Fibrin Glue Group Research Articles

Fibrin glue alone and skeletal myoblasts in a fibrin scaffold preserve cardiac function after myocardial infarction.

Current efforts in cardiac tissue engineering center around the use of scaffolds that deliver cells to the epicardial surface. In this study, we examined the effects of fibrin glue as an injectable scaffold and wall support in ischemic myocardium. The left coronary artery of rats was occluded for 17 min, followed by reperfusion. Echocardiography was performed 8 days after infarction. One to 2 days later, either 0.5% bovine serum albumin (BSA) in phosphate-buffered saline, fibrin glue alone, skeletal myoblasts alone, or skeletal myoblasts in fibrin glue were injected into the ischemic left ventricle. Echocardiography was again performed 5 weeks after injection. The animals were then sacrificed and the hearts were fresh frozen and sectioned for histology and immunohistochemistry. Both the fractional shortening (FS) and infarct wall thickness of the BSA group decreased significantly after 5 weeks (p = 0.0005 and 0.02, respectively). In contrast, both measurements for the fibrin glue group, cells group, and cells in fibrin glue group did not change significantly (FS: p = 0.18, 0.89, and 0.19, respectively; wall thickness: p = 0.40, 0.44, 0.43, respectively). Fibrin glue is capable of preserving infarct wall thickness and cardiac function after a myocardial infarction in rats and may be useful as a biomaterial scaffold for myocardial cell transplantation.

Healing of Colon Anastomoses Covered With Fibrin Glue After Immediate Postoperative Intraperitoneal Administration of 5-Fluorouracil

The aim of this experimental study was to investigate whether covering the colonic anastomoses with fibrin glue can protect the colonic healing from the adverse effects of 5-fluorouracil (5-FU), when it is injected intraperitoneally immediately after colon resection. Sixty-four rats were randomized to one of four groups. After resection of a 1-cm segment of the transverse colon, an end-to-end sutured anastomosis was performed. Rats of the control group and the fibrin glue group were injected with 6 ml of solution 0.9 percent NaCl intraperitoneally. Rats in the 5-FU and the 5-FU + fibrin glue groups received 5-FU intraperitoneally. The colonic anastomoses of the rats in the fibrin glue group and in the 5-FU + fibrin glue group were covered with fibrin glue. All rats were killed on the 8th postoperative day and the anastomoses were examined macroscopically. The bursting pressure measurements were recorded and the anastomoses were graded histologically. The leakage rate of the anastomoses was significantly higher in the rats of the 5-FU group than in those of the fibrin glue group and those of the 5-FU + fibrin glue group (37.5 percent vs. 0 percent, P = 0.020). The adhesion formation score was significantly higher in rats of the 5-FU group than in the other groups. Bursting pressures were also significantly lower in the 5-FUgroup than in the other groups ( P < 0.001). Rats in the 5-FU + fibrin glue group developed significantly more marked neoagiogenesis than rats in the other groups. Rats in the 5-FU + fibrin glue group also presented significantly more fibroblast activity than those in the 5-FU group. ( P = 0.004) The immediate postoperative, intraperitoneal administration of 5-FU inhibited wound healing. However, when the colonic anastomoses were covered with fibrin glue, the injection of 5-FU had no adverse effects on the healing of the anastomoses.

Tranexamic acid mouthwash versus autologous fibrin glue in patients taking warfarin undergoing dental extractions: a randomized prospective clinical study

Purpose: The aim of this prospective study was to compare the effectiveness of a 4.8% tranexamic acid mouthwash versus an autologous fibrin glue preparation to control hemostasis in patients therapeutically anticoagulated with warfarin who required dental extractions without interruption of their treatment. Patients and Methods: The 49 patients who underwent 152 dental extractions were randomly allocated to 2 groups: Group A were required to rinse with 10 mL of a 4.8% tranexamic acid solution 4 times a day for 7 days postoperatively. Group B received autologous fibrin glue intraoperatively. The international normalized ratio was measured on the day of the procedure. All procedures were performed on an ambulatory basis by the same surgeon. Results: Of the 49 patients, 2 presented with postoperative bleeding (4%). Both patients were from the autologous fibrin glue group and were found to have grossly elevated international normalized ratios on the day of the bleeding that was unaccounted for. Conclusions: This study supports the consensus that dental extractions can be performed without modification of oral anticoagulant treatment. Local hemostasis with an absorbable oxidized cellulose mesh, tranexamic acid, and sutures is the more cost efficient of the 2 methods compared; however, autologous fibrin glue has an important role in patients unable to use a mouthwash effectively.

