Degree Of Adhesion Research Articles

The effectiveness of Triamcinolone Acetonide (TA) and Interleukin-6 (IL-6) levels in preventing intraperitoneal adhesion

Background: Intraperitoneal adhesions are formed due to the inflammatory response in releasing proinflammatory cytokines such as IL-6. Triamcinolone Acetonide (TA) acts as an anti-inflammatory by inhibiting the production and release of IL-6 cytokines. This study aims to determine the effectiveness of triamcinolone acetonide in preventing intraperitoneal adhesions and its effect on assessing IL-6 levels in post-exploratory laparotomy in rats.Methods: An experimental study was conducted among 40 male Wistar rats from January and March 2021 in the Animal Laboratory of Universitas Padjadjaran, Bandung, Indonesia. Blood samples were taken before treatment and on the 14th day after treatment. In rats, laparotomy and cecum abrasion were performed with a needle. Rats in the treatment group were given triamcinolone acetonide at a dose of 0.1 mg, 0.3 mg, or 0.5 mg. On the 14th day, a microscopic examination of the degree of adhesion was performed. Data were analyzed using SPSS version 20 for Windows.Results: The results of the Kruskal-Wallis test analysis on the formation of intraperitoneal adhesions microscopically showed a significant difference between the control group and the treatment group (p < 0.001) with the lowest mean rank in the TA group of 0.3 mg (11.4), which stated that this dose was more effective in preventing intraperitoneal adhesions. The One-Way ANOVA test on IL-6 examination had a significant difference in postoperative IL-6 reduction between the control and treatment groups (p < 0.001).Conclusion: Triamcinolone acetonide was effective in preventing intraperitoneal adhesions and reducing IL-6 levels in post-exploratory laparotomy rats.

From Waste to Reuse: Manufacture of Ecological Composites Based on Biopolyethylene/wood Powder with PE-g-MA and Macaíba Oil

This work aimed to investigate the biopolyethylene (BioPE)/wood powder (WP) composites compatibilized with polyethylene-grafted maleic anhydride (PE-g-MA), using macaíba oil (OM) as a processing aid. The composites were prepared, fist, in an internal mixer and, later, the crushed flakes were molded by injection. Mechanical properties (impact, tensile, flexural and Shore D hardness), heat deflection temperature (HDT), differential scanning calorimetry (DSC), thermogravimetry (TG), water absorption, torque rheometry and scanning electron microscopy (SEM) were evaluated. The addition of 30% wood powder to the BioPE matrix increased the elastic modulus (tensile and flexural), Shore D hardness and heat deflection temperature (HDT), compared to neat BioPE. These properties were improved when 10% of the PE-g-MA compatibilizer was added, compared to neat BioPE and the non-compatibilized composite. There was a significant reduction in the torque of the composites with the addition of macaíba oil, indicating that it improved the processability. In addition, the incorporation of macaíba oil into the composites helped to reduce water absorption, as well as to increase impact strength. SEM micrographs illustrated a greater degree of interfacial adhesion when PE-g-MA and macaiba oil were added.

P–267 Characterising a novel embryo grading system for 4-cell embryos including symmetry, fragmentation, cell configuration, cell contacts per cell, distance between cells, and cell adhesion strength

