USE OF A NEW POLYBUTILATE-COATED POLYESTER SUTURE IN CARDIOVASCULAR SURGERY

Polybutilate coated polyester (Dacron) sutures were evaluated in a variety of cardiovascular procedures performed on 117 patients. The age range was from 6 months to 88 years, and long-term follow-up was available in 100 patients. The most frequently sutured tissues were those of the aorta, atrium, fascia and pericardium. Suture sizes ranged from 1-0 through 5-0, the most common being 3-0. There were no suture related complications, and the performance was found to be superior to non-coated polyester sutures and other forms of coated sutures. Favorable characteristics were: 1) ease of passage through tissue, especially through prosthetic materials; 2) ease of tying, 3) increased knot security; and 4) better handling characteristics in general. Because of the firm bonding of polybutilate with the polyester suture, flaking (minute amounts of the coating which become dislodged) and suture drag characteristics of other coated polyester sutures were not experienced.     

Application of 13C NMR to investigate the transformations and biodegradation of organic materials by wood- and soil-feeding termites, and a coprophagous litter-dwelling dipteran larva

Solid-state 13C nuclear magnetic resonance spectroscopy has been used to characterize the C in samples of the food (wood), gut contents and faeces from the wood-feeding termite, Microcerotermes parvus; soil in the guts and mound material from the soil-feeding termite, Thoracotermes macrothorax; and the food and faeces from the litter-feeding, coprophagous larvae of the dipteran fly, Bibio marci. Spectra from the wood-feeding termite indicated preferential loss of polysaccharide and accumulation of lignin with some modification to the O-aromatic-C and methoxyl-C (O-methyl-C) components during passage through the gut. Spectra for the soil-feeding termite indicated little change in the distribution of 13C between resonances following passage through the gut, except for some evidence of preferential polysaccharide loss. Interpretation of the spectra from these organisms was restricted by the relatively low C content of the soils and mound material, and by the large contribution to the NMR spectra from the gut tissue rather than the gut contents. Spectra for the litter-feeding dipteran larvae indicated preferential feeding on the polysaccharide-rich component of the litter and then overall loss of polysaccharide-C and accumulation of both aromatic-C and methoxyl-C in the gut. These changes were greater for the second passage than for the first passage through the gut, suggesting that principally mechanical and physical changes occurred initially and that chemical digestion was prevalent during the second passage.     

Optimizing the tissue anchoring performance of barbed sutures in skin and tendon tissues

The focus of the current work was to study how the geometric design of a single barbed monofilament suture effects its biomechanical behavior. Different cut angles and cut depths of barbs were prepared and tested in vitro for their tensile and tissue anchoring properties by means of a novel suture/tissue pullout test. Experiments were also performed using bovine tendon and porcine skin tissues. The experimental results revealed that since tendon tissue has a higher modulus than skin it needs a more rigid barb to penetrate and anchor the surrounding tissue. A cut angle of 150° and a cut depth of 0.18 mm are therefore recommended. On the other hand, for the softer skin tissue, a cut angle of 170° and a cut depth of 0.18 mm provides a more flexible barb that gives superior skin tissue anchoring. These findings confirm that the future development of barbed suture technology requires a detailed understanding of the biomechanical properties of the tissue in which they are to be used. This will lead to the future development of a range of tissue-specific barbed sutures.     

Parallel alternating sliding knots are effective for ligation of mesenteric arteries during resection and anastomosis of the equine jejunum

Background

In literature only one article describes and compares methods of achieving hemostasis in equine mesenteric arteries during jejunal resection and anastomosis, and most textbooks favor ligating-dividing mechanical devices. The latter method cannot always be used, not least because the devices are expensive and in some cases even contra-indicated. Various types of knots, including sliding knots, are widely used to provide hemostasis in laparoscopy.The objective of this study was to compare a triple ligature for mesenteric vessels composed of three sliding knots with a triple ligature composed of a modified transfixing and two surgeon’s knots.