From clinical evidence to everyday practice: implementing findings from a cost-effectiveness analysis for endoscopic injection therapy for upper-gastrointestinal bleeding.

A previous upper-gastrointestinal bleeding trial showed that patients treated with repeated fibrin glue injection for upper-gastrointestinal bleeding have significantly less rebleeding than those treated with polidocanol. To analyse the cost and effectiveness of repeated fibrin glue injection and to investigate whether these results change physicians' attitudes. A retrospective random sample of five hospitals from the previous study, collection of cost identification, and follow-up data on 320 patients (155 in the polidocanol group, 165 in the fibrin glue group). An incremental cost-effectiveness analysis and comparison of outcomes was performed using chi-squared tests and Kaplan-Meier survival analysis. A survey was carried out using a questionnaire in the five hospitals on local guidelines for management of ulcer bleeding, and its results were analysed qualitatively. The measure of effectiveness is the number of prevented rebleedings. Further variables were length of hospital stay and length of intensive care unit (ICU) stay. The cost for the prevention of one additional rebleeding by repeated fibrin glue treatment amounts to 14,316 +/- 4981 euros (incremental cost-effectiveness ratio). There were no significant differences in length of stays in ICU or in hospital. The physicians did not change their management plans for patients with upper-gastrointestinal bleeding. In a survey, it was seen that other factors, such as local guidelines, attitudes towards new treatment options, and ease of handling of drugs, are more important than a result of a single study for a behavioural change of the doctors. The study was not designed prospectively to address a pharmacoeconomic question. As relevant variables (e.g. length of ICU stay) could not be reliably ascertained retrospectively, this may lead to biased estimates of the incremental cost-effectiveness ratio.

間葉系幹細胞，フィブリンのりおよび生体吸収性足場を用いた注入法による骨再生に関する実験的研究

The purpose of this study was to investigate whether a combination of fibrin glue, biodegradable scaffold (β-tricalcium phosphate;β-TCP), and mesenchymal stem cells (MSCs) would promote new bone formation and provide three-dimensional templates for bone growth at heterotopic sites in rats with plasticity. Growing MSCs and developing matrices, explanted from the rat femur, were minced and mixed with fibrin glue in a syringe. The MSCs/fibrin glue-β-TCP complex was injected into the subcutaneous space of the back of the rat. Eight weeks after implantation, macroscopic examination revealed a pearly opalescence that was firm on palpation. Histologic investigations showed newly formed bone structures in all rats treated with the MSCs/fibrin glue-β-TCP complex. No bone structures were found in the fibrin glue or β-TCP control groups. Our results demonstrate that injectable MSCs/fibrin glue-β-TCP complex can provide a three-dimensional scaffold for the successful transplantation and engraftment of osteoblasts. This technique holds promise of becoming a minimally invasive means of delivering autogenous bone to correct or repair bone defects such as those associated with osteoprotic fractures, paradontosis, and tumor resection.

Does Fibrin Glue Reduce Complications After Femoral Artery Surgery? A Randomised Trial

Objectives: to determine whether application of fibrin glue before closure of inguinal wounds reduces the incidence of lymphatic complications.Design: we a prospective randomised trial.Materials and methods: 224 consecutive patients were enrolled. The wounds were randomly assigned to standard closure (group A, n = 134) or closure with application of fibrin glue (group B, n = 132). The incidence of local lymphatic and non-lymphatic complications, the amount of lymphatic fluid collected, and the time to drain removal were compared in the groups.Results: the incidence of lymphatic complications was 19% in group A and 10% in group B (p = 0.027). The average drain output and the time to drain removal did not differ in the two groups. The total incidence of non-lymphatic local complications was 10% and did not differ in the two groups.Conclusions:fibrin glue application is associated with a significant reduction in lymphatic complications.

