TISSEEL (Baxter). METHODS Sixty-four Sprague-Dawley rats (275-325 g obtained from Charles River Laboratories) were randomly assigned to control (n = 16) or experimental (n = 48) groups. Samples of the test materials (HM-CS [n = 16], CS [n = 16], and FS [n = 16]) applied to a nonlethal liver excision (0.4 ± 0.3 g of the medial lobe) in rats were left inside the abdomen to degrade. Animals were observed daily for signs of morbidity and mortality. Surviving animals were sacrificed at 1 and 6 wk; the explanted injury sites were microscopically assessed. RESULTS All animals (64/64) survived both the 1- and 6-wk time points without signs of morbidity. Histological examination showed a comparable pattern of degradation for the various test materials. FS remnants and significant adhesions to neighboring tissues were observed at 6 wk. Residual CS and HM-CS were observed at the 6 wk with fatty deposits at the site of injury. Minimal adhesions were observed for CS and HM-CS. CONCLUSIONS The internal safety observed in the HM-CS test group after abdominal implantation indicates that injectable HM-CS expanding foam may be an appropriate internal use hemostatic candidate.
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Affiliation(s)
- Meghan T Logun
- Regenerative Bioscience Center, University of Georgia, Athens, Georgia
| | | | - Srinivasa R Raghavan
- Department of Chemical and Biomolecular Engineering, University of Maryland, College Park, Maryland
| | - Mandy L Wallace
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Chad Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Steven Stice
- Regenerative Bioscience Center, University of Georgia, Athens, Georgia
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19
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Wang YC, Bai MY, Hsu WY, Yu MH. Evaluation of a series of silk fibroin protein-based nonwoven mats for use as an anti-adhesion patch for wound management in robotic surgery. J Biomed Mater Res A 2017; 106:221-230. [PMID: 28884506 DOI: 10.1002/jbm.a.36225] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/21/2017] [Accepted: 07/28/2017] [Indexed: 11/08/2022]
Abstract
A novel anti-adhesion nonwoven mat mainly composed of silk fibroin protein (SFP) was fabricated via the single-spinneret electrospinning technique. A series of SFP-based electrospun nonwoven mats containing additives of different synthetic polymer ratios, such as pure SFP, SFP/poly(vinyl alcohol) (PVA), SFP/polyethylene glycol (PEG), and SFP/polyethylene oxide (PEO) were produced and compared. All membranes were porous and had diameters of 324.02 ± 113.7, 308.86 ± 74.02, 366.22 ± 115.81, and 341.82 ± 119.42 nm, respectively. The average pore size for each membrane was 1.132 ± 0.99, 0.811 ± 0.424, 0.975 ± 0.741, and 0.784 ± 0.497 μm2 . No nonwoven mats showed significant cytotoxicity toward fibroblast cells based on the results of MTT assays. Surprisingly, for all groups of SFP-based nonwoven mats, nitrate formation was reduced by up to 94.55 ± 14.50%, 92.16 ± 19.38%, 91.28 ± 28.375%, and 92.00 ± 12.64% in lipopolysaccharide-induced RAW 264.7 macrophages model. Tissue anti-adhesion potential was evaluated in an in vitro fibroblast cell adhesion model and in vivo wounded mice model. In vitro, the mean cell anti-adhesion percentage of fibroblast cells changed over time in the following order: PVA/SFP > SFP > PEG/SFP∼PEO/SFP. In vivo, SFP and PVA/SFP-treated groups both showed superior collagen regeneration and wound closure. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 221-230, 2018.
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Affiliation(s)
- Yu-Chi Wang
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, City, Taiwan
| | - Meng-Yi Bai
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan (Republic of China).,Adjunct appointment to the Department of Biomedical Engineering, National Defense Medical Center, Taipei, 114, Taiwan (Republic of China)
| | - Wan-Yuan Hsu
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan (Republic of China)
| | - Mu-Hsien Yu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, City, Taiwan
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20
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Miyamoto H, Tsujimoto H, Horii T, Ozamoto Y, Ueda J, Takagi T, Saitoh N, Hagiwara A. The influences of a novel anti-adhesion device, thermally cross-linked gelatin film on peritoneal dissemination of tumor cells: The in vitro and in vivo experiments using murine carcinomatous peritonitis models. J Biomed Mater Res B Appl Biomater 2017; 106:2122-2130. [PMID: 29024447 DOI: 10.1002/jbm.b.34017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 08/16/2017] [Accepted: 09/24/2017] [Indexed: 11/07/2022]
Abstract
To create anti-adhesive materials to be more effective and safer, we developed a thermally cross-linked gelatin film that showed superior anti-adhesive effects with excellent peritoneal regeneration. However, it may act as a convenient scaffold for tumor cell growth, thereby accelerating peritoneal dissemination when used in surgery for abdominal tumors. In this study, we tried to clarify this issue using mouse carcinomatous peritonitis models. First, we examined the in vitro tumor cell growth of mouse B16 melanoma or Colon26 cells on the gelatin film or the conventional hyarulonate/carboxymethylcellulose film. Tumor cell growth on each film was significantly lower than that of the control (no film). Next, we conducted the following in vivo experiments: After the parietal peritoneum was partially removed and covered with each film or without any film, mice were inoculated intraperitoneally with B16 melanoma or Colon26/Nluc cells expressing NanoLuc luciferase gene. At 7 days after the operation, we measured the weight of B16 melanoma tumors or the NanoLuc activity of Colon26/Nluc cells using in vivo imaging at the injured sites. There were no significant differences in the weight of the tumors and the NanoLuc activity among the three groups. We also observed the survival time of mice receiving the same operation and treatments. There was no significant difference in the survival time among the three groups. These results suggest that the gelatin film will likely not accelerate peritoneal dissemination as a convenient scaffold for tumor cell growth when used in surgery for abdominal tumors. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2122-2130, 2018.
