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The goal of this study is to compare the healing rates of active lower extremity venous ulcers for patients receiving one of 3 ablation methods, compare their complications, and identify factors affecting successful healing and prevention of recurrence.For this study, data were collected retrospectively on 146 patients at a single institution, tertiary referral center, with an active venous ulcer who underwent ablation therapy via cyanoacrylate (VenaSeal), radiofrequency (RFA), or endovenous laser ablation (EVLA) from 2010 to 2020.The study showed a nonsignificant difference in days to ulcer healing postintervention between ablative techniques, with 80.8 days for cyanoacrylate ablation (n = 15), 70.07 for RFA (n = 44), and 67.04 days for EVLA (n = 79). A similar, nonsignificant trend was observed for ulcer recurrence, with a rate of 35.7% (5/14) for cyanoacrylate ablation, 26.7% (20/75) for EVLA, and 23.1% (9/39) for RFA. The same nonsignificant trend occurred with deep venous thrombosis following the procedure in 6.3% (1/16) of cyanoacrylate ablation, 4.8% (4/84) of EVLA, and 2.2% (1/46) of RFA cases. The rate of endovenous glue induced thrombosis was also higher (6.3%) for cyanoacrylate than endovenous heat induced thrombosis in EVLA (3.6%) and RFA (2.2%). Cox proportional hazard was significant for compliance with compression therapy (hazard ratio [HR] 2.12, confidence interval [CI] 95% = 1.10-4.20, P = 0.031) and a lack of working with a wound clinic (HR 0.50, CI 95% = 0.33-0.75, P = 0.001) were associated with the decreased time to healing of ulcer but was not influenced by the presence of other comorbidities of smoking or diabetes mellitus.This study indicates a trend toward cyanoacrylate ablation having longer healing times and more complications compared to other ablation methods when used in patients with active venous ulcers. Compliance with compression treatment is predictive of venous ulcer healing and working with a wound clinic had significantly longer healing times.

Chronic venous insufficiency (CVI) affects40% of the U.S. population; thus, intervention for symptomatic venous disease comprises a large portion of many vascular practices. The treatment of superficial CVI has evolved from open surgical treatment to minimally invasive endovenous closure, including both thermal and nonthermal techniques. Thrombotic complications of thermal ablation have been well reported, with an overall complication rate of 2%. However, a paucity of high-powered, real-world data is available on the thrombotic outcomes of nonthermal techniques. In the present study, we compared the incidence of endovenous heat-induced thrombosis (EHIT) and endovenous glue-induced thrombosis (EGIT) in a large cohort of patients with CVI.A retrospective review was conducted at two tertiary-level institutions of patients who had undergone superficial endovenous ablation from 2018 to 2021. The patient demographics, comorbidities, and periprocedural outcomes were collected through medical record review. A Caprini risk assessment model score was assigned using the information available from the electronic medical records. The patients were categorized by procedure type (ClosureFast [Medtronic Inc, Minneapolis, MN] radiofrequency ablation [RFA] vs VenaSeal [Medtronic Inc] cyanoacrylate glue closure [CAG]). The primary end point was the incidence of EHIT or EGIT. The secondary end point was the incidence of deep vein thrombosis and/or pulmonary embolism.A total of 803 patients had undergone 1096 procedures during the study period. Their mean age was 62 ± 15 years, and 67% were women. Of the 1096 procedures, 700 were RFA and 396 were CAG procedures, with a combined closure rate of 98% by postprocedure duplex ultrasound at 7 days. The average Caprini score was 5.2 ± 1.8 (RFA, 5.0; vs CAG, 5.4; P .001). The incidence of EHIT and EGIT was 1.9% and 1.3%, respectively (P = .57). The deep vein thrombosis rate was 0.1% in the RFA cohort and 0.3% in the CAG cohort (P = .81). A comparative analysis of thermal vs nonthermal techniques was performed. A univariate analysis of the risk factors for EHIT and EGIT revealed no significant factors predisposing to thrombotic events.The results from the present study have demonstrated the safety of RFA and CAG closure techniques for CVI, with lower thrombotic rates than previously reported. Further work might help to identify how these results can be achieved across all venous ablative techniques for CVI, even for patient populations with advanced venous disease and possibly a greater than average risk of thrombotic events.

Fungicide-resistant Fusarium has become a threaten to wheat production. Novel fungicide formulations can improve the efficacy of active ingredient and minimize the emergence of resistance. Encapsulation of fungicides in biodegradable carriers, especially, in polysaccharide, is a feasible approach to develop environment-friendly and efficient formulation. This study focused on the synthesis of ethyl cellulose-based phenamacril nano-delivery system by combining emulsion-solvent evaporation and high-pressure homogenization technology to improve the control of fusarium head blight in wheat. Emulsifier 125 and Tersperse 2500 were screened from eleven commonly used surfactants. Emulsifier 125 and Tersperse 2500 in a ratio of 2:1 and phenamacril nanocapsules with the mean particle size of 152.5 ± 1.3 nm were prepared. These showed excellent storage stability and wettability on crop leaves. A bioassay comparing the nanocapsules with a commercial preparation against Fusarium graminearum showed significantly improved biological activity. This formulation could be used to effectively not only to control fusarium head blight but also delay the occurrence of resistance.

The surface structure of mint (as-issued) and handled polymer five pounds sterling banknotes was studied by atomic force microscopy and laser scanning confocal microscopy. A total of 1856 fingermarks on mint and handled banknotes from four different issuing banks (Bank of England, Bank of Scotland, Royal Bank of Scotland and Clydesdale Bank) were visualised with Vacuum Metal Deposition (VMD), Cyanoacrylate Fuming (CAF) and, on Clydesdale Bank notes, magnetic fluorescent powder. VMD was significantly more effective in developing fingermarks on handled banknotes, across all the banks studied, although effectiveness varied with issuing bank. For example, on handled Bank of England notes 45% of marks showed ridge detail with VMD development and 28% with CAF; for Bank of Scotland handled notes success rates were 17% with VMD and 1% with CAF. Microscopy of degraded banknotes showed the loss of intaglio printing and the formation of a cracked surface structure in the handled notes. These features can lead to the trapping of powder, or contaminants, increasing quantity of development agent in fingermark background between the ridges, decreasing contrast and decreasing performance of powder-based fingermark development techniques. These same features can restrict the migration of components of the fingermark, preventing fingermarks degrading through spread of material and thus reducing potential formation of empty prints, so that VMD development is not adversely affected.

Previous studies have identified the potential benefit of the disulfur dinitride (S₂N₂) process to operationally relevant substrates. However, the majority of this work was conducted on prototype equipment that had substantial differences to the commercialised system (Recover Latent Fingerprint Technology (LFT)) in terms of design and chemical delivery. This paper evaluates the performance of Recover LFT on a problematic exhibit encountered within a fingerprint enhancement laboratory: unfired and fired ammunition. Three pseudo-operational experiments involving non-groomed, naturally handled fingermarks were conducted on the most commonly encountered types of ammunition used in crime in the United Kingdom (UK). In addition, Recover LFT was compared against Superglue Fuming followed by Basic Yellow 40 (BY40) Fluorescent Dye Staining (a commonly used alternative) to ascertain if the process provides added benefit to fingermark recovery rates. The results show that fingermark visualisation on small calibre cartridge cases remains difficult with few marks achieving enough ridge detail for comparison. However, this paper also shows that the novel Recover LFT process, which is still in its infancy and requiring optimisation, is no worse than currently implemented visualisation processes and is therefore worth further investigation.

To compare peri-operative outcomes of skin closure with octyl cyanoacrylate (OCA) skin adhesive (Dermabond) with or without subcuticular sutures after deep dermal suturing for implantable venous port placement closure.Seven hundred and ninety-two single-lumen implantable venous port insertions for chemotherapy were reviewed from September 2019 to March 2021 in a retrospective single-centre study. Propensity-score matching by a 1:1 nearest neighbour algorithm was conducted to control for confounding baseline differences. Distances were determined by logistic regression. Propensity-score matching was performed based on the following variables: age at procedure, gender, race, operator's seniority, use of anchoring polypropylene suture (PROLENE), port model, and volume of intra-operative local analgesia. The primary outcome was wound dehiscence at the first follow-up (∼1 week).The 792 port insertions were conducted in 302 males (38.1%), median age 63 years (IQR: 54-69). Of the 656 wounds closed with subcuticular sutures and skin adhesive, 136 were matched in a 1:1 fashion against procedures closed without a subcuticular suture. No significant differences were demonstrated in pain scores, bleeding, swelling, bruising, fever, wound dehiscence, and discharge at postoperative day 1 (POD1) and at first follow-up between the groups (all p0.05). Of note, no significant differences in wound dehiscence at first follow-up was found in both unmatched (p=0.133) and matched cohorts (McNemar-Bowker's χThese findings suggest that the omission of subcuticular sutures during implantable venous port closure may not compromise peri-operative outcomes when OCA skin adhesives were used.