End-to-end arterial anastomosis with fibrin glue in larger arteries: histology, hydroxyproline concentration and tensile strength study in carotids of rabbits

End-to-end conventional arterial anastomosis is time consuming, requires prolonged clamping times and is associated with focal necrosis, granulocyte infiltration and subsequently, fibrosis and calcification of the arterial wall. Fibrin glue as an alternative for microarterial anastomosis may obviate these lesions, with less adherence to adjacent tissues and better coaptation of the arterial margins. OBJECTIVE: In this study we compared the healing process of conventional to fibrin glue end-to-end anastomosis in larger arteries. METHODS: In 22 rabbits, both carotid arteries were cross sectioned and repaired by end-to-end anastomosis with 4 interrupted sutures and fibrin glue in one side (GI) and with 8 conventional interrupted sutures in the other side (G2). After 3 and 15 days, the animals were randomly allocated for tensile strength, hydroxyproline determination (8 animals), and histologic analysis of the anastomosis (3 animals). Conventional staining procedures (hematoxylin-eosin and Masson methods) and picrosirius red polarization (PSP) technique for collagen type determination were employed. RESULTS: From 3 to 15 days, the tensile strength increased in both groups, from 280.0± 32.6 g to 432.2± 131.2g in Group I and from 221.4± 72.4g to 452.2± 132.0g in Group 2 (p&lt;0.001), with no statistical difference between the groups in each period of the study. The hydroxyproline content, expressed as hydroxyproline /protein ratio, varied from 0.0816 ± 0.0651 to 0.0622 ± 0.0184 in Group l and from 0.0734 ± 0.0577 to 0.0460 ± 0.0271 in Group 2, with no significant difference between periods and groups (p&gt;0.05). Histology showed slight increase of inflammatory and reparative reactions in Group 2. PSP technique demonstrated predominant type I collagen in relation to type III collagen in the anastomosis of both groups, with no significant difference between them. CONCLUSION: Fibrin glue was less harmful to the arterial wall than conventional suture. Even using less sutures in fibrin glue anastomosis, similar tensile strength and healing characteristics were noted in both groups. Completion times for the fibrin glue group was significantly greater than for the conventional anastomosis.

The wound-healing effect of fibrin glue for tracheal anastomosis in experimental pulmonary surgery.

The leakage of tracheal anastomoses is one of the major complications that occurs after tracheal reconstruction. Improved reinforcing methods for anastomoses would thus be clinically useful. To find a better technique, we examined the postoperative would-healing effect of fibrin glue on tracheal anastomosis in the rat. Experimental rats were divided into two groups. In the control group (n = 21), the trachea was anastomosed by interrupted absorbable sutures. In the fibrin glue group (n = 21), the trachea was anastomosed in the same manner as the control group, with the addition of fibrin glue around the area of anastomosis. In the two groups, we studied the amount of hydroxyproline and histological findings on the seventh, 14th, and 21st postoperative day. The amount of hydroxyproline and collagen fibers in the fibrin glue group was more than in the control group on the seventh postoperative day. These results suggest that fibrin glue has a promotive effect in the healing of tracheal anastomosis.

Gracilis muscle flap with a tissue-engineered lining for experimental bladder wall reconstruction.