Abstract Study question What other cell junction factors can be easily characterised from imagery of 4-cell embryos to assist in embryo classification and prediction of viability? Summary answer 4-cell embryo grading should not only account for symmetry and fragmentation, but also cell configuration and cell adhesion quality. What is known already 4-cell embryos are clinically classified according to cell number, symmetry and fragmentation without accounting for cell orientation or quality of cell junctions. Our previous work has focused on classification of 4-cell embryos according to overall embryo shape (“tetrahedral” versus “planar”) using artificial intelligence. Our work, as confirmed by others, has demonstrated that embryo shape at the 4-cell stage is an important determinant of the ability of the embryo to reach blastocyst, utilisation, pregnancy and live birth. This is thought to be because of variations in intracellular communication between cells in embryos with different orientations, and consequently, different intracellular junction phenotypes. Study design, size, duration Using geometrical principles, possible permutations of 4-cell embryos (excluding redundant mirrored permutations) were identified and further classified based on shape and number of cell junctions. For ease of calculations, cells were assumed to be spherical, with at least one intracellular cell contact and symmetrical in size with other cells in the same embryo. Participants/materials, setting, methods The six distances between centroids of permutations for each configuration were calculated relative to the size of the cell, and the shortest distance between cell membranes. Adhesion was characterised from embryo imagery based on the overall shape of the cell, external angle between cells and the length of cell contact (the more spherical the cell, the larger the angle and the longer the cell contact point, the stronger the adhesion, adapted from Winklbauer,2015). Main results and the role of chance 4-cell embryos may be classified into 13 variant configurations: 1 typical Tetrahedral, 2 quasi-tetrahedral, 10 planar. These variants were classified according to number of cells with 0,1,2 and 3 intracellular contacts, leading to six possible configurations: 0004(tetrahedral), 0022(quasi tetrahedral/planar), 0040 (planar), 0121(quasi tetrahedral/planar), 0301(planar), 0220(planar). The number of total cell junctions in the embryo in each of these configurations was 12,10,8,8,6,6 respectively, with tetrahedral embryos (0004) having twice the cell contacts compared to planar embryos (p < 0.001). Tetrahedral embryos have an advantage over the other embryo configurations in terms of better embryo communication, as demonstrated by the lower average and variation in distance and shorter sum of all intracellular distances between centroids (mean: 0.78 vs 0.94,0.98,1.04,1.09,1.19; stdev:0.06 vs 0.2,0.3,0.3,0.4,0.4,0.3; sum:4.7 vs 5.2,6.3,6.1,6.7,7.0,6.0 cell lengths) and between cells (mean: 0 vs 0.34,0.07,0.39,0.42,0.56; stdev: 0 vs 0.56,0.11,0.51,0.53,0.66; sum: 0 vs 2.71,0.43,3.13,3.38,4.46 cell lengths) observed in tetrahedral embryos versus other five configurations respectively (p < 0.001). Cell junctions were classified according to degree of cell adhesion: A:none (cells remain spherical in shape); B:weak (external angle between the cells is acute, there is a narrow visible cell junction); C:strong (external angle between the cells is obtuse with a wide visible cell junction). Limitations, reasons for caution: Follow-up studies will evaluate the impact of different cell shapes,cells without intracellular contact,and asymmetrical embryos. The proposed classification will be validated against a database of known outcome from 8 clinics from 6 countries to quantify the clinical implications of this classification,and the consistency of assessment by humans and AI . Wider implications of the findings: It is clear that differences in intracellular communication between cells in embryos with different orientations, and different intracellular junction phenotypes is an important determinant of embryo viability. Our classification system allows for an easy to use and mathematically sound criteria for classifying 4-cell embryo cell junction quality. Trial registration number NA

Antifouling and Mechanical Properties of Photografted Zwitterionic Hydrogel Thin-Film Coatings Depend on the Cross-Link Density.

Zwitterionic polymer networks have shown promise in reducing the short- and long-term inflammatory foreign body response to implanted biomaterials by combining the antifouling properties of zwitterionic polymers with the mechanical stability provided by cross-linking. Cross-link density directly modulates mechanical properties (i.e., swelling behavior, resistance to stress and strain, and lubricity) but theoretically could reduce desirable biological properties (i.e., antifouling) of zwitterionic materials. This work examined the effect of varying poly(ethylene glycol) dimethacrylate cross-linker concentration on protein adsorption, cell adhesion, equilibrium swelling, compressive modulus, and lubricity of zwitterionic thin films. Furthermore, this work aimed to determine the appropriate balance among each of these mechanical and biologic properties to produce thin films that are strong, durable, and lubricious, yet also able to resist biofouling. The results demonstrated nearly a 20-fold reduction in fibrinogen adsorption on zwitterionic thin films photografted on polydimethylsiloxane (PDMS) across a wide range of cross-link densities. Interestingly, either at high or low cross-link densities, increased levels of protein adsorption were observed. In addition to fibrinogen, macrophage and fibroblast cell adhesion was reduced significantly on zwitterionic thin films, with a large range of cross-link densities, resulting in low cell counts. The macrophage count was reduced by 30-fold, while the fibroblast count was reduced nearly 10-fold on grafted zwitterionic films relative to uncoated films. Increasing degrees of cell adhesion were noted as the cross-linker concentration exceeded 50%. As expected, increased cross-link density resulted in a reduced swelling but greater compressive modulus. Notably, the coefficient of friction was dramatically reduced for zwitterionic thin films compared to uncoated PDMS across a broad range of cross-link densities, an attractive property for insertional implants. This work identified a broad range of cross-link densities that provide desirable antifouling effects while also maintaining the mechanical functionality of the thin films.