Off-label use of radiofrequency vessel sealing devices for intestinal thermofusion has been reported as an alternate approach for closing the small and large intestines. The study aimed to evaluate if reinforcing the thermofusion line with a modified N-butyl-2-CyanoAcrylate and methacryloxysulpholane produced improved burst pressure values in ex vivo swine jejunal loops.A suture-less full-thickness jejunal biopsy was performed with different radiofrequency vessel-sealing devices (Ligasure 5 mm: RFVS-1; Atlast 10 mm: RFVS-2; Cayman Maryland: RFVS-3), and reinforcement with modified cyanoacrylate Glubran-2 (G2) at the thermofusion defect was applied. Burst pressure(BP) values were compared with a control group, wherein a cold blade was utilized to obtain the biopsy, followed by the closing of the jejunum with seven Gambee sutures.Seventy (n = 70) jejunal loop samples were distributed into the experimental groups.The RFVS-1 and -2 groups exhibited BP values similar to those of the suture group. The RFVS-3 group showed significantly lower BP values (P 0.05) than the suture group. Conversely, in the groups wherein G2 was applied, all BP values were comparable to those of the suture group. BP test in the RFVS-3G2 group showed significantly (P 0.05) higher values in the group using the same instrument without the glue (RFVS-3).G2 has been shown to improve the BP on the defects created by instruments that are not completely efficient in intestinal thermofusion and sealing. This experimental model showed that the performance of full-thickness biopsies with RFVS devices and reinforcement with G2 provide feasible and promising results.

A common pattern of recurrence after cyanoacrylate treatment of incompetent saphenous veins has been associated with reflux from the residual stump. The purpose of this study was to analyze the starting point of cyanoacrylate glue injection from the junction to decrease the stump length.A retrospective review was performed using prospectively collected data of patients with cyanoacrylate closure (CAC). Preoperatively, the diameter of the saphenous vein was measured. CAC was performed according to the manufacturer's instructions. After the procedure, clinical outcomes including pain, Venous Clinical Severity Score, and quality of life using the Aberdeen Varicose Vein Questionnaire were evaluated. Postoperative duplex scanning was performed to evaluate the occlusion rate of the target vein, stump length, and presence of endovenous glue-induced thrombosis. The stump length was analyzed according to the preoperative venous diameter to determine the proper point of glue injection to decrease the stump length.During the study period, CAC was performed in 408 patients. The mean age was 56.2 ± 11.5 years (range, 19-84 years). A total of 279 patients (68.4%) were women. Occlusion of the target vein was achieved in all patients. After the procedure, pain, Venous Clinical Severity Score, and quality of life were improved (P .001). Endovenous glue-induced thrombosis developed in 5.8% of patients. There was a 1.53-fold linear increase in the stump length for every 1-mm increment of the preoperative venous diameter. In 20 patients with a venous diameter ≥5 mm, glue injection was performed safely 4 cm distal to the junction to decrease the stump length.The stump length linearly increased with an increase in the saphenous vein diameter. If the diameter of the saphenous vein is more than 5 mm, cyanoacrylate glue may be injected 4 cm distal to the junction to decrease the stump length.

Summary Background Wound closure in the head and neck region is challenging, primarily due to aesthetic concerns. Tissue adhesives have been prized for their ease of use. This study aimed to compare the effectiveness of tissue adhesives as a suitable alternative to other conventional wound closure techniques, in the head and neck region. Methods A systematic review was conducted in line with PRISMA guidelines. Available English literature from 2009 to 2019 was reviewed from PubMed, Scopus and Google Scholar. Randomized controlled trials and controlled clinical trials with wounds in the head and neck region were included in this study. Results Sixteen articles were found to meet the inclusion criteria. Main outcomes assessed included the following: cosmesis, pain, swelling, bleeding, wound dehiscence, time and cost. There was significant heterogeneity in results for pain, swelling and bleeding. No significant difference was observed in wound dehiscence and long-term cosmetic outcome when tissue adhesives were compared with sutures and staples. The time taken for wound closure with tissue adhesives was faster than sutures but were conflicted when compared with staples. Cost was found to be similar. Conclusion Overall, there is a consensus that there is no long-term difference in cosmetic outcome and wound dehiscence between tissue adhesives and other wound closure techniques. Tissue adhesives have the benefit of being easy and quick to use with excellent patient satisfaction levels. We recommend tissue adhesives as a suitable alternative for wound closure in low tension areas in the head and neck region.

Presence of an endoleak can compromise aneurysm exclusion after endovascular abdominal aortic aneurysm repair (EVAR). Type II endoleaks (T2Es) are most common and may cause sac expansion. We report outcomes of translumbar embolization (TLE) of T2Es following EVAR.We conducted a retrospective chart review of patients with T2E after EVAR treated with TLE from 2011 to 2018 at a single academic institution. Treatment indications were the presence of persistent T2E and aneurysm growth ≥5 mm. Sac stabilization was defined as growth ≤5 mm throughout the follow-up period.Thirty consecutive patients were identified. The majority were men (n = 24), with a mean age of 74.3 years (95% confidence interval [CI], 70.9-77.6 years). The most common comorbidities were hypertension (83.3%) and coronary artery disease (54.0%). The mean maximal sac diameter at T2E discovery was 5.8 cm (95% CI, 5.4-6.2 cm). The mean time to intervention from endoleak discovery was 33.7 ± 28 months with a mean growth of 0.84 cm (95% CI, 0.48-1.2 cm) during that time period. The mean follow-up time after TLE was 19.1 months (95% CI, 11.1-27.2 months). Twenty-eight patients were treated with cyanoacrylate glue (CyG) alone, and two were treated with CyG plus coil embolization (CE). There was immediate complete endoleak resolution as assessed intraoperatively, and sac stabilization in 15 cases (50.0%). Eleven patients (36.7%) had evidence of persistent T2E on initial imaging after the embolization procedure; additional follow-up revealed eventual sac stabilization at a mean of 21.3 ± 7.2 months, and therefore, these patients did not require further intervention. In the remaining four cases (13.3%), there was persistent T2E after the initial TLE, requiring a second intervention. Repeat TLE stabilized growth in three of these four patients after a mean of 17.6 ± 12.9 months. One patient required open sacotomy and ligation of lumbar vessels due to continued persistence of the T2E and continued aneurysm growth. There were no ischemic complications related to the embolization procedures. Factors associated with persistent endoleak after initial embolization were larger aneurysm diameter at the time of initial endoleak identification (P .001) and the use of antiplatelet agents (P .02). The use of anticoagulation was not a significant risk factor for endoleak recurrence or aneurysm growth after TLE.TLE of T2E is a safe and effective treatment option for T2E with aneurysm growth following EVAR. Patients taking antiplatelet medication and those with larger aneurysms at the time of endoleak identification appear to be at increased risk for persistent endoleak and need for subsequent procedures following initial TLE. These patients may require more intensive monitoring and follow-up.

Background The 2-octyl cyanoacrylate topical adhesive with flexible self-adhesive polyester mesh (Dermabond Prineo) is becoming widely used in many surgical fields. However, no prior studies have tested the efficacy and safety of this topical adhesive compared with subcuticular suture in the same patient. The purpose of this study was to compare the efficacy and safety between Dermabond Prineo and subcuticular suture for skin closure in patients undergoing same-day bilateral total knee arthroplasties (TKAs). Materials and Methods A prospective, double-blind randomized controlled trial was performed in 51 patients scheduled to undergo same-day bilateral TKAs. One knee was randomly assigned to the Dermabond Prineo and the other knee was allocated to the subcuticular suture. As primary outcomes, Vancouver scar scale was evaluated at 6 months and Patient and Observer Scar Assessment Scale was evaluated at 2 weeks, 6 weeks, 3 months, and 6 months. Secondary outcomes included cosmesis efficacy (Hollander wound evaluation scale [HWES] and cosmesis visual analog scale [VAS]), time and pain efficiency (skin suture time, stitch out time, and stitch out pain VAS), and safety (wound complications during the 6-month follow-up period). The primary and secondary outcome measures were compared between groups. Results There were no significant differences in Vancouver scar scale and Patient and Observer Scar Assessment Scale at 6 months. Although there were no significant differences in HWES at 2 weeks, the Dermabond Prineo group showed better step-off border item of HWES. There was also no difference in cosmesis VAS at 6 months. The Dermabond Prineo group showed superior results in terms of time (suture time: Dermabond Prineo = 191 second (sec) ± 60.1 sec, subcuticular suture = 356.8 sec ± 92.3 sec; stitch out time: Dermabond Prineo = 4 sec ± 1.3 sec, subcuticular suture = 26.6 sec ± 4.2 sec, all P .05). Conclusion Comparing cosmetic efficacy, time efficiency, and safety, Dermabond Prineo provided quicker wound closure, shorter stitch out time, and better wound margin coaptation in the early postoperative period but similar cosmetic efficacy compared with subcuticular suture. Based on our study, Dermabond Prineo is a useful alternative to subcuticular suture in patients undergoing TKA. Level of Evidence Therapeutic level 1.