To assess a pedicled gracilis muscle flap pre-laminated with autologous, in vitro-expanded urothelial cells to reconstruct an entire supratrigonal bladder-wall defect in rats. A gracilis muscle flap was harvested from 36 male Wistar rats, transposed into the abdomen and wrapped around a silicon-block space holder. Urothelial cells were harvested and expanded ex vivo. Cells were then suspended in fibrin glue and seeded into the gracilis muscle pocket. One week later this pre-laminated flap was transposed into a surgically created supratrigonal bladder-wall defect. All animals underwent such a pre-laminated gracilis flap bladder reconstruction and were categorized into three experimental groups. All surviving animals with urothelial-culture pre-laminated gracilis flap bladder reconstruction were killed 12 weeks (group 1) later. Control rats had gracilis flaps with no cell seeding and treated only with fibrin glue (group 2) or a standard culture medium (group 3) before reconstruction. Specimens stained with haematoxylin and eosin, and a specific immunohistochemical staining (AE1 and AE3-anti-cytokeratin monoclonal antibody stain) showed a continuous, multilayered functioning urothelial lining along the transposed pre-laminated gracilis flap in group 1. All animals in group 1 with an intact urothelial lining on the gracilis muscle survived, in contrast to most animals in groups 2 and 3, where eight and all 12 animals died, respectively. The surviving four animals in group 2 had no detectable urothelial lining. CONCLUSION Successful urinary reconstruction requires a contractile neo-reservoir resistant to resorption over time and a stable, protective urothelial lining. A gracilis muscle flap can be seeded with autologous cultured urothelial cells suspended in fibrin glue. This pre-laminated flap can be safely transposed on its pedicle and be successfully integrated into the remaining bladder wall, with a urothelial lining and the potential to contract. Further studies in larger animals, with a urodynamic assessment, are warranted to determine if this type of bladder-wall replacement technique is suitable for urinary reconstruction in humans.

Inhibition of Intra-Abdominal Adhesions: A Comparison of Hemaseel APR and Cryoprecipitate Fibrin Glue

Our previous studies demonstrated fibrin glue (FG) prepared from cryoprecipitate (cryo) inhibits intra-abdominal adhesions in rats. A new FG, Hemaseel APR, is Food and Drug Administration (FDA) approved for hemostasis during cardiac surgery and splenic trauma. This study was undertaken to determine if Hemaseel FG prevents intra-abdominal adhesions, and to compare it to cryo FG. Forty-five rats underwent laparotomy. Bilateral peritoneal-muscular defects were created. Polypropylene mesh was sewn into each defect with a running silk suture. The bowel was abraded with gauze. The rats were then randomized to mesh covered with Hemaseel FG, cryo FG, or control. On postoperative day 7, the severity of adhesions were graded by percentage of mesh covered by adhesion (0-100%) and degree of adhesion (0-3). The mean percentage of mesh covered by adhesion was 9% for Hemaseel FG, 43% for cryo FG (p = .005), and 65% for the controls (p < .0001). The mean density adhesion score was 0.5 for Hemaseel FG, 1.2 for cryo FG (p = .04), and 2.1 for the controls (p < .0001). In the Hemaseel FG group, 77% of patches had no adhesions, compared with 37% in the cryo FG group (p = .004) and 13% in the controls (p < .0001). Thus, Hemaseel FG significantly decreases intra-abdominal adhesions, and is more effective than cryo FG.

Effect of Fibrin Glue on Lymphatic Drainage after Modified Radical Mastectomy: A Prospective Randomized Trial

Fibrin as a tissue sealant has been used since the turn of the century for hemostasis. The development of cryoprecipitate and the resultant availability of higher concentrations of fibrinogen have led to a resurgence of interest in this material. Fibrin glue has since been shown to be effective for numerous applications throughout the field of surgery. Animal studies have shown fibrin glue to be effective at reducing drain output after mastectomy. Human studies, however, have been equivocal. Our objectives were to determine whether the use of fibrin glue would decrease lymphatic drainage after modified radical mastectomy and subsequently reduce time to drain removal. A prospective randomized trial was conducted consisting of 27 women. All women received modified radical mastectomy. At the completion of the mastectomy they were randomized to receive either standard closure or the application of fibrin glue before standard closure. Patients were then monitored for daily drain output, time to drain removal, and wound complications. A total of 14 women received fibrin glue and 13 received no glue. Those patients receiving fibrin glue had a significantly higher average drain output than patients who did not receive glue (1308 vs 754 cm3; P = 0.012). Time to drain removal was also increased by 4 days, although this did not reach statistical significance. The overall complication rate was higher for the fibrin glue group, although again, this did not reach significance. The application of fibrin glue significantly increased drain total drain output after modified radical mastectomy. Time to drain removal was increased as was the complication rate. On the basis of these data fibrin glue cannot be recommended for routine use in modified radical mastectomy.