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Affiliation(s)
- Hiroe Miyamoto
- Department of Medical Life Systems, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Kyoto, Japan
| | - Hiroyuki Tsujimoto
- Department of Medical Life Systems, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Kyoto, Japan
| | - Tsunehito Horii
- Department of Medical Life Systems, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Kyoto, Japan
| | | | - Joe Ueda
- Kainan Hospital, Yatomi, Aichi, Japan
| | - Toshitaka Takagi
- Department of Medical Life Systems, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Kyoto, Japan
| | - Naoto Saitoh
- Department of Medical Life Systems, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Kyoto, Japan
| | - Akeo Hagiwara
- Department of Medical Life Systems, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Kyoto, Japan
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Li J, Ren G, Zhang W. Reduction of Abdominal Adhesions with Elecrospun Fiber Membranes in Rat Models. J INVEST SURG 2017; 31:210-217. [PMID: 28402690 DOI: 10.1080/08941939.2017.1310961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Junsheng Li
- Department of General Surgery, Affiliated ZhongDa Hospital, Southeast University, Nanjing, P.R. China
| | - Guanghui Ren
- Department of General Surgery, Nanjing 2nd Hospital, Southeast University, Nanjing, P.R. China
| | - Weiyu Zhang
- Department of General Surgery, Affiliated ZhongDa Hospital, Southeast University, Nanjing, P.R. China
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Effectiveness of sodium hyaluronate (Protad) application in endoscopic endonasal dacryocystorhinostomy. Can J Ophthalmol 2017; 52:192-197. [DOI: 10.1016/j.jcjo.2016.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 07/25/2016] [Accepted: 08/15/2016] [Indexed: 11/22/2022]
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Makay O, Isik D, Erol V, Yenisey C, Kose T, Icoz G, Ertan Y, Ozutemiz O, Akyildiz M. Efficacy of simvastatin in reducing postoperative adhesions after thyroidectomy: an experimental study. Acta Chir Belg 2017; 117:77-83. [PMID: 27735220 DOI: 10.1080/00015458.2016.1242292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND We aimed to investigate whether simvastatin had any impact on the prevention of adhesion formation after thyroidectomy in a rat model. METHODS This study was performed in 66 Wistar albino rats randomized into three experimental groups. A right hemithyroidectomy was carried out in all the rats. Simvastatin was administered locally at a dose of 0.5 mg/kg and 0.8 mg/kg. Control rats received a saline solution only. Changes during the 1st week, 1st month and 3rd month were evaluated. Efficacy of the treatment was assessed by using a scoring system. RESULTS The severity of adhesions in low-dose simvastatin group was significantly less than the control and high-dose groups during the 1st and 3rd month (p < .05). In addition, adhesions were less in the high dose group during the 3rd month, when compared to the control group (p < .05). Moreover, fibrosis and fibroblast scores, which represent adhesions, were significantly lower in low-dose and high-dose groups at 3rd month, compared to controls (p < .05). CONCLUSIONS We investigated the influence of simvastatin application on post-thyroidectomy adhesion formation in rats. Whether adhesions, causing technical difficulties during neck redo surgery, can be reduced by the use of simvastatin in human, needs to be studied.
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Affiliation(s)
- Ozer Makay
- Department of General Surgery, School of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Dilek Isik
- Department of General Surgery, School of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Varlik Erol
- Department of General Surgery, Zubeyde Hanim Practice and Research Center, Baskent University, Izmir, Turkey
| | - Cigdem Yenisey
- Department of Biochemistry, School of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Timur Kose
- Department of Biostatistics, School of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Gokhan Icoz
- Department of General Surgery, School of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Yesim Ertan
- Department of Pathology, School of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Omer Ozutemiz
- Department of Gastroenterology, School of Medicine, Ege University, Bornova, Izmir, Turkey
| | - Mahir Akyildiz
- Department of General Surgery, School of Medicine, Ege University, Bornova, Izmir, Turkey
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Horii T, Tsujimoto H, Miyamoto H, Yamanaka K, Tanaka S, Torii H, Ozamoto Y, Takamori H, Nakamachi E, Ikada Y, Hagiwara A. Physical and biological properties of a novel anti-adhesion material made of thermally cross-linked gelatin film: Investigation of the usefulness as anti-adhesion material. J Biomed Mater Res B Appl Biomater 2017; 106:689-696. [DOI: 10.1002/jbm.b.33880] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 02/01/2017] [Accepted: 02/28/2017] [Indexed: 01/10/2023]
Affiliation(s)
- Tsunehito Horii
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Hiroyuki Tsujimoto
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Hiroe Miyamoto
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Koki Yamanaka
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Shota Tanaka
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Hiroko Torii
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Yuki Ozamoto
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Hideki Takamori
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Eiji Nakamachi
- Division of Biomedical Engineering, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Yoshito Ikada
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
| | - Akeo Hagiwara
- Division of Medical Life System, Department of Life and Medical Science; Doshisha University; Kyotanabe Kyoto 610-0394 Japan
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Güney G, Kaya C, Oto G, Yıldırım S, Özdemir H, Tokmak A. Effects of quercetin and surgicel for preventing adhesions after gynecological surgery: A rat uterine horn model. J Obstet Gynaecol Res 2016; 43:179-184. [PMID: 27943594 DOI: 10.1111/jog.13185] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/23/2016] [Indexed: 11/28/2022]
Abstract
AIM Postoperative pelvic adhesions are significant health care problems causing chronic pelvic pain, infertility and intestinal obstruction after abdominal or pelvic surgery. We investigated the effects of quercetin and Surgicel for the prevention of adhesions after gynecological surgery. METHODS A double blind, randomized, controlled experimental study was designed. Forty female Wistar Hannover rats were divided into five groups: control, sham operated, quercetin, Surgicel, and quercetin + Surgicel. The control group received medication used for the surgical procedure only. The sham group received a laparotomy only. The quercetin group received 15 mg/kg quercetin in addition to undergoing the standard surgical procedure, and the injuries in the surgical group were covered with a single, 1 cm2 layer of Surgicel (oxidized regenerated cellulose). The quercetin + Surgicel group received both 15 mg/kg quercetin and a single, 1 cm2 layer of Surgicel. Adhesions were scored 14 days after the first surgical procedure. RESULTS The extent, severity, degree, total adhesion, inflammation and fibrosis scores of the control group were significantly higher than those of the quercetin, Surgicel, and quercetin + Surgicel groups. There was no significant difference between the Surgicel and quercetin groups in degree, but all other parameters were significantly higher in the Surgicel than in the quercetin group. The quercetin + Surgicel group had lower adhesion scores than the quercetin group. CONCLUSIONS Quercetin, Surgicel and quercetin + Surgicel treatment may be useful for preventing pelvic adhesions.