Background and Aims Gastric variceal bleeding (GVB) is associated with high morbidity and mortality. EUS-guided coil and cyanoacrylate (CYA) injection (EUS-CCI) has been shown to be an effective therapy in acute bleeding and secondary prophylaxis; however, there is a paucity of data on primary prophylaxis. Methods In this single-center observational study, adult patients with high-risk gastric varices (GV; size >10 mm or cherry red spot) without prior bleeding underwent EUS-CCI for the primary prophylaxis of GVB between June 2009 and December 2019. The primary outcome was post-treatment GVB. Results Eighty patients with a mean variceal size of 22.5 ± 9.4 mm and a mean length of follow-up of 3.0 ± 2.4 years were included. The etiology of portal hypertension was cirrhosis in 71 patients (88.7%) and noncirrhotic in 9 (11.3). The mean model for end-stage liver disease score was 12.3 ± 3.7 in patients with cirrhosis. The mean coil number was 1.5 (range, 1-3) and mean glue volume injected 2 mL (range, .5-5). Technical success was achieved in 100%, 96.7% had EUS confirmation of GV obliteration, and 67.7% were obliterated with 1 treatment session. Post-treatment GVB occurred in 2 patients (2.5%) and adverse events in 4 (4.9%). No deaths related to GVB occurred, and emergent transjugular intrahepatic shunts were not needed during the follow-up period. Conclusions In patients with high-risk GV, EUS-CCI for primary prophylaxis is highly effective at preventing GVB with a low rate of adverse events. Primary prophylaxis of high-risk GV with coil and CYA glue injection should be considered in centers with the appropriate expertise.

Background Antibacterial meshes for hernia repair seek to avoid infection in the patient. As these biomaterials are especially prone to bacteria settling at their sutured borders, this study examines whether the use of a cyanoacrylate tissue adhesive could improve mesh behavior at the fixation zones. Methods First, antibacterial polypropylene meshes were prepared by soaking in 0.05% chlorhexidine, and the response of n-hexyl cyanoacrylate to contamination with Staphylococcus aureus ATCC25923 was assessed in vitro. Then, in a preclinical model, partial defects (5 x 3 cm) were created in the abdominal wall of 18 New Zealand White rabbits and repaired with mesh to establish the following 3 study groups: (1) mesh without chlorhexidine fixed with cyanoacrylate, (2) antibacterial mesh fixed with sutures, and (3) antibacterial mesh fixed with cyanoacrylate (n = 6 each). The implants were inoculated with 106 CFU/mL of S aureus. At 14 days after surgery, bacterial adhesion to the implant and its integration within host tissue were determined through microbiological, histological and immunohistochemical procedures. Results As observed in vitro, the cyanoacrylate gave rise to a 1.5-cm bacteria-free margin around the prosthetic mesh. In vivo, the tissue adhesive prevented bacterial adhesion to the fixation zones, reducing infection of chlorhexidine-free meshes and optimizing the efficacy of the antibacterial meshes compared with those fixed with sutures. Conclusion These findings indicated that cyanoacrylate fixation does not affect mesh integration into the host tissue. Likewise, the antibacterial behavior and tissue response of a chlorhexidine-treated polypropylene mesh is improved when cyanoacrylate is used for its fixation.

This « Magnum Opus » emphasizes that serendipity is a corner stone in research. The paths of discovery and innovation often result from the interdisciplinarity of scientific areas that are a priori disconnected from each other. In the 1970s, fundamental discoveries in cell biology led to unexpected advances in galenic pharmacy with the emergence of nanotechnologies for the intracellular delivery of non diffusing molecules. As well, fluorescein-loaded polyacrylamide nanocapsules were shown to deliver this fluorescent agent precisely into cellular lysosomes which represented a seminal observation. However, due to the lack of biodegradability of this carrier polymer, this approach was still far from therapeutic application. The use of cyanoacrylates as surgical glue inspired us to use this material in the design of the first biodegradable nanoparticles for human use. Capable of transporting compounds with anti-tumor activity, these polyalkylcyanoacrylate nanoparticles demonstrated the unexpected property of overcoming multi-drug resistance. This discovery led to the development of a nanomedicine that has completed phase III clinical trials for the treatment of resistant hepatocarcinoma. Going beyond the state-of-the art, a step ahead in the nanomedicine field was the drug « squalenoylation » technology, which represents a shift from the « physical » to the « chemical » encapsulation paradigm. The bioconjugation of anticancer and other drugs to squalene, a natural and biocompatible lipid, enabled a dramatic increase in drug payload, and eliminated the so-called « burst release » of drug: Two major drawbacks commonly associated with drug nanoencapsulation. The drug « squalenoylation » approach resulted in a generic nanomedicine platform with broad pharmacological applications.

Objective The proprietary cyanoacrylate closure (CAC) system vs radiofrequency ablation (RFA) trial (VenaSeal Sapheon Closure System Pivotal Study [VeClose]) showed that CAC, a nontumescent, nonthermal, nonsclerosant ablation technique, was effective and noninferior to RFA in vein closure with good 36-month outcomes. Conducted under a separate protocol, the aim of this extended follow-up was to assess the long-term safety and effectiveness of CAC and RFA for the treatment of incompetent great saphenous veins (GSV) at 5 years (60 months) of follow-up. Methods This 60-month extension study was conducted for all patients who completed the randomized VeClose study and who were willing to participate. The pivotal VeClose study included patients with symptomatic moderate to severe varicosities (Clinical, Etiology, Anatomy, and Pathophysiology [CEAP] class C2-C4b) and symptomatic GSV incompetence who were randomly assigned (1:1) to either CAC or RFA. The primary outcome measure of this 60-month extension study was complete closure of the target vein, with planned exploratory analysis of noninferiority. Secondary outcomes included CEAP class; completion of the Venous Clinical Severity Score, EuroQol-Five Dimension survey, and Aberdeen Varicose Vein Questionnaire; patient satisfaction with treatment; adverse events (AEs) related to target GSV; and details of adjunctive procedures. Results A total of 89 patients completed the 60-month visit, which included 47 from the CAC group, 33 from the RFA group, and 9 CAC roll-in patients. No new recanalization events have been observed in the groups between 36 and 60 months of follow-up. At 60 months, Kaplan-Meier estimates for freedom from recanalization in the randomized CAC and RFA groups were 91.4% and 85.2%, respectively, demonstrating noninferiority of CAC compared with RFA. Both groups demonstrated sustained improvements in EuroQol-Five Dimension and quality of life measures through 60 months. Whereas patients assigned to C0 or C1 clinical class were excluded from the original study, more than half of all returning patients (64% [57/89]) were now assigned to C0 or C1, suggesting an improved clinical class from baseline. Furthermore, 41.1% of returning CAC patients and 39.4% of returning RFA patients are presently at least two CEAP clinical classes lower than at baseline. No long-term device- or procedure-related serious AEs occurred in either group between 36- and 60-month follow-up. Conclusions CAC and RFA were effective in achieving complete target vein closure of the GSV at long-term follow-up, with CAC demonstrating continued noninferiority to RFA. CAC was also associated with sustained improvements in symptoms and quality of life, lower CEAP class, and high level of patient satisfaction without serious AEs between 36 and 60 months.