Gallbladder adhesion degree as predictor of conversion surgery, common bile duct injury and resurgery in laparoscopic cholecystectomy: A cross-sectional study

BackgroundThe gold-standard treatment for cholecystectomy, laparoscopic cholecystectomy, has remarkably variable outcomes and conversion rates. We investigated the gallbladder adhesion degree as a predictor of conversion surgery, common bile duct injury, and resurgery. MethodsWe reviewed 157 medical records and video recordings of laparoscopic cholecystectomy on patients with cholelithiasis with or without cholecystitis at three hospitals in Yogyakarta, Indonesia from January 2016 to December 2018. The degree of gallbladder adhesion is classified into 4 categories: no adhesion, <50% adhesion, 50%-buried GB, and completely buried GB. ResultsOne hundred fifty seven patients were involved in this study, of whom 58 were males and 99 females with average age 49.2. Eighty-one patients out of 157 patients (51.6%) had gallbladder adhesion comprising of 61/157 (38.9%) with <50% adhesion and 20/157 (12.7%) 50%-buried GB. There is one incidence each of conversion surgery, CBD injury, and resurgery. The degree of GB adhesion has low degree of correlation with conversion surgery, CBD injury, and resurgery wirh r value of 0.156, 0.041, and 0.156 respectively. There is significant correlation between the degree of GB adhesion and conversion surgery and resurgery with p value of 0.032, and 0.032 respectively. There is no significant correlation between degree of GB adhesion and CBD injury with p value of 0.453. ConclusionThe degree of GB adhesion has low degree of correlation with conversion, CBD injury and resurgery. This study also showed that patients with high degree of gallbladder adhesion are still eligible for laparoscopic procedure performed by an experienced surgeon.

Influence of the addition of different radiopacifiers and bioactive nano-hydroxyapatite on physicochemical and biological properties of calcium silicate based endodontic ceramic

The purpose of this study was to investigate the influence of different radiopacifiers on the physicochemical and biological properties of novel calcium silicate based endodontic ceramic enriched with bioactive nano-particulated hydroxyapatite – ECHA. Namely, ECHA was used as a basis for mixing with the following radiopacifiers: strontium fluoride (SrF2), zirconium dioxide (ZrO2) and bismuth oxide (Bi2O3). For comparison, Portland cement (PC) and mineral trioxide aggregate (MTA) were used. The following physicochemical characteristics were examined: the radiopacity, setting time, compressive strength, porosity, wettability and pH value. The biocompatibility of the cements was assessed by crystal violet, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) and cell adhesion assays. The highest radiopacity was obtained for the ECHA + Bi2O3 mixture and MTA that were statistically significant in comparison to other materials (p < 0.05). Both initial and final setting times as well as compressive strengths were statistically lower for experimental cements than for PC and MTA (p < 0.05). The lowest total porosity was observed in the ECHA + ZrO2 group when compared with the other two experimental cements (p < 0.05), but not when compared with PC and MTA (p > 0.05). Experimental cements exhibited statistically higher contact angles of glycerol than PC and MTA (p < 0.05). For blood plasma, a statistical difference was found only between ECHA + Bi2O3 and PC (p < 0.05). All investigated materials had alkalization ability. Cell viability assays revealed that the extracts of tested cements did not exhibit cytotoxic effect on L929 cells. Scanning electron microscopy had shown a high degree of cell proliferation and adhesion of cells from apical papilla on experimental cements’ surfaces. Novel endodontic ceramics with nano-hydroxyapatite addition have satisfactory biological and physicochemical properties when compared to MTA and PC controls. Considerable lower setting time of experimental cements might present a huge advantage of these synthesized materials in clinical practice. SrF2 presents a novel promising radiopacifying agent for dental cements manufacturing.