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Affiliation(s)
- Gürhan Güney
- Department of Obstetrics and Gynecology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Cihan Kaya
- Department of Obstetrics and Gynecology, Bakırköy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gökhan Oto
- Department of Pharmacology, Yuzuncu Yıl University, Faculty of Medicine, Van, Turkey
| | - Serkan Yıldırım
- Department of Pathology, Ataturk University, Faculty of Veterinary Medicine, Erzurum, Turkey
| | - Hülya Özdemir
- Department of Pharmacology, Yuzuncu Yıl University, Faculty of Medicine, Van, Turkey
| | - Aytekin Tokmak
- Zekai Tahir Burak Training and Research Hospital, Ankara, Turkey
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Osawa H, Nishimura J, Hiraki M, Takahashi H, Haraguchi N, Hata T, Ikenaga M, Murata K, Yamamoto H, Mizushima T, Doki Y, Mori M. Regeneration of peritoneal mesothelial cells after placement of hyaluronate carboxymethyl-cellulose (Seprafilm ®). Surg Today 2016; 47:130-136. [PMID: 27167879 DOI: 10.1007/s00595-016-1350-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 03/29/2016] [Indexed: 01/16/2023]
Abstract
PURPOSE To examine the regeneration of mesothelium under a bioresorbable membrane. METHODS A 1 cm2 piece of peritoneum was resected from both sides of the abdominal wall of retired female mice. A piece of hyaluronate and carboxymethyl-cellulose (Seprafilm®) was placed over the wound on one side and the other side was left uncovered. We evaluated the degree of adhesion and regeneration of mesothelial cells macroscopically and histologically using immunohistochemistry at different times. RESULTS Macroscopically, the degree of postoperative adhesion in the treated site was significantly less than that in the untreated site. The membrane was left in place for 7 postoperative days (PODs). By POD 5, the regenerated peritoneum mesothelial cells covered part of the area and by POD 7, they had regenerated over almost all of that area in the abdominal wall. CONCLUSION The anti-adhesion membrane worked as a physical barrier to prevent postoperative adhesion until the mesothelial cells had regenerated completely. To our knowledge, this is the first study conducted to assess the regeneration of peritoneum mesothelial cells under a bioresorbable membrane using immunohistochemistry.
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Affiliation(s)
- Hideki Osawa
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
| | - Junichi Nishimura
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan.
| | - Masayuki Hiraki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
| | - Hidekazu Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
| | - Naotsugu Haraguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
| | - Taishi Hata
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
| | - Masakazu Ikenaga
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan.,Department of Surgery, Higashiosaka City General Hospital, 3-4-5, Nishiiwata, Higashiosaka, 578-8588, Osaka, Japan
| | - Kohei Murata
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan.,Department of Surgery, Suita Municipal Hospital, 2-13-20 Katayama-cho, Suita, 564-0082, Osaka, Japan
| | - Hirofumi Yamamoto
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
| | - Tsunekazu Mizushima
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
| | - Masaki Mori
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, E2-2-2 Yamada-oka, Suita, 565-0871, Osaka, Japan
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Ren C, Zhao D, Zhu L. Use of N,O-carboxymethyl chitosan to prevent postsurgical adhesions in a rabbit double uterine horn model: a randomized controlled design. SCIENCE CHINA-LIFE SCIENCES 2016; 59:504-9. [DOI: 10.1007/s11427-016-5019-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/01/2015] [Indexed: 12/21/2022]
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Sheu C, Shalumon KT, Chen CH, Kuo CY, Fong YT, Chen JP. Dual crosslinked hyaluronic acid nanofibrous membranes for prolonged prevention of post-surgical peritoneal adhesion. J Mater Chem B 2016; 4:6680-6693. [DOI: 10.1039/c6tb01376g] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A HA NFM crosslinked with FeCl3and BDDE shows prolonged degradation to prevent peritoneal adhesion.