Methods

Portions of jejunum with associated mesenteric vessels were collected from 12 horses at a local abattoir. These were divided into 24 specimens containing five mesenteric arteries each. Each artery was closed with a triple ligature. In group A, a surgeon’s knot was used to tie the ligatures (two circumferential and one modified transfixing) while in group B all ligatures (three circumferential) were tied with a parallel alternating sliding knot. Both groups were divided ino two subgroups depending on suture material used (multifilament or monofilament suture material). Time to perform ligatures for every specimen were recorded and compared between groups.After closure, arteries were cannulated and intraluminal pressures were increased until ligature failure. Leaking pressures were recorded and compared between groups.

Results

Ligation of mesenteric arteries was significantly faster to perform with sliding knots than with surgeon’s knots, both with monofilament and multifilament suture material. With multifilament suture material, the leaking pressure of sliding knot ligatures was significantly higher than that of surgeon’s knot ligatures. With monofilament suture, there were no statistically significant differences in leaking pressure between ligature methods. Both ligating methods were stronger with monofilament suture material than with multifilament suture material.

Conclusions

Regardless of the ligature used, monofilament suture material performed better than multifilament suture material to achieve hemostatic knots. Independently of the suture material, the sliding knot is comparable or better than the surgeon’s knot in providing hemostasis, and is faster to perform.

     

Simulation of Seed Digestion by Birds: How Does It Reflect the Real Passage Through a Pigeon’s Gut?

Simulation of seed passage through a bird’s gut is an important tool for comparing the effect of bird digestion and thus the potential for plant dispersal by endozoochory. However, sufficient methodology is missing. Thus, we subjected seeds of 20 plant species to seven different simulations of gut passage and to the real passage through a pigeon’s gut to determine which simulation type best reflects the effects of real bird digestion. We also measured various seed traits to identify the traits responsible for differences between species. Results show that four out of seven simulations were significant predictors of seed survival after gut passage. The fit between direct digestion by the pigeon and the different simulation treatments was, however, species-specific and depends not only on the commonly tested traits such as seed mass and water permeability, but also on other unmeasured traits. Seed mass was the best predictor of differences between real digestion and simulation. Selecting one type of simulation to be a good predictor of seed survival after gut passage is difficult. The strongest simulation (24-h scarification and 240-min acid immersion) is the best predictor and may be used to compare the ability of seeds to be dispersed by bird endozoochory. Such knowledge can be included in databases of species traits, as is currently done for many other species traits.     

Effects of macaque ingestion on seed destruction and germination of a fleshy-fruited tree, <Emphasis Type="Italic">Eurya emarginata</Emphasis>

Effects of macaque ingestion were examined on both seed destruction during passage through the gut and germination enhancement after defecation, using typically endozoochorous fruits of Eurya emarginata. Mechanical and chemical actions associated with the ingestion were also examined. A fruit-feeding experiment found that 4.4% of ingested seeds could pass intact through the gut of Japanese macaques. No significant difference was detected between the seed passage percentages of six Eurya emarginata trees despite individual variation in seed weight and hardness, implying that mastication is a major factor in the severe seed mortality during the gut passage. Seeds in intact fruits showed lower germination percentage and longer germination delay than seeds with the flesh removed artificially. In contrast, no enhancement in germination was observed after passage through the gut. A series of seed treatment experiments indicated that seed abrasion did not affect germination percentage, though acid and heat-exposure enhanced the germination. The two factors, severe seed destruction and germination enhancement by flesh removal, opposed each other. With the survival proportion of uningested seeds taken as 1.0, the survival proportion of ingested seeds was estimated as 0.49 with the 95% confidence interval of 0.14–1.46, which indicated no significant difference between the proportions of ingested- and uningested-seeds.     