Objective Patients with venous leg ulcers (VLUs) represent the worse spectrum of chronic venous insufficiency (CVI). The Early Venous Reflux Ablation (EVRA) landmark trial published in 2018 demonstrated that early endovenous intervention results in faster healing of VLUs. We describe our post-EVRA experience using endovenous cyanoacrylate glue ablation (ECGA) to treat superficial venous reflux on an early basis and assess its efficacy and safety in the setting of VLUs. Methods There were 37 patients (39 legs, 43 truncal veins) with 43 discrete venous ulcers who underwent ECGA for CVI symptoms and VLUs. They received compression therapy and regular dressings for the VLUs postoperatively and were reviewed at 1 week, 3 months, 6 months, and 12 months after the procedure. Postoperative healing time for VLUs and complications were recorded along with the patient's satisfaction and postprocedure pain scores. Results The venous ulcers were all Conclusions ECGA together with compression therapy for VLUs is both safe and effective in this population of Asian patients. ECGA for patients with VLUs has excellent patient acceptability, minimal morbidity, and low recanalization rates at 12 months. Larger extensive studies and longer follow-up periods are required to validate the preliminary outcomes of this paper, and if it is proven to significantly improve ulcer healing rates, this will change the way we approach chronic venous ulceration.

Background Accurate and fast localization of small pulmonary nodules is required for local pulmonary resection. In this study, we introduced and assessed a novel technique for the preoperative localization of small pulmonary nodules by using ZT medical glue (2-octyl cyanoacrylate). Methods 101 patients who had a combined total of 106 small pulmonary nodules located by ZT glue and 53patients with 53 small pulmonary nodules located by hookwire were selected. Guided by computed tomography (CT), the surgeon injected certain volume ZT glue into an area adjacent to the small pulmonary nodule, then, the adjacent lung tissue infiltrated by ZT glue formed into a depressed hard nodule which can be used for preoperative localization with an obvious mark on lung surface or different hand touch. After localization, Wedge resection was performed via video-assisted thoracoscopic surgery and the specimen obtained from the procedure was immediately sent for pathological examination, followed by a standard surgical procedure. A contrast has been made between the ZT glue method and the hookwire. Results 101 operations were successfully performed by using this novel technique, and 106 small pulmonary nodules were successfully located. Compared with the hookwire location, ZT glue method obviouslyextended the Time interval between localization and operation (P = 0.00) and a same complication rate (P = 0.07). Conclusions The use of ZT glue is a safe and effective method for the localization of small pulmonary nodules. Trial registration This study was approved by the ethics committee of Shaoxing People's Hospital (Number:2016-004, Date:2016,2,24), and informed consent was obtained from all enrolled patients.

Mastery of the microsurgical anastomosis is an indispensable component of neurosurgical training. However, in many resource-limited countries, the training, materials, and equipment to obtain these surgical and decision making skills are severely lacking. This study aimed to compare different suturing techniques for microvascular anastomosis and to complete a comparative assessment of the performance of a young neurosurgeon when using the various techniques.We compared 3 end-to-end suturing techniques for microvascular anastomosis: interrupted suturing, continuous suturing, and a 2-octyl-cyanoacrylate-based lid technique using an umbilical artery model. We assessed the subjective difficulty of the suturing technique, the time needed to perform the procedure, and the flow rate and leakage of the vessel after each technique. This study was designed to use materials that would be available in developing countries. Surgical apparatus used, such as operating microscopes, were first-generation technology, and testing procedures were designed for neurosurgical residents in developing countries.The mean times to complete the anastomosis were 20.7 ± 7.7 minutes for the interrupted technique, 26.4 ± 7.7 minutes for the continuous technique, and 12.5 ± 2.5 minutes for the lid technique; these values were significantly different (P0.01). The differences among the 3 techniques in leakage and flow rates and subjective difficulty in performance were not significant.Suturing time was the only statistically significant difference among the 3 anastomotic techniques, with the lid technique apparently the quickest to perform. Such techniques can be designed to assess microsurgical abilities and help neurosurgery residents in developing countries improve their surgical skills and techniques.

Intervertebral disc (IVD) degeneration has been linked to Low Back Pain (LBP) which affects over 80% of the population ranking first in terms of disability worldwide. Degeneration progresses with age and is often accompanied by annulus fibrosus (AF) tearing and nucleus pulposus (NP) herniation. Existing therapies fail to restore IVD function and may worsen AF defects, increasing the risk of reherniation in nearly 30% of patients. Current AF closure options are ineffective, presenting biological or mechanical limitations. Bioadhesives have potential use in this area, however methods to assess performance are limited. Herein, we propose a biomechanical testing method to assess bioadhesives’ capacity to seal AF tears. Two candidate bioadhesives to seal AF tears were evaluated; a tough hydrogel adhesive, and a cyanoacrylate-based glue. The adhesion energy at the interface between bovine discs and the tough hydrogel adhesive was quantified using a peel test (n=4). An experimental method to measure the burst pressure of IVDs was then developed. This method was used to quantify the burst pressure of intact (n=7), injured (AF punctured with a 21G needle; n=7), and sealed IVDs (after applying either the tough hydrogel adhesive patch as a sealant; n=5, or the cyanoacrylate-based glue over the AF tear; n=6). The tough adhesive yielded a strong adhesion energy of 239 ± 49 J/m2 during the peel tests. A maximum pressure of 13.2 ± 3.8 MPa was observed for intact discs in the burst pressure tests, which reduced by 61.4% to 5.1 ± 1.5 MPa in the injured IVDs (p

The VenaSeal closure system (Medtronic, Minneapolis, Minn) is a nonthermal, minimally invasive method for the treatment of superficial venous insufficiency using a proprietary n-butyl cyanoacrylate. We report the case of a 45-year-old woman who underwent right great saphenous vein closure with VenaSeal and subsequently had a biphasic reaction to n-butyl cyanoacrylate, confirmed on patch testing that had negative results for other cyanoacrylates. Despite the initial allergic response, which settled with antihistamines, follow-up duplex ultrasound imaging confirmed successful great saphenous vein closure, and the affected vein remained in situ without further complication.

Surgical site infections (SSIs) are a common source of morbidity with vascular surgery incisions, especially in the groin. Single institution case series have widely varying, but high incidences of groin wound infection after open lower extremity revascularization. Optimally, a dressing that did not require changes, had low cost, and was water resistant would be optimal in these patients. We developed and validate a new dressing utilizing Dermabond (Ethibond™) and Tegaderm™ for vascular surgery incisions that could simplify and reduce postoperative SSIs. In this initial experience, we reviewed 94 patients. Of the 94 patients, 0 had signs of infection superficial or deep, dehiscence, or evidence of nonhealing. Gluing a Tegaderm to an incision using Dermabond is a novel and easy way to perform dressing that reduces wound infection, increases patient comfort, avoids dressing changes, and allows visualization of the wound.

A novel method for detection and visualization of latent DNA using Diamond™ Nucleic Acid Dye (DD) staining has been developed. Applying DD to an object has the real potential to visualize DNA on a substrate from which a DNA profile can be generated, but it is important to determine whether this staining will adversely affect other forensic investigational techniques and vice versa. The aim of this study was to examine the interactions between staining a fingermark to detect DNA and then generate a DNA profile in combination with several standard latent fingermark enhancement methods. Six common fingerprint enhancements processes were chosen; (1) black powder, (2) black magnetic powder, (3) red magnetic powder, (4) white powder, (5) aluminum powder and (6) cyanoacrylate fuming. For all six methods, mark enhancement was carried out before DD staining and vice versa. DD is effective in detection of DNA in the presence of both aluminum and white finger mark powders and DD does not compromise the subsequent detection of ridge patterns if DD is applied first. Whilst magnetic powders could be used to successfully enhance latent fingermarks even after DD had been applied to them, latent DNA could not be observed in the marks irrespective of whether magnetic powder was applied before or after DD treatment. Magnetic powders did not adversely affect the profiling of DNA present in the marks. The application of DD to fingermarks did not adversely affect the enhancement of fingermarks using cyanoacrylate fuming. Whilst fluorescent particles resembling cells stained with DD were observed in marks either post-treated or pre-treated with cyanoacrylate vapor, DNA amplification and profiling was not successful. While it may be important in particular investigations to collect DNA profiles from latent fingermarks with continuous ridges and clear minutiae, the main utility of the technique described here would be in relation to investigations where enhancement has resulted in only partial or smudged marks. The results presented here indicate that if it is desirable to visualize latent DNA on an object but it is also planned to treat the object with cyanoacrylate vapor or magnetic powders then it is important to apply DD first, record the location of DNA and then apply the mark enhancement technique. For aluminum and white powder mark treatments such precautions are not important.