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Affiliation(s)
- Chialin Sheu
- Department of Chemical and Materials Engineering
- Chang Gung University
- Taoyuan 33302
- Republic of China
| | - K. T. Shalumon
- Department of Chemical and Materials Engineering
- Chang Gung University
- Taoyuan 33302
- Republic of China
| | - Chih-Hao Chen
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
- Chang Gung Memorial Hospital
- Taoyuan 33305
- Republic of China
| | - Chang-Yi Kuo
- Department of Chemical and Materials Engineering
- Chang Gung University
- Taoyuan 33302
- Republic of China
| | - Yi Teng Fong
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
- Chang Gung Memorial Hospital
- Taoyuan 33305
- Republic of China
| | - Jyh-Ping Chen
- Department of Chemical and Materials Engineering
- Chang Gung University
- Taoyuan 33302
- Republic of China
- Department of Plastic and Reconstructive Surgery and Craniofacial Research Center
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Poehnert D, Abbas M, Kreipe HH, Klempnauer J, Winny M. Evaluation of 4DryField® PH as Adhesion Prevention Barrier Tested in an Optimized Adhesion Model in Rats. Eur Surg Res 2015; 55:341-351. [PMID: 26505616 DOI: 10.1159/000441025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 09/10/2015] [Indexed: 12/08/2022]
Abstract
BACKGROUND Adhesions due to pelvic/abdominal surgery are a common serious pathology possibly entailing severe complications. This study investigates the adhesion prevention capability of the novel starch-based agent 4DryField® PH, which together with saline solution forms a barrier gel. Herein, an optimized adhesion model (OPAM) inducing severe adhesions/agglutinations with high reproducibility was used. METHODS In 19 Lewis rats, a 1 × 2 cm abdominal wall defect was created, the peritoneum of the neighboring cecum was abraded, and both injured areas were approximated by suture. Rats were randomized to control (n = 10) or 4DryField PH treatment (n = 9) groups. Another 8 rats had sham surgery for safety assessment of 4DryField PH. At day 7, the quantity and quality of adhesions were assessed macro-/microscopically and evaluated statistically. RESULTS 4DryField PH treatment significantly reduced the incidence and severity of adhesions as verified by significantly improved adhesion scorings (0.4 vs. 4.5; 1.1 vs. 9). Histology revealed reconstitution of the cecum and abdominal wall including regeneration of the visceral/parietal peritoneum. In sham-operated rats, 4DryField PH did not induce adhesion formation. CONCLUSIONS 4DryField PH gel was highly effective in preventing adhesions. Histologically, the injured cecum and abdominal wall regenerated well in the presence of 4DryField PH. Considering the severity of OPAM trauma, the potential of 4DryField PH to prevent adhesions can be rated excellent.
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Affiliation(s)
- Daniel Poehnert
- Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany
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Intraperitoneal application of phospholipids for the prevention of postoperative adhesions: a possible role of myofibroblasts. J Surg Res 2015; 197:291-300. [DOI: 10.1016/j.jss.2015.04.036] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 04/03/2015] [Accepted: 04/09/2015] [Indexed: 12/20/2022]
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Trabeculectomy with Healaflow versus Trabeculectomy for the Treatment of Glaucoma: A Case-Control Study. J Ophthalmol 2015; 2015:836269. [PMID: 26171243 PMCID: PMC4480810 DOI: 10.1155/2015/836269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/03/2015] [Accepted: 05/25/2015] [Indexed: 12/19/2022] Open
Abstract
Purpose. To compare the outcomes of trabeculectomy with and without Healaflow (Anteis S.A, Geneva, Switzerland), a high molecular weight viscoelastic gel, in patients requiring glaucoma surgery. Methods. This was a retrospective, comparative, interventional case-control study. Forty patients formed two matched study groups and were analyzed (trabeculectomy alone (control) versus trabeculectomy with Healaflow (study)). Results. The postoperative levels of mean IOP were statistically significantly lower (P < 0.05) than preoperatively in both groups, for all time intervals. There was no statistical difference, at the end of the follow-up period, between the two groups in the mean values of the IOP (14.9 ± 3.2 mmHg for the study group versus 14.8 ± 3.3 mmHg for the control group). The number of antiglaucoma drugs used in the study group was reduced from a preoperative mean of 3.4 ± 0.75 to a 6-month postoperative mean of 0.6 ± 0.8 (P < 0.001) and in the control group from 3.6 ± 0.59 to 0.55 ± 0.9 (P < 0.001). Conclusions. Although trabeculectomy with Healaflow appears to be a safe procedure, we failed to identify any significant advantages in the use of Healaflow when compared with trabeculectomy alone, at the end of the 6-month follow-up period.
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Tolerance and long-term MRI imaging of gadolinium-modified meshes used in soft organ repair. PLoS One 2015; 10:e0120218. [PMID: 25811855 PMCID: PMC4374942 DOI: 10.1371/journal.pone.0120218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/20/2015] [Indexed: 11/19/2022] Open
Abstract
Background Synthetic meshes are frequently used to reinforce soft tissues. The aim of this translational study is to evaluate tolerance and long-term MRI visibility of two recently developed Gadolinium-modified meshes in a rat animal model. Materials and Methods Gadolinium-poly-ε-caprolactone (Gd-PCL) and Gadolinium-polymethylacrylate (Gd-PMA) modified meshes were implanted in Wistar rats and their tolerance was assessed daily. Inflammation and biocompatibility of the implants were assessed by histology and immunohistochemistry after 30 days post implantation. Implants were visualised by 7T and 3T MRI at day 30 and at day 90. Diffusion of Gadolinium in the tissues of the implanted animals was assessed by Inductively Coupled Plasma Mass Spectrometry. Results Overall Gd-PMA coated implants were better tolerated as compared to those coated with Gd-PCL. In fact, Gd-PMA implants were characterised by a high ratio collagen I/III and good vascularisation of the integration tissues. High resolution images of the coated mesh were obtained in vivo with experimental 7T as well as 3T clinical MRI. Mass spectrometry analyses showed that levels of Gadolinium in animals implanted with coated mesh were similar to those of the control group. Conclusions Meshes coated with Gd-PMA are better tolerated as compared to those coated with Gd-PCL as no signs of erosion or significant inflammation were detected at 30 days post implantation. Also, Gd-PMA coated meshes were clearly visualised with both 7T and 3T MRI devices. This new technique of mesh optimisation may represent a valuable tool in soft tissue repair and management.