Identification of genes differentially expressed by prematurely fused human sutures using a novel in vivo - in vitro approach

Abstract Craniosynostosis is the premature fusion of calvarial sutures. It results from abnormal differentiation or proliferation of cells within the osteogenic fronts of growing calvarial bones. To date, research has focused on animal models and in vitro organ and tissue culture to determine the molecular mechanisms controlling calvarial suture morphogenesis. Here, we test a new, in vivo–in vitro approach based on the hypothesis that calvarial suture cells passaged in minimal medium exhibit a stable gene expression profile similar to undifferentiated osteoblastic cells that can provide a benchmark for comparison with in vivo expression of differentiated tissue. We show that tissue-specific expression is lost after the first passage and, using cDNA microarrays, compare expression between fused suture tissue from craniosynostosis patients and in vitro de-differentiated explant cells. A large number of differentially expressed genes were identified, including novel genes WIF1, LEF1 , SATB2, RARRES1, DEFA1, DMP1 , PTPRZ1 , and PTPRC , as well as those commonly associated with human suture morphogenesis, e.g., FGF2, MSX2 , and BMP2 . Two differentially expressed genes, WIF1 and FGF2 , were further examined in an in vivo–in vivo comparison between unfused and prematurely fused tissue. The same pattern of differential expression was observed in each case, further validating the ability of our in vivo–in vitro approach to identify genes involved in in vivo human calvarial tissue differentiation.     

Mobilization of soil phosphorus during passage through the gut of larvae of Pachnoda ephippiata (Coleoptera: Scarabaeidae)

Soil macrofauna play important roles in the mobilization of soil nutrients. The influence of gut passage on soil phosphorus availability was investigated using the larvae of the scarabaeid beetle Pachnoda ephippiata. Gut passage significantly increased the levels of available P in the feces over that of the soil consumed. ³¹P-NMR recorded the changes in the nature of organic P in alkaline extracts from gut content. Alkaline phosphatase activity was high in the alkaline midgut, but low in the hindgut and soil. Ferric iron (Fe³⁺) in the soil was reduced to ferrous iron (Fe²⁺) in the gut. The amount of Ca²⁺ was lower in the gut than in the soil. Iron reduction and the decrease of Ca²⁺ concentration in the gut would reduce P sorption. We think that the following effects are responsible for increased availability of P during the gut passage: alkaline extraction of soil organic matter; hydrolysis of organic phosphate esters with alkaline phosphatase; digestion by the resident microorganisms; and changes in the concentration of metal ions during gut passage. This study suggests that the feeding activities of humivorous larvae would affect the amount of soil P available to plant growth.     

Action of Douglas Fir Tussock Moth Larvae and Their Microflora on Dietary Terpenes

A single type of bacterium, tentatively identified as a member of the genus Bacillus, was isolated from 2 of 20 midguts of Douglas fir tussock moth larvae being fed a diet of fir needles. No bacteria could be isolated from most midguts. Although spherically shaped bodies were present in the food bolus, these bodies, if microorganisms, could not be distinguished from spherical bodies associated with the plant tissue. The Douglas fir tussock moth dietary terpenes were altered during their passage through the insects, with two new terpenes being detected in the feces. One of these was identified as isoborneol. The relative significance of the insect and gut microflora with respect to terpene modification is unresolved. The well-established toxicity of terpenes may account for the near absence of common gut microflora in the insects.     

Effects of suture material on incision healing, growth and survival of juvenile largemouth bass implanted with miniature radio transmitters: case study of a novice and experienced fish surgeon

Juvenile largemouth bass Micropterus salmoides , intraperitoneally implanted with microradio transmitters exhibited short-term (5 days) inflammation around the incision and suture insertion points for both non-absorbable braided silk and non-absorbable polypropylene monofilament, but in the longer term (20 days) almost all sutures were shed and the incisions were completely healed. Cumulative mortality was higher for fish with braided silk sutures, however, post-mortem analysis revealed that violations to the gastro-intestinal tract from the surgical procedure were the usual cause of the mortality. Mortality was generally low in control fish. The two surgeons who performed the implantations differed substantially in experience. Despite receiving basic training, the novice surgeon took longer to complete the surgeries, had reduced suture precision and experienced more fish mortality relative to the experienced surgeon. For both surgeons, it took longer to complete suturing with polypropylene than with braided silk. During the surgery day, the experienced surgeon exhibited consistently rapid surgery times, whereas the novice surgeon exhibited significantly improved speed as the number of surgeries completed increased. This study suggests that microtransmitters can be successfully implanted in juvenile largemouth bass but some mortality can be expected. This mortality seems to be independent of suture material, but dependent upon the experience of the surgeon.     

