The hierarchical design of the toe pad surface in geckos and its reversible adhesiveness have inspired material scientists for many years. Micro- and nano-patterned surfaces with impressive adhesive performance have been developed to mimic gecko\'s properties. While the adhesive performance achieved in some examples has surpassed living counterparts, the durability of the fabricated surfaces is limited and the capability to self-renew and restore function-inherent to biological systems-is unimaginable. Here the morphogenesis of gecko setae using skin samples from the Bibron´s gecko (Chondrodactylus bibronii) is studied. Gecko setae develop as specialized apical differentiation structures at a distinct cell-cell layer interface within the skin epidermis. A primary role for F-actin and microtubules as templating structural elements is necessary for the development of setae\'s hierarchical morphology, and a stabilization role of keratins and corneus beta proteins is identified. Setae grow from single cells in a bottom layer protruding into four neighboring cells in the upper layer. The resulting multicellular junction can play a role during shedding by facilitating fracture of the cell-cell interface and release of the high aspect ratio setae. The results contribute to the understanding of setae regeneration and may inspire future concepts to bioengineer self-renewable patterned adhesive surfaces.

暂无摘要。

We investigated a skin adhesive closure device consisting of a self-adhesive polyester mesh placed over the surgical incision, followed by a liquid adhesive that is spread over the mesh and surrounding the skin. It is intended to reduce wound closure times, scarring, and skin complications associated with traditional closure with sutures or staples. The aim of this study was to report on skin reactions in patients who underwent primary total knee arthroplasty (TKA) using the skin adhesive closure system.
A retrospective review of patients who underwent TKA using adhesive closure between 2016 to 2021 at a single institute was performed. A total of 1,719 cases were analyzed. Patient demographics were collected. The primary outcome was any postoperative skin reaction. Skin reactions were classified as allergic dermatitis, cellulitis, or other. Treatment(s), duration of symptoms, and surgical infections were also collected.
A total of 5.0% (86) of patients were found to have any type of skin reaction following their TKA. Of these 86, 39 (2.3%) had symptoms of allergic dermatitis (AD), 23 (1.3%) had symptoms of cellulitis, and 24 (1.4%) had other symptoms. A total of 27 (69%) allergic dermatitis patients were treated with a topical corticosteroid cream only; their symptoms resolved within an average of 25 days. There was only 1 case of superficial infection (<0.001%). No prosthetic joint infections were observed.
Despite skin reactions appearing in 5.0% of cases, the rate of infection was low. A patient-specific preoperative workup and effective treatment strategies can minimize complications associated with adhesive closure system and increase patient satisfaction following TKA.

暂无摘要。

Tuberculous bronchoesophageal fistula is a rare complication of tuberculosis. Herein, we report the case of a woman in her late 60s with a choking cough for more than 1 month. Iohexol esophagography revealed a fistulous communication between the esophagus and the right principal bronchus, and gastroscopy documented a fistulous orifice in the esophagus. Endoscopic closure with metal clips failed, and other treatment options, such as extended conservative treatment, covered self-expandable metal stents, and over-the-scope clips were rejected by the patient. Therefore, a combined therapy, endoscopic submucosal dissection-based suture combined with medical adhesive, was performed. Follow-up iohexol esophagography and gastroscopy confirmed fistula closure. During 1 year of follow-up after discharge, the bronchoesophageal fistula did not recur. Endoscopic submucosal dissection-based suture combined with medical adhesive appears to be a practical and feasible solution to complicated tuberculous bronchoesophageal fistula.

BACKGROUND: An open abdomen with frozen adherent bowels is classified as grade 4 in Björck\'s open abdomen classification, and skin grafting after wound granulation is a typical closure option. We achieved delayed primary fascia closure for a patient who developed open abdomen with enteroatmospheric fistulas due to severe adherent small bowel obstruction. We present here the details of his management.
METHODS: A 52-year-old man suffered acute abdominal pain during a flight and received an emergency laparotomy due to adhesive small bowel obstruction. Repeated laparotomies were required, and later open abdomen and proximal site jejunostomy were selected. After negative pressure wound therapy, he was transferred to our institution. Two enteroatmospheric fistulas emerged on the exposed intestine, and we diagnosed the condition as a Björck grade 4 open abdomen. After 8 months of wound care and parenteral nutrition, we decided to attempt primary wound closure because the patient required permanent oral restriction and total parenteral nutrition due to short bowel syndrome. A circular incision along the circumference of the exposed bowel allowed us to take a safe approach into the abdominal cavity. We removed the intestinal adhesions completely and resected the bowels, including the fistulas and anastomosed parts. Finally, the abdominal wall defect was reconstructed using the component separation technique, and the patient was discharged without an ostomy.
CONCLUSIONS: Primary fascia closure for grade 4 open abdomen is hard, but leaving a long interval before radical surgery and applying pertinent wound management may help solve this adverse situation.