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Spontaneous fractures in custom-made porous hydroxyapatite cranioplasty implants: is fragility the only culprit? Acta Neurochir (Wien) 2015; 157:517-23. [PMID: 25588747 DOI: 10.1007/s00701-014-2319-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 12/17/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Although the porous hydroxyapatite (PHA) used in custom-made cranioplasty implants is a material appreciated for its biomimetic properties, before osteointegration it is initially very fragile. Nevertheless, we wondered whether this primary fragility is entirely due to brittleness or whether the surgeon's actions may influence the behavior of the material. METHODS To study the influence of the surgeon's behavior, we made a virtual model of a custom-made PHA cranioplasty implant and submitted it to three implant procedural variables using finite element methods. In the first test, a scenario in which the surgeon's design, validation, and positioning techniques are impeccable, the edges of the implant adhered well to the craniectomy margins. In the second test, a discrepancy between a portion of the perimeter of the craniectomy and the profile of the prosthesis was modeled, and in the third test, several gaps were simulated between the implant and the craniectomy margins. RESULTS Our mathematical model showed that when local and general discontinuities were included in the test scenarios, there was an increase in the load coming to bear on the cranioplasty implant, which amounted to 80 and 50 %, respectively. CONCLUSIONS The fragility of custom-made PHA cranioplasty implants increases if the surgeon fails to achieve a precise design and validation, and/or an accurate surgical procedure. Nevertheless, careful attention during these phases helps to maintain the strength of the implant, given the more favorable mechanical conditions, without interfering with its biomimetic capacity.
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Coelho Junior ER, Costa LOBF, Alencar AV, Barbosa APG, Pinto FCM, Aguiar JLDA. Prevention of peritoneal adhesion using a bacterial cellulose hydrogel, in experimental study. Acta Cir Bras 2015; 30:194-8. [DOI: 10.1590/s0102-865020150030000005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/16/2015] [Indexed: 11/21/2022] Open
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Intraperitoneal administration of activated protein C prevents postsurgical adhesion band formation. Blood 2015; 125:1339-48. [PMID: 25575539 DOI: 10.1182/blood-2014-10-609339] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Postsurgical peritoneal adhesion bands are the most important causes of intestinal obstruction, pelvic pain, and female infertility. In this study, we used a mouse model of adhesion and compared the protective effect of activated protein C (APC) to that of the Food and Drug Administration-approved antiadhesion agent, sodium hyaluronate/carboxymethylcellulose (Seprafilm) by intraperitoneal administration of either APC or Seprafilm to experimental animals. Pathological adhesion bands were graded on day 7, and peritoneal fluid concentrations of tissue plasminogen activator (tPA), d-dimer, thrombin-antithrombin complex, and cytokines (IL-1β, IL-6, interferon-γ, tumor necrosis factor-α, transforming growth factor-β1) were evaluated. Inflammation scores were also measured based on histologic data obtained from peritoneal tissues. Relative to Seprafilm, intraperitoneal administration of human APC led to significantly higher reduction of postsurgical adhesion bands. Moreover, a markedly lower inflammation score was obtained in the adhesive tissues of the APC-treated group, which correlated with significantly reduced peritoneal concentrations of proinflammatory cytokines and an elevated tPA level. Further studies using variants of human APC with or without protease-activated receptor 1 (PAR1) signaling function and mutant mice deficient for either endothelial protein C receptor (EPCR) or PAR1 revealed that the EPCR-dependent signaling activity of APC is primarily responsible for its protective activity in this model. These results suggest APC has therapeutic potential for preventing postsurgical adhesion bands.
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Histological analysis of the effects of anti-adhesive haemostatic agents on the middle ear of the guinea pig. The Journal of Laryngology & Otology 2014; 128:885-91. [PMID: 25264149 DOI: 10.1017/s0022215114001571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Adhesion formation is a frequent and serious post-operative problem in ENT surgery. This study assessed the effect of two anti-adhesive haemostatic agents on an experimental guinea pig model. MATERIALS AND METHODS The middle-ear mucosa of 14 guinea pigs was exposed to surgical trauma. After surgery, Arista™ AH was injected into the right middle ear of seven animals, while Ankaferd Blood Stopper was injected into the right middle ear of the other seven animals. The left ears were left untreated and regarded as the control group. The three groups were compared by histological examination at post-operative week 4. RESULTS In each of the three groups, consolidation of the lamina propria and epithelium mucosae, increments in the number of active fibroblasts, collagen fibrils and inflammatory cells, and increased vascular dilation were observed on haematoxylin and eosin-stained sections, and were more prominent in the control and Ankaferd Blood Stopper groups. Epithelial thickness and capillary vasodilation were significantly lower in the Arista™ AH group compared with the control and Ankaferd Blood Stopper groups (p < 0.008). CONCLUSION Arista™ AH may prevent the formation of adhesions in middle-ear surgery. Further experimental studies are required to determine its ototoxic potential.
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Kawai H, Nakagawa I, Nishimura F, Motoyama Y, Park YS, Nakamura M, Nakase H, Suzuki S, Ikada Y. Usefulness of a new gelatin glue sealant system for dural closure in a rat durotomy model. Neurol Med Chir (Tokyo) 2014; 54:640-6. [PMID: 25070015 PMCID: PMC4533497 DOI: 10.2176/nmc.oa.2014-0005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Watertight dural closure is imperative after neurosurgical procedures, because inadequately treated leakage of cerebrospinal fluid (CSF) can have serious consequences. We used a rat durotomy model to test the usefulness of a new gelatin glue as a dural sealant in a rat model of transdural CSF leakage. All rats were randomly divided into one of the following three treatment groups: no application (control group: N = 18), application of fibrin glue (fibrin glue group: N = 18), and application of the new gelatin glue (new gelatin glue group: N = 18). The craniotomy side was re-opened, and CSF leakage was checked and recorded at 1, 7, and 28 days postoperatively. The new gelatin glue was adequate for stopping CSF leakage; no leakage was observed at postoperative days 1 or 7, and leakage was observed in only one rat at postoperative day 28. This result was statistically significant when compared to the control group (P = 0.002, P = 0.015, P = 0.015, respectively). The pathologic score of the new gelatin group was not different from that of the control or fibrin glue groups. We conclude that our new gelatin glue provides effective watertight closure 1, 7, and 28 days after operation in the rat durotomy model.