Correlation Between Levels of Interleukin-6 in Peritoneal Fluid With Degree of Pain, Adhesion, and Endometriosis Fertility Index Score in Endometriosis

Introduction : Endometriosis is a benign gynecological disorder characterized by the presence of endometrial tissue and stroma outside the uterine cavity. Several theories have been proposed to explain the occurrence of endometriosis, one of which is the theory of inflammation. Endometriosis lesions can produce inflammatory cytokines, resulting in their increased levels in the peritoneal fluid. This process causes disruption in pelvic anatomy, ovarian function, prostaglandin production and growth factor production that causes pain, adhesions and infertility. Interleukin-6 (IL-6) is an important and potential inflammatory cytokine in assisting the diagnosis of endometriosis. These cytokines act as activating macrophages that can stimulate endometrial cell proliferation and modulate the secretion of other cytokines such as IL-10, IL-13 and TNF-α which augments the inflammatory process. High levels of IL-6 in the peritoneum are relatedto advanced endometriosis associated with pain, severe pelvic adhesions and embryotoxic effects leading to infertility. The effect of IL-6, both local and systemic, on the growth of endometriosis lesions and its associated symptoms is great that this cytokine is considered an important marker.Objective : This study aims to determine the relationship between local inflammatory factors (IL-6 in peritoneal fluid) obtained during laparoscopy with the degree of pain, the degree of adhesions and the correlation with the Endometriosis Fertility Index (EFI) score in endometriosis patients.Material and methods : This is a quantitative analytic research with a cross sectional study design which was conducted on 22 patients with endometriosis. Prior to the laparoscopy, historical factor (EFI score) was recorded and an assessment of the pain scale was performed by filling out a questionnaire. Intraoperatively, the peritoneal fluid was obtained. If the peritoneal fluid was found, it was taken directly with a volume of 3-5 cc using 10 cc syringe. If no fluid was found, peritoneal rinsing was performed using 0.9% NaCl fluid, then 3-5 cc fluid was aspirated using a 10 cc syringe. Subsequently, an examination was carried out using the RayBio Human IL-6 ELISA Kit. During the laparoscopy procedure, the degree of adhesion of the pelvic organs was assessed by looking at the shape and how the adhesions can be separated. Surgical factor (EFI score) was assessed intraoperatively to obtain data for the least function score, AFS endometriosis score and AFS total score. Statistical analysis was performed using paired t test and correlation test.Results : The mean age of the respondents was 34.86 ± 6.11 years, 81.8% were nulliparous, 100% were married, 100% experienced both primary and secondary infertility and 81.8% had no prior pregnancy history. In the study, it was found that IL-6 levels of peritoneal fluid were higher in patients with the degree of severe pain (P &lt;0.05) compared to moderate with the results of 32.58 ± 7.31 pg/ml and 25.39 ± 2.70 pg/ml. IL-6 levels were found to be higher in grade three adhesions than grade two (P &lt;0.05) with results of 32.78 ± 6.65 pg/ml and 23.86 ± 2.18 pg/ml. The mean peritoneal fluid IL-6 levels were 30.75 ± 7.01 pg/ml and the mean EFI score was 4.09 ± 2.09. The correlation of IL-6 levels in peritoneal fluid with EFI score showed a value of r = -0.448 which had moderate strength and a negative pattern, indicating that the higher the IL-6 level of peritoneal fluid, the lower the EFI score (P &lt;0.05).Conclusion : There is a relationship between IL-6 levels of peritoneal fluid in endometriosis with the degree of pain and the degree of adhesion, where IL-6 levels were found to be higher in the degree of severe than moderate pain (P &lt;0.05), higher in third degree adhesions than second degree ( P &lt;0.05). There was a correlation between IL-6 levels of peritoneal fluid with EFI score (P &lt;0.05) with a negative pattern of moderate strength analysis results (r = -0.448).Keywords: Endometriosis, Interleukin-6, Degree of Pain, Degree of Adhesion, Endometriosis Fertility Index Score

PRECLINICAL TRIALS FOR ADVANCED CHITOSAN-BASED COATINGS IN TREATING PURULENT WOUNDS

Wound healing is a complex set of body responses to damaged tissues, which manifests itself through local destructive-inflammatory changes and general reactions. There are numerous coatings used currently in clinical practice to treat wounds. These coatings serve to develop a wet anti-bacterial environment, which is essential to facilitate the healing process. This work focuses on studying multifunctional coatings, which are based on chitosan, a biocompatible polymer featuring wound-healing properties. The distinctive feature to be found in chitosan fibers is their density and the orientation of pores. The coatings within this study were tested on scalped full-layer skin wounds of male Wistar-Kyoto rats and male rabbits. The sample with a dense structure and low biological resorption was found to be effective in performing the function of a framework, as well as in ensuring proper drainage at the affected area. This is important when treating purulent wounds. The experimental sample with a high degree of adhesion and a shorter biodegradation life can be recommended for treating wounds with no purulent-inflammatory issues, for granulating wounds, as well as a drug carrier-matrix. The studied wound coatings have revealed their medical efficiency at the preclinical stage (in vivo). Using wound coatings with specified structural and functional features would allow making a reasonable choice when selecting a coating depending on the stage of wound healing course.