In modern ophthalmological practice, three types of adhesives are most often used: synthetic (cyanoacrylate), biological (fibrin), and polyethylene glycol. Cyanoacrylate adhesive is very strong and polymerizes quickly, however, is generally more toxic compared to other types of adhesives, especially if applied to highly vascularized tissues. It is also believed to have bacteriostatic activity and suppress progressive stroma lysis within the area of ulceration by inhibiting polymorphonuclear leukocytes that exhibit collagenolytic and proteolytic activity. The article presents a clinical case of effective use of Russian-made cyanoacrylate (sulfacrylate) adhesive for the treatment of corneal perforation in a patient with neurotrophic keratopathy. The use of polymer glue can be an effective, affordable, and safe alternative to other methods of urgent treatment of corneal perforations and deep ulcers, as shown by this case and literature data. Depending on the lesion location and prognosis for vision, the method can be used either independently or become a treatment stage before keratoplasty. The latter would enable delayed transplantation with lower risk of complications.
В современной офтальмологической практике наиболее часто применяют три вида клеев: синтетические — цианоакрилатный, полиэтиленгликолевый и биологический — фибриновый. Цианоакрилатный клей обладает высокой прочностью, быстро полимеризуется, но может быть более токсичным в сравнении с вышеупомянутыми видами, особенно в обильно васкуляризированных тканях. Также считается, что он обладает бактериостатической активностью, подавляет прогрессирующий лизис стромы в зоне изъязвления за счет ингибирования полиморфноядерных лейкоцитов, обладающих выраженной коллагенолитической и протеолитической активностью. В статье представлен клинический случай эффективного применения отечественного цианоакрилатного (сульфакрилатного) клея для лечения перфорации роговицы на фоне нейротрофической кератопатии. Применение полимерного клея может быть успешной, доступной и безопасной альтернативой другим методам ургентного лечения перфорации роговицы и глубоких язв, о чем свидетельствуют описанный случай и данные литературы. В зависимости от локализации поражения и прогноза зрительных функций метод может быть как самостоятельным, так и этапом перед проведением кератопластики, позволяя выполнить трансплантацию роговицы с оптической целью в отдаленный период с меньшим риском осложнений.

Spinal adhesive arachnoiditis (SAA) is a rare, but often devastating, cause of compressive myelopathy. We report a patient with SAA resulting in a longitudinally extensive T2-hyperintense spinal cord lesion with initial nodular pial and dural enhancement mimicking neurosarcoidosis. Neurologists should be aware of this entity, especially in patients who have pertinent risk factors, such as prior meningitis, spinal cord trauma, or surgery.

暂无摘要。

This study investigated the effects of drug recrystallization on the in vitro performance of testosterone drug-in-adhesive transdermal delivery system (TDS). Six formulations were prepared with a range of dry drug loading in the adhesive matrix from 1% to 10% w/w with the aim of generating TDS with various levels of drug crystals. We visually quantified the amount of crystals in TDS by polarized light microscopy. The effect of drug recrystallization on adhesion, tackiness, cohesive strength, viscoelasticity, drug release, and drug permeation through human cadaver skin were evaluated for these TDS samples. The Optical images showed no crystals in 1% and 2% testosterone TDSs; however, the amount of crystals increased by increasing testosterone loading from 4 to 10%. A proportional and significant decrease (p < 0.05) in tack, peel, and shear strength of the adhesive matrix with increasing amount of crystals in TDS was observed. The drug crystals resulted in a proportional deterioration of the viscoelastic properties of the adhesive matrix. The 2% testosterone TDS showed faster drug release rate when compared to 1% testosterone TDS. The increase in drug loading from 2% to 4% w/w slightly increased the cumulative amount of testosterone released. Further increase in drug loading in TDS to 6, 8, and 10% was nonsignificant (p > 0.05) to affect the drug release and permeation. In conclusion, this study demonstrated that the extent of drug recrystallization can be quantitatively correlated with the deterioration of performance characteristics of TDS products.