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Karatas A, Ozlu T, Ozyalvacli G, Tosun M, Cetinkaya A, Donmez ME, Turker A, Bayrakdar H. Intraperitoneal Nigella sativa for prevention of postoperative intra-abdominal adhesions in rats. J INVEST SURG 2014; 27:319-26. [PMID: 24833552 DOI: 10.3109/08941939.2014.908988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate intraperitoneal administration of Nigella sativa (NS) to prevent postoperative intraperitoneal adhesion (PPA) after surgical manipulation of rat uterine horn. MATERIALS AND METHODS Two forms of NS were used in the study (Volatile oil (NSVO) and the ethanolic extract (NSEE)). A total of 50 rats were randomly assigned to the sham group (n = 10), control group (n = 10), NSVO group (n = 10), NSEE group (n = 10), and the Seprafilm group(n = 10). After 14 days, rats were sacrificed. Adhesions were examined macroscopically, and degree of adhesions was scored. A part of horn was excised, and superoxide dismutase (SOD) and glutathione peroxidase activities as well as malondialdehyde levels were evaluated, and histological score was calculated. RESULTS Total microscopic score of the NSEE group was significantly lower than the control group (p = .001) and was marginally significantly lower than the seprafilm group (p = .005). Collagen formation score was higher in the seprafilm group compared to the sham and NSEE groups (p < 0.001, p = .003, respectively). Apoptotic cells were lower in the NSEE group compared to the control group (p = .003) and also lower in the NSEE and NSVO groups compared to the seprafilm group (p = .001, p < .001, respectively). Only SOD activity was higher in the NSVO and seprafilm groups compared to the control group (p < .001). CONCLUSION NSEE form seems to have a possible effect in the prevention of PPAs. This may occur by its effect in decreasing collagen formation and by decreasing apoptosis in the injured tissues. NSVO form seems to induce SOD. Therefore, combined use of NSVO with seprafilm may increase the adhesion preventive effect of seprafilm.
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Affiliation(s)
- Ahmet Karatas
- 1Department of Obstetrics and Gynecology, Abant Izzet Baysal University Medical School, Bolu, Turkey
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Hızlı D, Hızlı F, Köşüş A, Yılmaz S, Köşüş N, Haltaş H, Dede H, Kafalı H. Effect of Hypericum perforatum on intraperitoneal adhesion formation in rats. Arch Med Sci 2014; 10:396-400. [PMID: 24904678 PMCID: PMC4042034 DOI: 10.5114/aoms.2013.33070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 09/19/2012] [Accepted: 11/29/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the efficacy of Hypericum perforatum for prevention of adhesion formation in rats. MATERIAL AND METHODS Twenty-four female wistar rats underwent left uterine horn adhesion model. Rats were randomised into 4 groups. Group 1 (Control): Closure of abdominal incision without any agent administration. Group 2: Closure of incision after administration of intraperitoneal (i.p.) Ringer's lactate solution. Group 3: Closure of incision after administration of i.p. olive oil (diluent of H. perforatum). Group 4: Hypericum perforatum extract (Ecodab(®)) was administered i.p. before the closure of incision. Fourteen days later, relaparatomy was performed and surgical adhesion scores, inflammation and fibrosis scores were noted. Groups were compared according to these scores. RESULTS There was statistical significant difference between ringer's lactate group and olive oil group according to surgical adhesion score (p = 0.009). However, groups were not different according to inflammation and fibrosis scores (p > 0.05). CONCLUSIONS Despite antiinflammatory, antioxidants and antimicrobial properties of H. perforatum, our results revealed no positive effect of H. perforatum on the prevention of intraperitoneal adhesion formation.