Objectives Split thickness skin graft is an essential component of release of post burn contracture of neck. There are many methods of fixation of skin grafts; however, there is lack of objective comparison between different techniques. This study has been designed to compare three commonly used techniques of split thickness skin graft fixation methods. Surgical time, advantages, cost factor and post-operative outcome have been compared amongst three techniques. Methods A randomized interventional comparative study was conducted to compare three methods of skin graft fixation in patients of 10–50 years age group, with contracture of more than 3 month duration having more than 100 cm2 skin defects after contracture release. Resurfacing of the defects after contracture release was carried out in all the groups using autologous split skin grafts. Patients were included in three groups; Group 1: tie over method, Group 2: skin stapler fixation and Group 3: Cyanoacrylate glue fixation. Results Mean duration of fixation procedure was 34 min in tie over group, in skin stapler group 7 min and in cyanoacrylate group 12 min. Mean cost of fixation material was 10.23 USD in tie-over group, 11.23 USD in stapler group and 40.06 USD in cyanoacrylate group. Mean score of pain/discomfort (visual analog score) on dressing removal in tie-over group was 3, for skin stapler group was 2.9 and that for cyanoacrylate glue group was 1.8. mean graft take was found to be 90.1% in tie-over group, 94.1% in skin stapler group & 93.8% in cyanoacrylate glue group. On logistic regression analysis, keeping all the variables constant in the groups the complications as the outcome variable, three groups are comparable. The need for regrafting remains inconclusive. Conclusions Skin stapler method for skin graft fixation was least time consuming, affordable and highly reliable when graft take success was considered. Cyanoacrylate glue fixation method was least painful and reliable in terms of graft take success though costlier than other two

Poly(butyl-2-cyanoacrylate) (PBCA) nanoparticles have been widely elaborated for nearly half a century. However, PBCA nanowires (PNWs) were seldom investigated. Here, new polymeric biomaterial PNWs were prepared via emulsion polymerization based on the sodium dodecyl sulfate (SDS)-assisted emulsion process. Results indicated that SDS micelles and PBCA polymer can develop surfactant-polymer complexes by self-assembly at room temperature. SDS concentration was confirmed to be the critical parameter for the association of the surfactant and the polymer. With the addition of SDS (0–40 mM), the interaction between SDS and PBCA led to a series of transitions from nanoparticles to nanowires. These morphology transitions were triggered by changing the electrostatic repulsion in the SDS-PBCA system, confirmed by the variety of zeta potential with increasing molar contents of SDS. To overcome the electrostatic repulsion, the complexes underwent transitions from spherical, worm-like (short-cylindrical), to elongated-cylindrical form. Finally, associated with the results from scanning / transmission electron microscopy (SEM / TEM), the elongated-cylindrical PNWs acquired at 20 mM of SDS were chosen to execute cell viability assay, which showed that they had no toxicity but with good-biocompatibility at the doses ≤ 50 μg/ml. These results indicate that the PNWs prepared by this facile-green and low-toxic strategy can potentially work as promising biomaterials in the biomedicine field.

Cyanoacrylate closure for the treatment of incompetent saphenous veins does not cause thermal damage and demonstrates satisfactory outcomes with rapid recovery. However, the characteristics of phlebitis-like abnormal reaction (PLAR), the most common adverse event after cyanoacrylate closure, have not been clarified. Moreover, it differs from typical phlebitis after thermal ablation. The objective of our study is to investigate the clinical features of PLAR after cyanoacrylate closure and to report its management.A total of 160 patients with 271 incompetent saphenous veins (great saphenous veins, 201; small saphenous veins, 70) underwent cyanoacrylate closure with the VenaSeal™ system. We defined PLAR as any unusual skin condition that develops suddenly, such as erythema, itching, swelling, and pain/tenderness, over the treated veins several days after cyanoacrylate closure. Oral antihistamines and intravenous dexamethasone were administered to manage PLAR.Of the 271 treated veins, 69 experienced PLAR (25.4%). The mean time of occurrence was 13.6 ± 4.6 days after treatment. The rate of occurrence of erythema, itching, swelling, and pain/tenderness were 92.2%, 91.2%, 66.2%, and 48.5%, respectively. The occurrence of PLAR was significantly higher for great saphenous veins than for small saphenous veins (P 0.001). Occurrences were more frequent in cases with a suprafascial great saphenous vein of length10 cm than in cases with a subfascial great saphenous vein (P = 0.001). The proportion of patients who reported swelling decreased by more than half after the administration of oral antihistamine. The pain score on the 10th day also decreased significantly after the administration of antihistamine (P = 0.006).PLAR must be distinguished from classic phlebitis. We believe that PLAR is a type IV hypersensitivity reaction due to a foreign body, and in our experience, antihistamines or steroids are effective for the prevention and management of PLAR.

Source at https://doi.org/10.1016/j.jconrel.2018.11.029. Licensed CC BY-NC-ND 4.0. The effect of poly(2-ethyl-butyl cyanoacrylate) nanoparticles containing the cytotoxic drug cabazitaxel was studied in three breast cancer cell lines and one basal-like patient-derived xenograft model grown in the mammary fat pad of immunodeficient mice. Nanoparticle-encapsulated cabazitaxel had a much better efficacy than similar concentrations of free drug in the basal-like patient-derived xenograft and resulted in complete remission of 6 out of 8 tumors, whereas free drug gave complete remission only with 2 out of 9 tumors. To investigate the different efficacies obtained with nanoparticle-encapsulated versus free cabazitaxel, mass spectrometry quantification of cabazitaxel was performed in mice plasma and selected tissue samples. Nanoparticle-encapsulated drug had a longer circulation time in blood. There was approximately a three times higher drug concentration in tumor tissue 24 h after injection, and two times higher 96 h after injection of nanoparticles with drug compared to the free drug. The tissue biodistribution obtained after 24 h using mass spectrometry analyses correlates well with biodistribution data obtained using IVIS® Spectrum in vivo imaging of nanoparticles labeled with the fluorescent substance NR668, indicating that these data also are representative for the nanoparticle distribution. Furthermore, immunohistochemistry was used to estimate infiltration of macrophages into the tumor tissue following injection of nanoparticle-encapsulated and free cabazitaxel. The higher infiltration of anti-tumorigenic versus pro-tumorigenic macrophages in tumors treated with the nanoparticles might also contribute to the improved effect obtained with the nanoparticle-encapsulated drug. Tumor infiltration of pro-tumorigenic macrophages was four times lower when using nanoparticles containing cabazitaxel than when using particles without drug, and we speculate that the very good therapeutic efficacy obtained with our cabazitaxel-containing particles may be due to their ability to reduce the level of pro-tumorigenic macrophages in the tumor. In summary, encapsulation of cabazitaxel in poly(2-ethyl-butyl cyanoacrylate) nanoparticles seems promising for treatment of breast cancer.

Aim The aim of the study was to compare postoperative sequelae and wound healing outcome following closure of surgical wound with either cyanoacrylate tissue adhesive or silk suture. Methods Subjects with mesio-angularly impacted mandibular third molar were allocated randomly into 2 equal groups. The control group had wound closure with silk suture and study group with cyanoacrylate tissue adhesive. Subjects were followed up for 7 postoperative days. Postoperative pain, swelling, trismus, bleeding, wound dehiscence and wound infection were evaluated. Results Sixty subjects in each group completed the study. No significant difference was observed in the mean postoperative pain, swelling, trismus, wound dehiscence and infection between the 2 groups. There was a statistically significant difference in postoperative bleeding between the 2 groups on postoperative day 1, with more bleeding in the control group. Conclusions This study shows that cyanoacrylate tissue adhesive compares favourably with silk suture as a wound closure material. In addition, cyanoacrylate tissue adhesive seems to have beneficial haemostatic effect on postoperative bleeding.

There has been growing interest in the Foster+Freeman RECOVER® Latent Fingerprint Technology system to develop fingermarks from fired ammunition. Over a six-month period, 1540 fingermarks were deposited on brass.223 ammunition, the majority of which were then fired after different time intervals. Samples were subjected to a cleaning protocol and/or processed with disulfur dinitride, cyanoacrylate/Brilliant Yellow 40, and/or vacuum metal deposition. Overall, 121 out of 1304 (9.3%) of natural fingermarks deposited were deemed identifiable post-firing and processing. This translated to 102 out of 652 (15.6%) of fired cartridges having identifiable fingermarks. A pseudo-operational study, which involved processing 1000 fired brass ammunition of various caliber using disulfur dinitride with and without a cleaning protocol, was conducted; only 18 (1.8%) comparable fingermarks were developed. This study demonstrates the need for more robust research involving this challenging substrate and novel technology, with which several issues were identified.