LESSONS LEARNED FROM LASER TISSUE SOLDERING AND FIBRIN GLUE PYELOPLASTY IN AN IN VIVO PORCINE MODEL

LESSONS LEARNED FROM LASER TISSUE SOLDERING AND FIBRIN GLUE PYELOPLASTY IN AN IN VIVO PORCINE MODEL

Fibrin Glue Reduces Intra-Abdominal Adhesions to Synthetic Mesh in a Rat Ventral Hernia Model

Postoperative intra-abdominal adhesions are associated with significant morbidity and mortality. In this study, the effect of topical fibrin glue (FG) on adhesion formation in a rat model was investigated. Forty Sprague-Dawley male rats underwent midline laparotomy. Bilateral peritoneal-muscular abdominal wall defects were created and then replaced with premeasured soft tissue Goretex patches. Rats were randomized to FG sprayed over the patches or to a control group. Two observers blinded to the randomization assessed the severity of adhesions to the patch by scoring the density of adhesions (grades 0-3) and the percentage of the patch area covered by adhesions (0-100%). The mean percentage of the patch covered by adhesions was 32.8 +/- 6.1 per cent for the FG group versus 57.9 +/- 6.7 per cent for the control group (P < 0.01). The mean density of adhesions for the FG group was 0.95 (+/-0.17) versus 2.0 (+/-0.21) for the control group (P = 0.001). Topical FG reduces the severity and density of intra-abdominal adhesions in a rat model.

Fibrin glue reduces the severity of intra-abdominal adhesions in a rat model

Background: The purpose of this study was to determine whether fibrin glue inhibits intra-abdominal adhesions.Methods: Twenty rats underwent midline laparotomy. To maximize adhesions, bilateral peritoneal muscular defects were created and covered with polypropylene mesh sewn with a braided suture. The bowel was abraded with dry gauze. Rats were randomized to either fibrin glue (FG) sprayed over the mesh or to control (no further treatment) groups. At 1 week, the adhesion density (graded 0 to 3), the percentage of the patch covered by adhesion (0% to 100%), and adhesion type were recorded.Results: The mean adhesion density was 1.45 ± 0.33 for FG versus 2.8 ± 0.11 for controls (P = 0.001). The mean percentage of adhesions was 36 ± 9.9 for the FG group and 94 ± 3.7 for controls (P = 0.0002). Bowel or solid organs were adherent to the patch in 6 of 20 (30%) in the FG group versus 12 of 20 (70%) in controls (P = 0.057).Conclusions: Topical fibrin glue reduces the density and severity of intra-abdominal adhesions in a rat model.

USE OF FIBRIN GLUE DERIVED FROM SNAKE VENOM IN TESTICULAR BIOPSY OF RAMS

Sequelae due to testicular biopsy such as hemorrhage, adhesion and fibrosis may be limiting factors to the use of this surgical procedure. Fibrin glue (FG) derived from snake venom was used to minimize these sequelae, as well as to evaluate its healing property in tunica vaginalis and scrotal skin of rams. Applicability of fibrin glue derived from snake venom was tested in different tissues of other animals such as in sciatic nerve and colon of rats and skin of rabbits. In the present study, 30 healthy adult rams were used. They were divided into 3 groups of 10 animals each as follows: G1: fibrin glue group (application of fibrin glue on puncture sites and skin incisions after bilateral testicular biopsy with a Tru-Cut needle); G2: swab/nylon group (hemostasis by compression with a swab on puncture sites and skin suturing with nylon after biopsy) and G3: control group (the animals were not subjected either to biopsy or to surgery). On the 20<IMG SRC="Image485.gif" WIDTH=10 HEIGHT=17> day after biopsy, the presence of adhesion strands between the sites of skin incision and testicle was evaluated by palpation. Adhesion strands were found in three testicles (15%) in G1 and in two testicles (10%) in G2. One hundred days after biopsy, orchiectomy was carried out and the material collected was assessed for subcutaneous (SC) and/or tunica vaginalis adhesions. G3 did not present any abnormality. Groups G1 and G2 presented four testicles each (20%) with adhesion between the tunics at biopsy site. On the other hand, subcutaneous adhesions were found once (5%) in G1 and three times (15%) in G2. Fibrin glue showed to be of easy application, required short postoperative monitoring, presented fast and good-quality healing property and tended to reduce formation of subcutaneous adhesion.