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Affiliation(s)
- Deniz Hızlı
- Department of Obstetrics and Gynecology, Fatih University Faculty of Medicine, Ankara, Turkey
| | - Fatih Hızlı
- Department of Urology, Oncology Training and Research Hospital, Ankara, Turkey
| | - Aydın Köşüş
- Department of Obstetrics and Gynecology, Fatih University Faculty of Medicine, Ankara, Turkey
| | - Saynur Yılmaz
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health and Education Hospital, Ankara, Turkey
| | - Nermin Köşüş
- Department of Obstetrics and Gynecology, Fatih University Faculty of Medicine, Ankara, Turkey
| | - Hacer Haltaş
- Department of Pathology, Fatih University Faculty of Medicine, Ankara, Turkey
| | - Hülya Dede
- Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health and Education Hospital, Ankara, Turkey
| | - Hasan Kafalı
- Department of Obstetrics and Gynecology, Fatih University Faculty of Medicine, Ankara, Turkey
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Kaya C, Sever N, Cengiz H, Yıldız Ş, Ekin M, Yaşar L. A randomized controlled study of the efficacy of misoprostol and hyaluronic acid in preventing adhesion formation after gynecological surgery: a rat uterine horn model. Eur J Obstet Gynecol Reprod Biol 2014; 176:44-9. [DOI: 10.1016/j.ejogrb.2014.02.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Revised: 02/03/2014] [Accepted: 02/14/2014] [Indexed: 10/25/2022]
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Aristizabal FA, Lopes MA, Silva A, Avanza MF, Nieto JE. Evaluation of the Effect of Onlay Mesenteric Flaps on End-To-End Jejunojejunostomy Healing in Horses. Vet Surg 2014; 43:479-86. [DOI: 10.1111/j.1532-950x.2014.12120.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 11/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Fabio A. Aristizabal
- Departamento de Médicina Veterinária; Universidade Federal de Viçosa; Viçosa MG Brazil
| | - Marco Aurélio Lopes
- Departamento de Médicina Veterinária; Universidade Federal de Viçosa; Viçosa MG Brazil
| | - Adriana Silva
- Departamento de Médicina Veterinária; Universidade Federal de Viçosa; Viçosa MG Brazil
| | | | - Jorge E. Nieto
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine University of California-Davis; Davis California
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Wang B, Dong J, Li Q, Xiong Z, Xiong C, Chen D. Mechanism of inhibition on L929 rat fibroblasts proliferation induced by potential adhesion barrier material poly(p-dioxanone-co-l-phenylalanine) electrospun membranes. J Biomed Mater Res A 2014; 102:4062-70. [DOI: 10.1002/jbm.a.35077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 11/28/2013] [Accepted: 12/20/2013] [Indexed: 01/17/2023]
Affiliation(s)
- Bing Wang
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences; Chengdu China
- Department of Polymer Chemistry and Physics, University of Chinese Academy of Sciences; Beijing China
| | - Jun Dong
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences; Chengdu China
- Department of Polymer Chemistry and Physics, University of Chinese Academy of Sciences; Beijing China
| | - Qijie Li
- Basic Medical Colleges, Chengdu University of Traditional Chinese Medicine; Chengdu China
| | - Zuochun Xiong
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences; Chengdu China
| | - Chengdong Xiong
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences; Chengdu China
| | - Dongliang Chen
- Chengdu Institute of Organic Chemistry, Chinese Academy of Sciences; Chengdu China
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Peker K, Inal A, Sayar I, Sahin M, Gullu H, Inal DG, Isik A. Prevention of intraabdominal adhesions by local and systemic administration of immunosuppressive drugs. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:e14148. [PMID: 24693396 PMCID: PMC3955511 DOI: 10.5812/ircmj.14148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 01/14/2013] [Accepted: 05/15/2013] [Indexed: 11/21/2022]
Abstract
Background: Intraperitoneal adhesion formation is a serious postsurgical issue. Adhesions develop after damage to the peritoneum by surgery, irradiation, infection or trauma. Objectives: Using a rat model, we compared the effectiveness of systemic and intraperitoneally administered common immunosuppressive drugs for prevention of postoperative intraperitoneal adhesions. Materials and Methods: Peritoneal adhesions were induced in 98 female Wistar-Albino rats by cecal abrasion and peritoneal excision. Rats were randomly separated into seven groups, each containing fourteen rats, and the standard experimental model was applied to all of rats. 14 days later, rats were euthanized, intraperitoneal adhesions were scored and tissues were examined histologically using hematoxylin/eosin and Masson’s trichrome staining. Results: Throughout the investigation, no animal died during or after surgery. In all of experimental groups, decrease in fibrosis was statistically significant. Decrease in fibrosis was most prominently in intraperitoneal tacrolimus group (P = 0.000), and decrease was least in intraperitoneal cyclosporine group (P = 0.022). Vascular proliferation was significantly decreased in all experimental groups (P < 0.05) except for systemic tacrolimus group (P = 0.139). Most prominent reduction in vascular proliferation was in intraperitoneal tacrolimus group (P = 0.000). Conclusions: Administration of immunosuppressive drugs is effective for prevention of intraperitoneal adhesions.
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Affiliation(s)
- Kemal Peker
- Department of General Surgery, Erzincan University, Erzincan, Turkey
- Corresponding Author: Kemal Peker, Department of General Surgery, Erzincan University, Erzincan, Turkey. Tel: +90-5359368528, E-mail:
| | - Abdullah Inal
- Department of General Surgery, Erzincan University, Erzincan, Turkey
| | - Ilyas Sayar
- Department of Pathology, Erzincan University, Erzincan, Turkey
| | - Murat Sahin
- Department of Anesthesiology & Reanimation, Erzincan University, Erzincan, Turkey
| | - Huriye Gullu
- Department of Anesthesiology & Reanimation, Erzincan University, Erzincan, Turkey
| | - Duriye Gul Inal
- Department of Anesthesiology & Reanimation, Erzincan University, Erzincan, Turkey
| | - Arda Isik
- Department of General Surgery, Erzincan University, Erzincan, Turkey
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Bae SH, Son SR, Kumar Sakar S, Nguyen TH, Kim SW, Min YK, Lee BT. Evaluation of the potential anti-adhesion effect of the PVA/Gelatin membrane. J Biomed Mater Res B Appl Biomater 2013; 102:840-9. [DOI: 10.1002/jbm.b.33066] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 08/27/2013] [Accepted: 10/20/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Sang-Ho Bae
- Department of Surgery; College of Medicine; Soonchunhyang University Hospital; Cheonan Chungnam 330-090 Republic of Korea