Disease of the venous system is an underappreciated public health problem. Minimally invasive treatments such as radiofrequency ablation (RFA) or cyanoacrylate adhesive ablation (CAA) have almost entirely replaced surgical stripping (SS) of the great and small saphenous veins. The purpose of the present study was to compare the outcomes at 3 years after SS, RFA, and CAA by assessing the incidence of complications and reinterventions and performing a cost-effectiveness analysis.From February 2016 to February 2019, all consecutive patients with symptomatic varicose veins treated at vascular department of two hospitals using SS, RFA, or CAA were included in the present study. The clinical outcomes were measured by quality-adjusted life years (QALYs), complications, and reintervention. A comparison with conservative treatment was also performed. A detailed resource use was recorded for each procedure. All costs were normalized to May 2020 U.S. dollars and euros. Analysis of the data was by the treatment received. All statistical tests were two-sided, and the significance level was set at 5%. Two perspectives of the analysis were considered: the social perspective and that of the Spanish Public Health System. The study period was 3 years. No discount rate was applied.A total of 233 patients were enrolled in the present study: SS, n = 90 (38.6%); RFA, 93 (39.9%); and CAA, n = 50 (21.5%). The number of complications was 11 (12.2%), 3 (3.3%), and 3 (6%) in the SS, RFA, and CAA groups, respectively (P = .06). No patient had required reintervention. The median loss of workdays for the SS, RFA, and CAA group was 15 days (interquartile range [IQR], 10-30 days), 0 days (IQR, 0-6 days), and 0 days (IQR, 0-1 days), respectively (P .001). The median level of satisfaction for the SS, RFA, and CAA group was 9 (IQR, 8-10), 10 (IQR, 9-10), and 10 (IQR, 9-10), respectively (P .001). The QALYs was 2.6 years for all three procedures. The median overall cost was €852 (US$926) for SS, €1002 (US$1089) for RFA, and €1228.3 (US$1335) for CAA. The total cost per QALY was €323/QALY (US$351/QALY) for SS, €380/QALY (US$413/QALY) for RFA, and €467/QALY (US$508/QALY) for CAA. The indirect costs were measured by the cost of the workdays lost for each patient and were €1527 (US$1660; IQR, €1018-3054); €0 (IQR, €0-611) for RFA, and €0 (IQR, €0-102) for CAA (P .001).All three techniques were cost-effective (procedures with an incremental cost-effectiveness ratio €30,000/QALY can be recommended). From the Spanish Public Health System perspective, when considering only the health care costs, the most cost-effective technique was SS. From the social perspective, including the opportunity costs of medical leave, CAA was the most cost-effective technique, saving €1600 per patient, a cost that more than compensated for the savings realized from using SS in direct health care costs.

In 2020 the Fingerprint Working Group (EFP-WG) of the European Network of Forensic Science Institutes (ENFSI) undertook a collaborative exercise (CE) with the aim of assessing the ability in developing fingermarks on an item constituted of compostable polymers. The test was prepared and managed by the officially established advisory group. The characteristics of the CE are summarised. Different approaches emerged from the outcomes. Multi-Metal Deposition (MMD) was used as reference method for the assessment of the results. It demonstrated to be the more effective and consistent technique for fingermark visualisation on the specific kind of Mater-Bi® compostable polymer used for the test. Alternative techniques, such as Vacuum Metal Deposition (VMD), cyanoacrylate fuming, followed by Basic Yellow 40 dye staining or in its fluorescent forms demonstrated to be effective methods. However, it seems that the operational conditions need to be controlled in order to find the optimal ones. Conversely, data does not support the use of amino acid sensitive techniques.

Gemcitabine is the cornerstone of pancreatic cancer treatment. Although effective in most patients, development of tumor resistance to gemcitabine can critically limit its efficacy. The mechanisms responsible for this phenomenon remain elusive, but evidence suggests that ubiquitin-specific peptidases (USPs) may be key regulators in cancer chemo-resistance. The present study aimed to investigate the role of USP9X in gemcitabine resistance using in vitro pancreatic cell lines and a mouse xenograft model. We found that the expression of USP9X in pancreatic cancer cells was positively correlated with gemcitabine resistance, and that inhibition of USP9X by WP1130 sensitized pancreatic cancer cells to gemcitabine. Gemcitabine induced autophagy, and blocking autophagy with chloroquine improved sensitivity to gemcitabine. We also found that WP1130 inhibited gemcitabine-induced autophagy, and blocking autophagy abolished the sensitization effect of WP1130 on gemcitabine in pancreatic cancer cells. Finally, combined gemcitabine and WP1130 treatment enhanced the anti-tumor effect of gemcitabine by suppressing autophagy in vivo. Taken together, these results demonstrate that inhibition of USP9X sensitized pancreatic cancer cells to gemcitabine by inhibiting autophagy, which provides a novel insight into gemcitabine resistance in pancreatic cancer.

Previous data from our research group showed that chitosan-coated poly(isobutylcyanoacrylate) nanoparticles (NPs) (denoted PIBCA/Chito20) exhibited intrinsic anti-Trichomonas vaginalis activity, while PIBCA/pluronic® F68 without chitosan (PIBCA/F68) were inactive. However, the mechanism of anti-T. vaginalis activity of chitosan-coated PIBCA NPs is still unknown. Our hypothesis is that chitosan-coated NPs are internalized by the parasite, contrarily to PIBCA/F68. In this investigation, the impact of NP surface on their internalization by the protozoan was studied using flow cytometry and parasite morphological changes after different incubation times with PIBCA/Chito20 NPs were monitored by electron microscopy. Flow-cytometry revealed that PIBCA/Chito20 NPs were uptaken by T. vaginalis as early as 10-min-incubation. Drastic cell morphological transformations were observed from scanning electron microscopy and transmission electron microscopy after incubation with PIBCA/Chito20 NPs. Numerous pits were seen on cell membrane since 10 min. Gradual increase in contact time increased NP endocytosis and induced proportional damages to T. vaginalis membrane. Then, investigation of whether PIBCA/Chito20 NPs can improve MTZ anti-T. vaginalis activity was studied using checkerboard experiment. Calculation of fractional inhibitory concentration index (FICI = 3.53) showed an additive effect between NPs and MTZ.

Purpose To determine the efficacy and safety of transabdominal direct sac puncture embolization of type II endoleaks after endovascular abdominal aortic aneurysm repair (EVAR). Materials and Methods This retrospective review included 30 patients (4 women, 26 men; mean age = 79.1 years) who underwent 33 transabdominal direct sac puncture embolization procedures for type II endoleaks after EVAR. Embolization agents included cyanoacrylate glue only (45.5%), glue/coils (36.4%), and Onyx with or without glue/coils (18.1%). Technical success was defined as complete endoleak embolization on intraprocedural fluoroscopy. The primary outcome was freedom of aneurysm growth, which was defined as ≤ 5% aneurysm sac volume change on follow-up computed tomography (CT) imaging or ≤ 5 mm aneurysm sac diameter change on ultrasound without definite endoflow. Aneurysm sac volumes before and after embolization were manually segmented from CT images. The procedural complication rate was calculated. Results Technical success was achieved in 97% of patients (29/30). Follow-up imaging was available in 27 patients (25 CT; 2 ultrasound), and mean imaging follow-up duration was 15.5 months. Freedom of aneurysm growth was achieved in 85.2% of patients (23/27) after 1 or more embolization procedures. Median fluoroscopic and procedure times were 11.3 minutes and 90 minutes, respectively. The complication rate was 9.1% (3/33) and included 1 case of nontarget embolization with transient neuropraxia and 2 self-limiting rectus sheath hematomas relating to the percutaneous puncture site. No aneurysm-related mortality occurred during the follow-up period. Conclusions Percutaneous transabdominal embolization is a safe and efficacious treatment for type II endoleak, with a short procedure time.

Repair of the nail bed and plate after distal phalanx trauma remains controversial. The aim of this study was to determine whether simple approximation of the nail bed flaps maintained by tension band suture of the nail plate is sufficient to prevent nail dystrophies. Our series gathered 27 fingers in 25 patients with a mean age of 36 years. In 15 cases (Group I), the nail plate was fixed in a single layer by a point in a frame, and in 12 cases (Group II), the bed and the plate were fixed layer-by-layer using the wound adhesive, 2-octylcyanoacrylate. At the last follow-up, the Zook score was excellent and very good in 100% of Group I patients, and in 83.3% of Group II patients. Within 8 days, the average pain was 1/10 in Group I, and 2.5/10 in Group II. There was one infection in Group I and four hematomas in Group II. The Quick DASH score was 1.13/100 in Group I and 0 in Group II. Our results show that in the case of a traumatic nail bed injury, suturing the nail bed and applying 2-octylcyanoacrylate adhesive is less effective than simple approximation of the nail bed flaps by tension band suture of the nail plate.