Effectiveness of fibrin glue in the reduction of postoperative intrapericardial adhesions.

The hemostatic properties of fibrin sealant have been well described. Previously published reports have attempted to clarify the possible role of fibrin glue in the inhibition of the formation of intrapericardial adhesions following cardiac surgery. Earlier work hypothesized that fibrin glue may reduce the severity of postoperative adhesions and that the use of autologous fibrin glue may have similar effects, without the risks that accompany homologous blood products. Six juvenile farm pigs were utilized to test this hypothesis. Conventional fibrin glue and single-donor fibrin glue were tested in open-heart surgery. This experimental model was also reexamined and found to be of significant utility in simulating adult reoperative cardiac surgery. The fibrin glue subjects were universally easier to reoperate due to fewer adhesions, as demonstrated grossly and histologically. The single-donor fibrin glue had no significant advantage on adhesion formation, when compared to the conventional fibrin glue group, but the ramifications of formulating fibrin glue in this fashion offer a significant benefit toward the complete use of autologous blood products in open-heart surgery.

Fibrin Glue and Conventional Sutured Vasal Anastomosis in the Rat

The present study was undertaken to evaluate the use of fibrin glue (Tisseel, Immune U.S., Inc) for vasovasostomy and to compare this technique to conventional sutured vasovasostomy. Thirty immature Sprague-Dawley rats, weighing from 60 to 80 g, were used in this study. A conventional one-layer sutured anastomosis (Ethilon 10-0) in 10 rats was compared to a fibrin glue technique of vasal anastomosis (10 rats). The fibrin glue technique was performed without sutures and was unstented. The biological glue was utilized to seal both ends of the vas. The contralateral vas was ligated with 5-O prolein. In the control group (10 rats) the left vas was ligated in the same way, and only the contralateral vas was explored. After 2 months, one male and two female rats were placed in a cage for a further 2 months. At the end of this period, the fertility rate was 80% (n = 8) of the control group, 60% (n = 6) of the conventional anastomosis, and 70% (n = 7) of fibrin glue groups, respectively. The testes and vasal specimens were evaluated for the presence of sperm granuloma, and histologic studies were performed. The incidence of sperm granuloma after vasovasostomy was 20% (n = 2) for the fibrin glue group and 30% (n = 3) for the sutured group. The sperms were seen in the proximal and distal side of the vasal anastomosis in 10 rats in the control group, in 8 in the glue group, and in 8 in the conventional sutured anastomosis group. Histology of testes revealed similar morphological changes in the area of anastomosis with both techniques. Operative time for sutured vasovasostomy averaged 31 min compared to an average of 10 min for the glue group. This study indicates that fibrin glue is a potentially useful adjunct to vasovasostomy.