Unlocking Entropic Elasticity of Nematic Elastomers Through Light and Dynamic Adhesion

AbstractNematic liquid crystal elastomers (LCEs) generally show soft elasticity, masking entropic elasticity inherent in crosslinked networks. They macroscopically deform with little stress increase under straining because of the soft shear mode attained by nematic director rotations. Moreover, the nematic interaction in main‐chain LCEs can arrest the ergodic response to cycling strain. It manifests hysteresis, slow relaxation, and increased viscosity, which critically affect their mechanical applications such as actuation and adhesion. Here, it is shown that entropic elasticity fully recovers after photo‐isomerization of azobenzene units incorporated in a nematic LCE. With the light‐induced bent cis‐isomers at room temperature, the degree of soft elasticity, viscosity, and adhesion are tangibly lowered. Mechanical responses rationalize that cis isomers unlock the frozen configurational degree of freedom by reducing nematic order in the same manner observed upon temperature increase. The present results not only unveil how the nematic interaction suppresses entropic elasticity leading to the soft state, but also offer a guide to tuning viscoelasticity toward dynamic mechanical applications.

Impact Evaluation of High Energy Ball Milling Homogenization Process in the Phase Distribution of Hydroxyapatite-Barium Titanate Plasma Spray Biocoating

Air plasma spray technique (APS) is widely used in the biomedical industry for the development of HA-based biocoatings. The present study focuses on the influence of powder homogenization treatment by high-energy ball milling (HEBM) in developing a novel hydroxyapatite-barium titanate (HA/BT) composite coating deposited by APS; in order to compare the impact of the milling process, powders were homogenized by mechanical stirring homogenization (MSH) too. For the two-homogenization process, three weight percent ratios were studied; 10%, 30%, and 50% w/w of BT in the HA matrix. The phase and crystallite size were analyzed by X-ray diffraction patterns (XRD); the BT-phase distribution in the coating was analyzed by backscattered electron image (BSE) with a scanning electron microscope (SEM); the energy-dispersive X-ray spectroscopy (EDS) analysis was used to determinate the Ca/P molar ratio of the coatings, the degree of adhesion (bonding strength) of coatings was determinate by pull-out test according to ASTM C633, and finally the nanomechanical properties was determinate by nanoindentation. In the results, the HEBM powder processing shows better efficiency in phase distribution, being the 30% (w/w) of BT in HA matrix that promotes the best bonding strength performance and failure type conduct (cohesive-type), on the other hand HEBM powder treatment promotes a slightly greater crystal phase stability and crystal shrank conduct against MSH; the HEBM promotes a better behavior in the nanomechanical properties of (i) adhesive strength, (ii) cohesive/adhesive failure-type, (iii) stiffness, (iv) elastic modulus, and (v) hardness properties.

Methodological proposal for evaluation of adhesion of root canal sealers to gutta‐percha

To compare the bond strength of an epoxy resin-based sealer and two calcium silicate-based sealers (CSS) to gutta-percha discs using a new method. Round discs of gutta-percha (n=60), measuring 10mm in diameter and 2mm in thickness, were placed on a glass plate and a drop of each sealer (AH Plus, EndoSequence BC Sealer and EndoSeal MTA) was placed on their surface. Another identical disc was placed onto the first one and a standardized weight (0.0981N) applied over them using a specially developed apparatus. Ten samples prepared for each sealer were submitted to a microshear bond strength test accomplished by a specially designed set-up coupled to a universal testing machine. The Kruskal-Wallis test followed by a post hoc procedure was used to compare groups considering the preliminary analysis of the raw data had indicated the nonadherence to a Gaussian distribution (Shapiro-Wilk, p<.05). Alpha error was set at 5%. Overall, no premature failure occurred. All sealers had some degree of adhesiveness to gutta-percha discs but with a significant difference amongst them (Kruskal-Wallis, p=.019). The epoxy resin-based sealer (AH Plus) had significantly higher median shear bond strength values (1.43MPa; 1.40-1.83) compared to EndoSeal MTA (0.53MPa; 0.46-0.73) (p=.021) and EndoSequence BC Sealer (0.45MPa; 0.34-0.46) (p=.023), whilst the lowest median value was observed with EndoSequence BC Sealer (0.45MPa; 0.34-0.46) (p<.05). CSS sealers had weaker bonding to gutta-percha when compared to the epoxy resin-based AH Plus sealer. The proposed methodology is an innovative and reproducible method for testing the bond strength of root canal sealers to gutta-percha.