Background Surgical site infection (SSI) is a debilitating complication of lower limb arthroplasty with significant morbidity and increased costs. Numerous risk factors are associated with SSI. Methods In an effort to identify novel risk factors for SSI, we undertook a retrospective cohort study of 1832 primary total hip arthroplasties and 2100 primary total knee arthroplasties performed in our high volume arthroplasty unit over a 2-year period. Results Two risk factors were identified for SSI following total hip arthroplasty: body mass index ≥30 and peri-operative blood transfusion. Eight risk factors were identified for SSI following total knee arthroplasty: hypertension, peri-operative blood transfusion, skin closure using 2-octyl cyanoacrylate, use of oral steroids, reduced serum mean cell volume, reduced mean cell hemoglobin, elevated serum neutrophil count, and use of warfarin or rivaroxaban for venous thromboembolism prophylaxis. Conclusions Our work proposes a number of previously undocumented risk factors in relation to SSI. Further investigation is required to ascertain the magnitude of their effect.

Penile adhesions are the most common complication after circumcision, although strategies to decrease them are poorly studied. We conducted a prospective, randomized trial comparing the use of 2-octyl cyanoacrylate (glue) skin adhesive to hydrophobic ointment after circumcision.Patients7years old undergoing circumcision were randomized to glue around the sutures and corona of the penis or antibiotic ointment. The primary outcome variable was postoperative penile adhesions. Utilizing a power of 0.8 and an alpha of 0.05, 168 patients were calculated for each arm. Because of high attrition, we planned to include up to 500 patients. Presence/absence of adhesions was evaluated 2-4weeks postop. Parents subjectively scored happiness, comfort, distress, and concern on a Likert scale 1-5.From 11/2012 through 7/2016, 409 patients were enrolled. Adhesion data were available on 243 patients. There was no difference between glue (16.8%) and those with antibiotic ointment (15.2%) (p=0.88) or in parental satisfaction across all areas measured. 165 patients were lost to follow-up, evenly distributed between the two groups (38% vs. 42%, p=0.49).The placement of 2-octyl cyanoacrylate skin adhesive does not decrease the rate of postoperative penile adhesions after circumcision. Parent satisfaction outcomes are similar.Treatment study.Level II.

Background As an alternative to sutures, meshes used for hernia repair can be fixed using cyanoacrylate-based adhesives. Attempts to improve these adhesives include alkyl-chain lengthening to reduce their toxicity. This preclinical study compares the long-term behavior of cyanoacrylates of different chain lengths already used in hernia repair and new ones for this application. Materials and methods Partial abdominal wall defects were repaired using a Surgipro mesh in 18 New Zealand White rabbits, and groups were established according to the mesh fixation method: sutures (control), Glubran 2 (n-butyl), Ifabond (n-hexyl), and the new adhesives SafetySeal (n-butyl), and Evobond (n-octyl). Six months after surgery, recovered implants were examined to assess adhesive degradation, host tissue reaction, and biomechanical strength. Results All the cyanoacrylate groups showed good host tissue incorporation in the meshes. Macrophage responses to Glubran and Ifabond were quantitatively greater compared with sutures. Cell damage caused by the adhesives was similar, and only Glubran induced significantly more damage than sutures. Significantly lower collagen 1/3 messenger RNA expression was induced by Ifabond than the remaining fixation materials. No differences were observed in collagen expression except slightly reduced collagen I deposition in Glubran/Ifabond and collagen III deposition in the suture group. Mechanical strengths failed to vary between the suture and cyanoacrylate groups. Conclusions All cyanoacrylates showed good long-term behavior and tolerance irrespective of their long or intermediate chain length. Cyanoacrylate residues persisted at 6 mo, indicating their incomplete degradation. Biomechanical strengths were similar both for the adhesives and sutures.

Background The mechanochemical enzyme dynamin mediates endocytosis and regulates neuroendocrine cell exocytosis. Enteroendocrine L cells co-secrete the anorectic gut hormones glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) postprandially and is a potential therapeutic target for metabolic diseases. In the present study, we aimed to determine if dynamin is implicated in human L cell secretion. Methods Western blot was performed on the murine L cell line GLUTag. Static incubation of human colonic mucosae with activators and inhibitors of dynamin was carried out. GLP-1 and PYY contents of the secretion supernatants were assayed using ELISA. Results and conclusion s: Both dynamin I and II are expressed in GLUTag cells. The dynamin activator Ryngo 1–23 evoked significant GLP-1 and PYY release from human colonic mucosae while the dynamin inhibitor Dynole 3–42 significantly inhibited release triggered by known L cell secretagogues. Thus, the cell signaling regulator dynamin is able to bi-directionally regulate L cell hormone secretion in the human gut and may represent a novel target for gastrointestinal-targeted metabolic drug development.

As one of the principal etiological agents of hand, foot, and mouth disease (HFMD), enterovirus 71 (EV71) is associated with severe neurological complications or fatal diseases, while without effective medications thus far. Here we applied dually activated Michael acceptor to develop a series of reversible covalent compounds for EV71 3C protease (3Cpro), a promising antiviral drug target that plays an essential role during viral replication by cleaving the precursor polyprotein, inhibiting host protein synthesis, and evading innate immunity. Among them, cyanoacrylate and Boc-protected cyanoarylamide derivatives (SLQ-4 and SLQ-5) showed effective antiviral activity against EV71. The two inhibitors exhibited broad antiviral effects, acting on RD, 293T, and Vero cell lines, as well as on EV71 A, B, C, CVA16, and CVB3 viral strains. We further determined the binding pockets between the two inhibitors and 3Cpro based on docking studies. These results, together with our previous studies, provide evidence to elucidate the mechanism of action of these two reversible covalent inhibitors and contribute to the development of clinically effective medicines to treat EV71 infections.

As early as 2004, the Fingerprint Working Group (EFP-WG) of the European Network of Forensic Science Institutes (ENFSI) has organised proficiency tests (PT’s), as well as collaborative exercises (CE’s), as a way of raising standards within the fingerprint profession. This article provides an overview of the three collaborative exercises carried out in 2015. The characteristics of the testing programme are summarised, followed by an overview of the knowledge that has been gained, including depicting what lessons have been learnt.

Twenty-five novel pregnenolone/2-cyanoacryloyl conjugates (6-30) were designed and prepared, with the aim of developing novel anticancer drugs with dual NF-κB inhibitory and anti-proliferative activities. Compounds 22 and 27-30 showed inhibition against TNF-α-induced NF-κB activation in luciferase assay, which was confirmed by Western blotting. Among them, compound 30 showed potent NF-κB inhibitory activity (IC50=2.5μM) and anti-proliferative against MCF-7, A549, H157, and HL-60 cell lines (IC50=6.5-36.2μM). The present study indicated that pregnenolone/2-cyanoacryloyl conjugate I can server asa novel scaffold for developing NF-κB inhibitors and anti-proliferative agents in cancer chemotherapy.

Experiments were conducted to investigate the effectiveness of a range of fingermark visualisation processes on brand new, uncirculated, £5 polymer banknotes (and their test note predecessors), as produced by the Bank of England (BoE). In the main study of this paper, a total of 14 individual processes were investigated on BoE £5 polymer banknotes, which included both ‘Category A’ processes (as recommended in the Home Office Fingermark Visualisation Manual) as well as recently developed processes, including fp Natural ® 2 powder (cuprorivaite) from Foster + Freeman and a vacuum metal deposition sequence that evaporates silver followed by zinc. Results from this preliminary investigation indicate that fp Natural ® 2, multimetal deposition, Wet Powder ™ Black, iron oxide powder suspension and black magnetic powder are the most effective processes on these uncirculated £5 BoE polymer banknotes, when viewed under “primary viewing” conditions (white light or fluorescence). Additional fingermarks were visualised on the polymer banknotes following the subsequent use of reflected infrared imaging and lifting techniques, and with the benefit of these techniques taken into consideration, the aforementioned processes remained amongst the most effective overall. This work provides initial insight into fingermark visualisation strategies for BoE £5 polymer banknotes, and the need for further studies in order to generate mature operational guidance is emphasised.