FGF-1 Affixation Stimulates ePTFE Endothelialization without Intimal Hyperplasia

The affixation of FGF-1 to porous vascular grafts has been reported to stimulate capillary ingrowth and surface endothelialization. The current study further characterizes responses to fibroblast growth factor (FGF)-1 affixation to 30-cm-long grafts followed 140 days. ePTFE grafts (30 cm × 8 mm i.d.), 60 μm internodal distance, were impregnated with fibrin glue (FG) suspensions containing FGF- 1 and heparin. Two negative control groups were treated either with FG with heparin alone or left untreated. Grafts were explanted from the canine thoracoabdominal aortic position after 10, 30, or 140 days (n = 3/time/group) 10 hr after im injection of tritiated thymidine (0.5 μCi/kg). Specimens were studied by light and electron microscopy, immunohistochemistry, morphometric analyses, and cross-sectional autoradiography. RNA preparations from inner capsule tissues were used for reverse transcription-polymerase chain reaction (RT-PCR) analyses of FGF-1, FGF-2, transforming growth factor-β1, (TGFβ1) and FGF receptor mRNA species. Inner capsule collagen was quantitated by hydroxyproline colorimetry. Histologic analyses of perianastomotic regions were performed for comparison purposes. All explants were patent and without intimal hyperplasia. Progressive capillarization of the internodal spaces occurred over time and was significantly more extensive in the FGF1-treated group. Endothelialization of the luminal surface increased with time, at 140 days covering 86.7 ± 11.6% of the FGF-1 explants vs 46.1 ± 7.5% and 48.1 ± 13.3% in the other groups, P < 0.007 and P < 0.04, respectively. Inner capsule thickness at 140 days differed significantly (P < 0.05) between the FGF- 1 group (138.8 μm) vs either control group (93 and 67 μm, respectively), which did not significantly differ from each other. Cross-sectional autoradiography demonstrated an FGF-1-induced mitotic index increase at 30 days, 9.6 ± 4.4% compared to 2.5 ± 1.0 and 0 ± 0%, respectively, with both myofibroblasts and endothelial cells incorporating the [3H]thymidine label. The mitotic index returned to quiescent levels at 140 days (<1% in all groups). Collagen content increased with time in all groups, significantly greater in both FG groups vs antreated controls at 30 and 140 days. RT-PCR analyses revealed FGF-1, FGF-2, FGFR-1 (fig), and TGF-β1 mRNA in all samples without evidence of modulation by FGF-1 affixation. These data demonstrate FGF-1-induced graft capillarization and surface endothelialization without functionally significant intimal hyperplasia in this model.

A PROSPECTIVE STUDY OF THE USEFULNESS OF FIBRIN GLUE TO PREVENT POSTOPERATIVE PANCREATIC FISTULA

The clinical courses of 37 consecutive patients undergone distal pancreatectomy between January 1990 and December 1991 were prospectively studied for the usefulness of fibrin glue to prevent postoperative pancreatic fistula. The 37 cases were allocated to fibrin glue used group (18 cases) and without fibrin glue group (19). There was no significant difference in background factors between the both groups. In all patients pancreatic ducts were ligated with a 3-0 silk thread and the stumps of the pancreas were sutured continuously with a 3-0 prolene thread. Pancreatic fistula occurred postoperatively in 13 out of 37 patients (35.1%). Ten pancreatic fistulas (52.6%) occurred among 19 patients without fibrin glue, versus 3 pancreatic fistulas (16.7%) among 18 patients with fibrin glue, with a significant difference (p<0.05). These results suggest that, in patients undergone distal pancreatectomy, application of fibrin glue to the stumps of the pancreas after ligation of pancreatic duct might be useful to prevent from postoperative pencreatic fistula.

Fertility rates with delayed fibrin glue: vasovasostomy in rats

To determine if fibrin glued vasovasostomy had comparable fertility rates to sutured vasovasostomy. Twenty adult male Sprague-Dawley rats underwent bilateral vasectomy. Two weeks after vasectomy, 10 rats had a bilateral sutured vasal anastomosis consisting of four mucosal and four seromuscular sutures with 10-0 nylon. The second group of 10 rats underwent bilateral fibrin glue vasal anastomosis consisting of two transmural sutures with 10-0 nylon followed by application of fibrin glue. One month after vasectomy reversal, each male rat was mated with a female rat for a period of 2 weeks. Animal laboratory. PATIENTS PARTICIPANTS: Twenty male Sprague-Dawley rats. Bilateral vasectomies in 20 male Sprague-Dawley rats. Two weeks after vasectomy, 10 rats had bilateral sutured vasal anastomosis, and 10 rats had bilateral glued vasal anastomosis. Pregnancy after vasectomy reversal. Ten of 10 rats in the sutured group produced offspring for a fertility rate of 100%. Eight of 10 rats in the fibrin glue group produced offspring for a fertility rate of 80%. There was no statistically significant difference in the pregnancy rates between the two groups at the 95% confidence interval. Fibrin glue-delayed vasectomy reversal produces comparable fertility rates compared with conventional sutured vasectomy reversal in the rat.