Pectin as Rheology Modifier of a Gelatin-Based Biomaterial Ink.

Gelatin is a natural biopolymer extensively used for tissue engineering applications due to its similarities to the native extracellular matrix. However, the rheological properties of gelatin formulations are not ideal for extrusion-based bioprinting. In this work, we present an approach to improve gelatin bioprinting performances by using pectin as a rheology modifier of gelatin and (3-glycidyloxypropyl)trimethoxysilane (GPTMS) as a gelatin–pectin crosslinking agent. The preparation of gelatin–pectin formulations is initially optimized to obtain homogenous gelatin–pectin gels. Since the use of GPTMS requires a drying step to induce the completion of the crosslinking reaction, microporous gelatin–pectin–GPTMS sponges are produced through freeze-drying, and the intrinsic properties of gelatin–pectin–GPTMS networks (e.g., porosity, pore size, degree of swelling, compressive modulus, and cell adhesion) are investigated. Subsequently, rheological investigations together with bioprinting assessments demonstrate the key role of pectin in increasing the viscosity and the yield stress of low viscous gelatin solutions. Water stable, three-dimensional, and self-supporting gelatin–pectin–GPTMS scaffolds with interconnected micro- and macroporosity are successfully obtained by combining extrusion-based bioprinting and freeze-drying. The proposed biofabrication approach does not require any additional temperature controller to further modulate the rheological properties of gelatin solutions and it could furthermore be extended to improve the bioprintability of other biopolymers.

Application of a Simple Microfluidic Chip Analysis Technology to Evaluate the Inhibitory Role of Protocatechuic Acid on Shear-Induced Platelet Aggregation.

This study aimed to develop a simple microfluidic chip analysis technology to study the inhibitory effect of protocatechuic acid on shear-induced platelet aggregation. The microfluidic chip designed in this study simulates 80% fixed narrow microchannels. This microchannel narrow model uses the finite element analysis module of the three-dimensional modeling software solidwork to analyze fluid dynamic behavior. Blood treated with protocatechuic acid at 1, 2, 4, 8, or 16 µg/mL was passed through the microchannel stenosis model at a shear rate of 10,000 s−1. The platelet adhesion and aggregation behaviors were then measured using fluorescence microscopy and observed in real time. Simultaneously, the antiplatelet aggregation effect of protocatechuic acid was analyzed using thromboelastography and photoelectric turbidimetry. The designed stenosis model of the microfluidic chip can produce a gradient of fluid shear rate, and the gradient of fluid shear rate can induce platelet aggregation. Under this model, the degree of platelet adhesion and aggregation increased as the shear rate increased. In the experimental concentration range of 0–8 µmol/mL, protocatechuic acid exerted a concentration-dependent inhibition of platelet aggregation. In contrast, thromboelastography and photoelectric turbidimetry failed to demonstrate an inhibitory effect. The microfluidic chip analysis technology developed in this study can be used to study the effect of protocatechin in inhibiting platelet aggregation induced by shear rate in vitro. This technology is simple to operate and can be used as a new type of antiplatelet aggregation analysis technology for screening studies of novel potential antiplatelet aggregation drugs.