Cyanoacrylate esters (CA) and their corresponding polymers (PolyCA) are used as general and medical adhesives, biodegradable carriers for controlled drug delivery, and as agents for fingerprint development in forensic science. Most reports of cyanoacrylate are on ethyl or 2-octyl cyanoacrylate ester with little attention to other esters. It is the objective of this study to determine the differences amongst cyanoacrylate esters regarding their synthesis, chemical characterization, hydrolytic degradation, and thermal and mechanical properties. Cyanoacrylate polymers of short and long alkyls or oxy-alkyls, cyclic, and aromatic esters have been synthesized and evaluated. All monomers form polymers when exposed to triethylamine vapours possessing molecular weights in the range of 15,000–150,000 Da, where the alkyl esters form high MW polymers. A wide range of hydrolytic degradation rates has been found, as monitored by the release of formaldehyde over time. Alkoxy CAs show faster hydrolytic degradation compared to alkyl CAs. Regarding mechanical properties, CAs are classified into primarily viscous (G′ > G″) and primarily elastic (G″ > G′). Alkoxy CA polymers have a higher loss modulus (G′) than storage modulus (G″). Octyl CA polymer possess a G′ ≈ G″ (phase angle ∼45°) providing appropriate balance between mechanical strength and plasticity. Most alkyl CAs are compact and brittle. Alkoxy CAs show enhanced plasticity, but they lack mechanical strength. In general, the Tg for alkoxy CAs is less than alkyl CAs. Alkoxy CAs depolymerise rapidly at temperatures >200 °C. Overall, ester sidechains of CA esters strongly affect the polymer property. Statement of Significance Polycyanoacrylates are an important class of biodegradable polymers mainly used as bioadhesives. The study describes comparative evaluation of different cyanoacrylate polymers with respect to their chemistry, degradation, safety, mechanical, and thermal properties. The study forms the basis for choosing appropriate combination of cyanoacrylate esters for various biomedical uses. Moreover, this study reveals properties of a few new polycyanoacrylates for the first time.

Objectives Surgery is a cornerstone for patients with gynecologic malignancies. Surgical site infections (SSI) remain a source of post-operative morbidity. Consequences range from escalated costs, delay in adjuvant therapy, and increased morbidity. Our primary objective was to evaluate the effectiveness of a cyanoacrylate microbial sealant (CMS) to reduce post-operative SSI following laparotomy for suspected gynecologic malignancy. Methods Patients were randomized using a 1:1 allocation to receive either standard skin preparation or standard preparation with CMS and stratified by BMI. Patients were followed for 6weeks for SSI. Demographic data was collected through the EMR. Associations between SSI, use of CMS, and clinicopathologic factors were explored using descriptive statistics, chi-square and multivariate analysis. Results 300 patients underwent randomization. Median age of the cohort was 58. Arms were matched and there was no difference in rate of medical comorbidities. Mean BMI was 38.8kg/m 2 in patients randomized to BMI≥30 and 26.3kg/m 2 randomized to BMI p =0.18). Multivariate model demonstrated that BMI≥30 ( p p =0.010), transfusion in the OR ( p p =0.0005) were associated with post-operative SSI. Conclusions Patients presenting to a gynecologic oncologist for surgery frequently present with multiple risk factors for SSI and laparotomy is complicated by surgical-site complications in up to 30% of cases. The addition of CMS alone does not appear to reduce risk of overall SSI. Additional risk-reducing strategies including use of antimicrobial agents and optimization of modifiable risk factors prior to surgery should be explored as pathways for reducing this significant post-operative morbidity.

International audience; Zeolitic imidazolate framework (ZIF-8) particles with an average size of ca. 355 nm and a specific surface area of 1786 m2.g−1 were used as an heterogenous catalyst for the Knoevenagel synthesis of α,β-unsaturated cyanoesters and 3-cyanocoumarins. The preparation of 3-cyanocoumarins was efficiently achieved using DMF as the solvent and conducting the condensation at 80 °C. When the reaction was performed in ethanol, only the intermediates α,β-unsaturated cyanoesters were obtained. The ZIF-8 catalyst can be reused up to five times without any degradation in activity. SEM and XRD analyses demonstrate the high stability of ZIF-8 crystals during the recycling test.

Delamination of the maxillofacial silicone elastomer away from the commercially pure titanium (cpTi)-encapsulated magnets affects the long-term performance of the facial restoration.The purposes of this in vitro study were to investigate the interfacial microleakage patterns of 2 maxillofacial silicone elastomers with cpTi when 3 different primers were used and to evaluate the porosity of the 2 elastomers tested.To test the interfacial microleakage patterns of the 2 elastomers MDX4-4210 (EL1) and A-2006 (EL2) with cpTi when 3 metal primers, A-304 (PR1), A-320 bonding enhancer (PR2), Super-Bond CB monomer (PR3), and ethyl-cyanoacrylate (Super Glue) were used, the bonded interfaces were observed using reflected light microscopy, and the percentage of the linear extent of leakage along the interface (%microleakage) was measured. High-resolution x-ray computed microtomography scanning was used to investigate the percentage of void volume fraction (%VF) for both silicone EL1 and EL2. The data were analyzed with 2-way ANOVA and post hoc tests (α=.05).No statistically significant differences were found among the percentages of PR1, PR2, and PR3 microleakage, whereas ethyl-cyanoacrylate showed a statistically significant higher percentage of microleakage than either of the silicone elastomers (P.001). EL1 medical grade elastomer groups have always had a statistically significantly higher percentage of microleakage than the EL2 platinum silicone elastomer groups (P.001). For both elastomers, no statistically significant differences were found in %VF (P=.056).Differences in mechanical properties, chemical composition, and manipulations during handling of the maxillofacial silicone elastomers can affect the linear microleakage along the cpTi-silicone elastomer bonding interface and the porosity of the silicone elastomer.

Background Prolonged air leak is one of the most common complications after lung surgery and the cause of prolonged hospital stay frequently associated with major postoperative morbidity and thus responsible for even higher hospital costs. This case-control study was designed to test the sealing efficacy and safety of Enable-Innoseal TP4 in patients undergoing pulmonary resection for lung cancer. Methods This was a case-control trial enrolling patients with primary or single site metastatic lung cancer scheduled for elective anatomic or nonanatomic pulmonary resection presenting intraoperative grade 1 or 2 air leak at water submersion test; the study group population was then matched 1:1 according to surgical procedure, male/female ratio, preoperative FEV1, and age. Results In the study population, 21 patients (70.0%) presented intraoperative grade 1 air leak and 9 patients grade 2 (30.0%) air leak; after comparison with the control group, we observed a significant shorter time for chest drain removal in the study population ( P = 0.0050), whereas no difference was registered in terms of number of days needing for discharge ( P = 0.0762). Conclusions Enable-Innoseal TP4 was effective in treating limited intraoperative air leaks after pulmonary resection and preventing prolonged postoperative air leaks in patients receiving either anatomic or nonanatomic lung resections. Further randomized double-arm studies are required to confirm the efficacy of Enable-Innoseal TP4 demonstrated by this pilot study.

International audience; Surgical sealants are widely used in cardiothoracic and vascular surgery essentially for hemostasis and sealing. Their adhesive properties have mainly been studied by clinical experiments. The objective of this study is to measure adhesion of the three main types of surgical sealant used in cardiothoracic and vascular surgery under normalized realistic conditions. The bulge-and-blister test was used to quantify adhesive performances of three types of surgical adhesives: cyanoacrylates, polyethylene glycol (PEG), and aldehydes. Samples were composed of two circular layers of equine pericardium glued by the surgical sealant studied. Comparative adhesion testing was carried out in eight samples bonded with a Dermabond® (cyanoacrylate), five samples with Bioglue® (aldehyde), four samples with Coseal® (PEG), and thirteen samples bonded with an industrial cyanoacrylate. Scanning electron microscope (SEM) observations of cross-sections of samples glued by Dermabond® and environmental scanning electron microscopy (ESEM) images of samples composed of equine pericardium glued by Bioglue® were also performed. The average value of the adhesion energy is 2.3+/-1.5 J.m-2 for samples glued with Dermabond®, 6.04+/-1.61 J.m-2 with Bioglue®, 2.37+/-1.25 J m-2 with Coseal®, 3.74+/-1.33 J m-2 with the industrial cyanoacrylate glue in surgical conditions. SEM observations of cross-sections of samples glued by Dermabond® showed a failure at the interface between the glue and the pericardial layer. ESEM observations have revealed a majority of regions where the glue is not linked to the pericardium. Adhesive performance measurements and microscopy observations in surgical conditions show that surgical sealants adhesion is weak and explain their poor efficacy in clinical practice. To improve adhesion in the surgical field, we need to focus on achieving a better cohesion between the adhesive and the substrate by modifying conditions adhesive bonding and consequently tend toward cohesive failure.