| | - So-Ra Son
- Department of Tissue Regeneration; College of Medicine; Soonchunhyang University; Cheonan Chungnam 330-090 Republic of Korea
| | - Swapan Kumar Sakar
- Department of Tissue Regeneration; College of Medicine; Soonchunhyang University; Cheonan Chungnam 330-090 Republic of Korea
| | - Thi-Hiep Nguyen
- Department of Tissue Regeneration; College of Medicine; Soonchunhyang University; Cheonan Chungnam 330-090 Republic of Korea
| | - Shin-Woo Kim
- Department of Physiology; College of Medicine; Soonchunhyang University; Cheonan Chungnam 330-090 Republic of Korea
| | - Young-Ki Min
- Department of Physiology; College of Medicine; Soonchunhyang University; Cheonan Chungnam 330-090 Republic of Korea
| | - Byong-Taek Lee
- Department of Tissue Regeneration; College of Medicine; Soonchunhyang University; Cheonan Chungnam 330-090 Republic of Korea
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Sahbaz A, Ersan F, Aydin S. Effect of Nigella sativa
oil on postoperative peritoneal adhesion formation. J Obstet Gynaecol Res 2013; 40:532-7. [DOI: 10.1111/jog.12172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 04/26/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Ahmet Sahbaz
- School of Medicine; Department of Obstetrics and Gynecology; Bulent Ecevit University; Kozlu/Zonguldak Turkey
| | - Firat Ersan
- Department of Obstetrics and Gynecology; Kanuni Sultan Suleyman Research and Training Hospital; Istanbul Turkey
| | - Serdar Aydin
- Department of Obstetrics and Gynecology; Kanuni Sultan Suleyman Research and Training Hospital; Istanbul Turkey
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Dinarvand P, Farhadian S, Seyedjafari E, Shafiee A, Jalali A, Sanaei-rad P, Dinarvand B, Soleimani M. Novel approach to reduce postsurgical adhesions to a minimum: Administration of losartan plus atorvastatin intraperitoneally. J Surg Res 2013; 181:91-8. [DOI: 10.1016/j.jss.2012.05.035] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 05/02/2012] [Accepted: 05/09/2012] [Indexed: 12/08/2022]
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Dayton MT, Dempsey DT, Larson GM, Posner AR. New paradigms in the treatment of small bowel obstruction. Curr Probl Surg 2012; 49:642-717. [PMID: 23057861 DOI: 10.1067/j.cpsurg.2012.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Merril T Dayton
- Department of Surgery, SUNY Buffalo, Kaleida Health System, Buffalo, NY, USA
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Brochhausen C, Schmitt VH, Planck CNE, Rajab TK, Hollemann D, Tapprich C, Krämer B, Wallwiener C, Hierlemann H, Zehbe R, Planck H, Kirkpatrick CJ. Current strategies and future perspectives for intraperitoneal adhesion prevention. J Gastrointest Surg 2012; 16:1256-74. [PMID: 22297658 DOI: 10.1007/s11605-011-1819-9] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 12/28/2011] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The formation of peritoneal adhesions still is a relevant clinical problem after abdominal surgery. Until today, the most important clinical strategies for adhesion prevention are accurate surgical technique and the physical separation of traumatized serosal areas. Despite a variety of barriers which are available in clinical use, the optimal material has not yet been found. DISCUSSION Mesothelial cells play a crucial physiological role in friction less gliding of the serosa and the maintenance of anantiadhesive surface. The formation of postoperative adhesions results from a cascade of events and is regulated by various cellular and humoral factors. Therefore, optimization or functionalization of barrier materials by developments interacting with this cascade on a structural or pharmacological level could give an innovative input for future strategies in peritoneal adhesion prevention. For this purpose, the proper understanding of the formal pathogenesis of adhesion formation is essential. Based on the physiology of the serosa and the pathophysiology of adhesion formation, the available barriers in current clinical practice as well as new innovations are discussed in the present review.
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Affiliation(s)
- Christoph Brochhausen
- REPAIR-lab, Institute of Pathology, University Medical Centre, Johannes Gutenberg-University, Langenbeckstraße 1,55101 Mainz, Germany.
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Diamond MP, Burns EL, Accomando B, Mian S, Holmdahl L. Seprafilm® adhesion barrier: (1) a review of preclinical, animal, and human investigational studies. ACTA ACUST UNITED AC 2012; 9:237-245. [PMID: 22837732 PMCID: PMC3401296 DOI: 10.1007/s10397-012-0741-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 02/13/2012] [Indexed: 01/30/2023]
Abstract
The aim of this study was to provide a single site resource for investigators, clinicians, and others seeking preclinical, animal, and human investigational studies concerning the postsurgical, anti-adhesion barrier Seprafilm™ (Genzyme Corporation, Cambridge, MA). All published preclinical, animal, human extra-abdominal research as of July 2011 have been summarized and included in this document. Searches of Medline and EMBASE Drugs and Pharmaceuticals databases were conducted for original preclinical, animal, and human extra-abdominal studies involving Seprafilm. Preclinical, animal, and extra-abdominal human investigational studies are the study selection for this manuscript. Intraabdominal use is discussed in the accompanying manuscript. Data extraction includes systematic manuscript review. Summary of preclinical, animal, and extra-abdominal human investigational use of Seprafilm by surgical discipline were gathered for data synthesis. The clinical use of Seprafilm, which was approved by the FDA for intra-abdominal procedures, is supported by preclinical and animal studies relating to general surgical and obstetrical/gynecological applications. Findings from preclinical, animal, and human investigational studies at other sites throughout the body raises the potential for additional human clinical trials to assess efficacy and safety following surgical procedures at non-abdominal locations.
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Affiliation(s)
- Michael P. Diamond
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University, 60 West Hancock, Detroit, MI 48201 USA
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Dietrich A, Bouzidi M, Hartwig T, Schütz A, Jonas S. Rapamycin and a hyaluronic acid-carboxymethylcellulose membrane did not lead to reduced adhesion formations in a rat abdominal adhesion model. Arch Gynecol Obstet 2012; 285:1603-9. [DOI: 10.1007/s00404-011-2184-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Accepted: 12/14/2011] [Indexed: 11/28/2022]
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