Clinical application of Wide-awake technique in flexor tendon tenolysis

To discuss the method and effectiveness of Wide-awake technique in flexor tendon tenolysis. The clinical data of 16 patients (22 fingers) with flexor tendon adhesion treated by Wide-awake technique for flexor tendon tenolysis between May 2019 and December 2019 were retrospectively analyzed. The patients were all male, aged from 18 to 55 years old, with an average of 35 years old. Among them, 4 cases (7 fingers) after replantation of severed fingers, 4 cases (7 fingers) after flexor tendon rupture repair, and 8 cases (8 fingers) after open reduction and internal fixation of proximal fractures. The time from the original operation to this operation was 6-18 months, with an average of 8 months. The visual analogue scale (VAS) score was used to evaluate the patient's pain during local anesthesia (when the first needle penetrated the skin), intraoperative, and 24 hours postoperatively; and the recovery of finger movement was evaluated by total finger joint active range of motion (TAM) evaluation system and Strickland (1980) standard after operation. Intraoperative hemostasis and anesthesia were satisfactory, and the patient could fully cooperate with the surgeon in active finger movements. There were different degrees of pain during local anesthesia (VAS score was 2-4), no pain during operation (VAS score was 0), and different degrees of pain after operation (VAS score was 1-8, 9 patients needed analgesics). All incisions healed by first intention after operation. All 16 cases were followed up 9-15 months with an average of 12 months. Finger function was significantly improved, no tendon rupture occurred. At last follow-up, the patients after proximal fracture open reduction and internal fixation were rated as excellent in 4 fingers and good in 4 fingers according to the TAM standard, and both were excellent according to the Strickland (1980) standard; and the patients after replantation of severed fingers and flexor tendon rupture repair were rated as excellent in 4 fingers and good in 10 fingers according to TAM standard, and as excellent in 6 fingers and good in 8 fingers according to Strickland (1980) standard. Wide-awake technique applied in flexor tendon tenolysis can accurately judge the tendon adhesion and release degree through the patient's active activity, achieve the purpose of complete release, and the effectiveness is satisfactory; the effectiveness of tendon adhesion release surgery after fracture internal fixation is better than that of patients after tendon rupture suture and replantation.

Poly (L-lactic acid) coatings on 316 SS substrates for biomedical devices: The impact of surface silanization

Metals and their alloys make them critical materials in orthopaedic applications for bone support due to their biocompatibility and mechanical properties. Nevertheless, these materials do not stimulate bone regeneration. A way to overcome this problem, may involve the application of a coating over the alloys using biocompatible and biodegradable materials capable of stimulating bone regeneration. In this work, poly (L-lactic acid) (PLLA) films were used over 316 SS substrates and a silanization reaction was employed to improve the interfacial adhesion between polymer and metal, to achieve physicochemically stable PLLA coatings. PLLA was chosen as a coating due to its biocompatible, biodegradable and piezoelectric properties, stimulating the activity of the host bone tissue. Our results reveal that the functionalization of the metal substrate with silane reagents is effective and efficient in the adhesion of PLLA films to 316 SS. Differences in the degree of adhesion are demonstrated, as well as their dependence on film thickness, concentration of polymer solution, and crystallization degree of the polymeric film. These results have implications on the understanding of how to produce stable PLLA coatings on 316 SS substrates, with suitable adhesion to apply in medical devices, paving the way for the possibility of exploring other advantageous properties of PLLA for bone regeneration such as piezoelectricity.

Hysteroscopy as a diagnostic tool in women with recurrent pregnancy loss, a prospective randomized controlled study

Background:Uterine abnormalities, are implicated as one of the causes of recurrent miscarriages, and have been estimated to be diagnosed in as many as 10% to 15% of patients with repeated miscarriages. The present study was designed to assess the value of hysteroscopy in the diagnosis of intra-uterine lesions in women with recurrent pregnancy loss. Design: This is a prospective cohort study which was done in El-Sayed Galal hospital, faculty of medicine, Al-Azhar university after the approved of the research ethics committee, during the period from March 2018 to April 2019 and included 300 patients aged 18 to 40 years with a history of unexplained pregnancy loss prior to 20 weeks of pregnancy Results: 300 patients with history of recurrent pregnancy loss were included in this study, 44% had a normal finding, 14% had intrauterine septum, 2% had bicornuate uterus, 15.3% had endometrial polyp, 0.7% had submucous myoma, 1.3% had tubular cavity, 2% had subseptate uterus, 2% had fundal cupping and 18.7% had intrauterine adhesions. There was statistically significant correlation between the numbers of E&C and different pathological finding, cases with tubular cavity showed the highest mean number of E&C and also there was statistical significant difference between degree of adhesion and number of abortion which the moderate degree associated with highest number of abortionConclusion: Hysteroscopy has an important role in the diagnosis of causes in women with recurrent pregnancy loss.