Heterotopic Mucosal Engrafting Procedure for Direct Drug Delivery to the Brain in Mice

Delivery of therapeutics into the brain is impeded by the presence of the blood-brain barrier (BBB) which restricts the passage of polar and high molecular weight compounds from the bloodstream and into brain tissue. Some direct delivery success in humans has been achieved via implantation of transcranial catheters; however this method is highly invasive and associated with numerous complications. A less invasive alternative would be to dose the brain through a surgically implanted, semipermeable membrane such as the nasal mucosa that is used to repair skull base defects following endoscopic transnasal tumor removal surgery in humans. Drug transfer though this membrane would effectively bypass the BBB and diffuse directly into the brain and cerebrospinal fluid. Inspired by this approach, a surgical approach in mice was developed that uses a donor septal mucosal membrane engrafted over an extracranial surgical BBB defect. This model has been shown to effectively allow the passage of high molecular weight compounds into the brain. Since numerous drug candidates are incapable of crossing the BBB, this model is valuable for performing preclinical testing of novel therapies for neurological and psychiatric diseases.     

Passage and Survival of Chlamydospores of Phytophthora cinnamomi Rands, the Causal Agent of Forest Dieback Disease, Through the Gastrointestinal Tracts of Termites and Wild Birds

Chlamydospores of Phytophthora cinnamomi Rands have been shown to survive in the intestinal tracts of termites (Nasutitermes exitiosus) and two species of forest birds indigenous to West Australian jarrah forests. Viable chlamydospores were recovered from bird feces within the normal rate of passage time for food through the gut. The above factors would allow these creatures to function as vectors for the spores.     

Effect of temperature on rate of passage of food through the alimentary canal of the plaice Pleuronectes platessa L.

The relation between temperature and rate of passage of pieces of Arenicola marina through the gut of Pleuronectes platessa was investigated by an X-ray method, using barium sulphate as a contrast medium. Time in hours taken for stomach evacuation and travel of gut contents to the rectum plotted against temperature gave negative exponential curves. Plotted logarithmically the relationships were linear.     

Surgical implantation techniques for electronic tags in fish

Intracoelomic implantation of transmitters into fish requires making a surgical incision, incision closure, and other surgery related techniques; however, the tools and techniques used in the surgical process vary widely. We review the available literature and focus on tools and techniques used for conducting surgery on juvenile salmonids because of the large amount of research that is conducted on them. The use of sterilized surgical instruments properly selected for a given size of fish will minimize tissue damage and infection rates, and speed the wound healing of fish implanted with transmitters. For the implantation of transmitters into small fish, the optimal surgical methods include making an incision on the ventral midline along the linea alba (for studies under 1 month), protecting the viscera (by lifting the skin with forceps while creating the incision), and using absorbable monofilament suture with a small-swaged-on swaged-on tapered or reverse-cutting needle. Standardizing the implantation techniques to be used in a study involving particular species and age classes of fish will improve survival and transmitter retention while allowing for comparisons to be made among studies and across multiple years. This review should be useful for researchers working on juvenile salmonids and other sizes and species of fish.     

Bridging meta-analysis and the comparative method: a test of seed size effect on germination after frugivores’ gut passage

Most studies using meta-analysis try to establish relationships between traits across taxa from interspecific databases and, thus, the phylogenetic relatedness among these taxa should be taken into account to avoid pseudoreplication derived from common ancestry. This paper illustrates, with a representative example of the relationship between seed size and the effect of frugivores gut on seed germination, that meta-analytic procedures can also be phylogenetically corrected by means of the comparative method. The conclusions obtained in the meta-analytical and phylogenetical approaches are very different. The meta-analysis revealed that the positive effects that gut passage had on seed germination increased with seed size in the case of gut passage through birds whereas decreased in the case of gut passage through non-flying mammals. However, once the phylogenetic relatedness among plant species was taken into account, the effects of gut passage on seed germination did not depend on seed size and were similar between birds and non-flying mammals. Some methodological considerations are given to improve the bridge between the meta-analysis and the comparative method.     