A LITERATURE REVIEW ON SELF BALANCING IN LINE TWO-WHEELER (BI-CYCLE)

Bicycles are a global product and are present in every culture of the world. They are extensively used for travelling, they are pollution free and easy to manufacture. However, the stability is a great problem of concern while riding a bicycle. A two-wheeler is bound to fall after being tilted more than a certain angle of tilt. This paper aims to provide a literature review of the previously methods of achieving self-balancing condition in a bicycle. Further, up to 4 methods or de-signs have been broadly classified in this paper taking into account the previously published papers on self-balancing. Also, Gyroscopes are highly stabilizing de-vices which are used as stabilizing systems in ships and flight control of aircrafts. The goal of this paper is to finalize the best possible method for building a self-balancing twowheeler prototype capable of balancing itself using a gyroscope and PID (Proportional integral derivative) controller. The gyroscope will provide the necessary balance to the bicycle at the time of tilt. The idea of a selfbalancing bicycle can be further employed in the manufacture of driverless and driver operated automated two-wheelers respectively, with a high degree of road safety and road adhesion. Finally, this paper also covers the future scope and future techniques in the field of self-balancing

Formation of adhesions after cesarean section

Purpose. To assess the frequency of adhesions after cesarean section and to investigate the prevalence and location of pelvic adhesions in women with a history of cesarean section.Materials and methods. In total, the study included 390 patients who underwent a caesarean section at the 1st Clinical Medical Center in Baku, Azerbaijan in the period from January 2013 to January 2015. We studied 30 cases of primary CS surgery and 360 cases of repeated CS operations. We used 3 classifications to assess adhesions: the peritoneal adhesion index (PAI), the classification of the adhesive process according to T. Tulandi and the general classification of the prevalence of adhesions, the degree and severity of adhesions were assessed prospectively.

Surgical benchmarks, mid-term\xa0oncological outcomes, and impact of surgical team composition on simultaneous enbloc robot-assisted radical cystectomy and nephroureterectomy

BackgroundSimultaneous urothelial cancer manifestation in the lower and upper urinary tract affects approximately 2% of patients. Data on the surgical benchmarks and mid-term oncological outcomes of enbloc robot-assisted radical cystectomy and nephro-ureterectomy are scarce.MethodsAfter written informed consent was obtained, we prospectively enrolled consecutive patients undergoing enbloc radical cystectomy and nephro-ureterectomy with robotic assistance from the DaVinci Si-HD® system in a prospective institutional database and collected surgical benchmarks and oncological outcomes. Furthermore, as one console surgeon conducted all the procedures, whereas the team providing bedside assistance was composed ad hoc, we assessed the impact of this approach on the operative duration.ResultsNineteen patients (9 women), with a mean age of 73 (SD: 7.5) years, underwent simultaneous enbloc robot-assisted radical cystectomy and nephro-ureterectomy. There were no cases of conversion to open surgery. In the postoperative period, we registered 2 Clavien-Dindo class 2 complications (transfusions) and 1 Clavien-Dindo class 3b complication (port hernia). After a median follow-up of 23 months, there were 3 cases of mortality and 1 case of metachronous urothelial cancer (contralateral kidney).The total operative duration did not decrease with increasing experience (r = 0.174, p = 0.534). In contrast, there was a significant, inverse, strong correlation between the console time relative to the total operative duration and the number of conducted procedures after adjusting for the degree of adhesions and the type of urinary diversion(r = -0.593, p = 0.02).ConclusionsThese data suggest that en bloc simultaneous robot-assisted radical cystectomy and nephro-ureterectomy can be safely conducted with satisfactory mid-term oncological outcomes. With increasing experience, improved performance was detectable for the console surgeon but not in terms of the total operative duration. Simulation training of all team members for highly complex procedures might be a suitable approach for improving team performance.Trial registration: Not applicable.Dm4iGs5nWD8FkGrYCfJL2MVideo

Pd/TiO2 Coated in a Microscale‐Based Reactor by Electrophoretic Deposition for Biohydrogenated Diesel Production

AbstractElectrophoretic deposition (EPD) was applied for the coating of a Pd/TiO2 catalyst for the production of biohydrogenated diesel (BHD) in a microscale‐based reactor. The coating of TiO2 using EPD was investigated under various operating conditions. The Pd/TiO2 catalysts prepared by EPD were compared with the samples obtained by the conventional washcoating (WC) technique. The optimum EPD condition giving a high degree of adhesion was determined, using Tiron and Pluronic F127 as the additives. The coated catalysts were tested for their catalytic activity. By comparing with Pd/TiO2(WC), Pd/TiO2(EPD) catalysts exhibited a higher catalytic performance which could be explained by their uniformity, high amount of Ti3+ species, and oxygen vacancies.