Duration of gut passage and its dependence on temperature and food consumption in roach, Rutilus rutilus L: laboratory and field experiments

A laboratory method is described by means of which gut passage time as a function of temperature, diet and consumption rate is investigated in roach, an omnivorous cyprinid. Rates of food passage are accelerated by increasing temperature and food consumption. Equations for the regressions between gut passage time and consumption rate at four temperatures are given. Animal food causes a delay in gut passage time. In adult roach (30-100 g body weight) gut passage time was found to be independent of size.
A field method was also developed which allows the direct estimation of gut passage time and consumption rate in natural fish populations. The results of experiments with this field method agree with those of laboratory experiments.     

Effects of gut treatment on recovery and germinability of bovine and ovine ingested seeds of four woody species from the Sudanian savanna in West Africa

Passage rate through the digestive tracts of zebu cattle and sheep, and subsequent germination of egested seeds of four woody species from the Sudanian savanna, Acacia dudgeoni, Acacia seyal, Burkea africana and Prosopis africana, were studied. The result indicates large differences in passage rate among woody species, as well as between animals. The values ranged from 46% to 87% for seeds ingested by cattle while the lowest passage rate was 2.3% and the highest being 74% for seeds ingested by sheep. Among plant species, seeds of Prosopis africana had the highest passage rate through the digestive tract of both cattle and sheep. Seed passage through the gut showed a significant positive correlation with seed mass and thickness for cattle and sheep, respectively. The gut treatment and the retention time in the gut did not improve germination capacity and the speed of germination of dormant seeds. For non-dormant seeds of Acacia dudgeoni, the germination capacity was higher for seeds ingested by cattle than sheep. The speed of germination was also significantly higher for egested seeds than the control. It can be concluded that large herbivores could play an essential role in long distance dispersal of seeds. Gut treatment alone was not effective in breaking seed coat-imposed dormancy, although it enhanced the rate of germination of non-dormant seeds. To get a complete picture of the effect of frugivore on the release of seed dormancy, the combined effect of initial mastication and subsequent gut treatment needs to be investigated.     

In situ growth and photosynthetic activity of Cyanobacteria and phytoplankton dynamics after passage through the gut of silver carp (Hypophthalmichthys molitrix), bighead carp (Aristichthys nobilis), and Nile tilapia (Oreochromis niloticus)

The growth and photosynthetic activities of Cyanobacteria passed through the gut of silver carp (Hypophthalmichthys molitrix), bighead carp (Aristichthys nobilis), and tilapia (Oreochromis niloticus) were compared with those of phytoplankton taken directly from Lake Taihu during a 13-day in situ dialysis culture. After the first 3–5 days of reduced activity after excretion by silver carp and bighead carp, the photosynthetic activity of Cyanobacteria recovered and rose significantly higher (P < 0.01) than levels in the control population, whereas there was a notable reduction of photosynthetic activity after passage through tilapia gut. The phytoplankton biomass showed a 2- to 3-fold increase of growth, and extracellular polysaccharide production was also stimulated after passage through silver carp and bighead carp gut. Chlorophyta fluorescence was detected at much higher levels than that of Cyanobacteria and Bacillariophyta after passage through tilapia gut. Scenedesmus obliqnus and Chlamydomonas sp. contributed much to the growth of the Chlorophyta during the in situ cultivation. However, the total phytoplankton biomass showed a distinct reduction in the tilapia treatment during the culture. The study indicated that Nile tilapia feeding and defecation may help remove Cyanobacteria from the water column and favor a community shift to Chlorophyta.     

The inverted nipple: its grading and surgical correction

Inverted nipples have been treated by various methods by many authors, but the relationship between the grade of the deformity and the appropriate surgical procedure is not clearly described. One hundred seven inverted nipples in 60 patients were treated from 1993 to 1997. They were divided into three groups by the authors' system of grading. The grade was made by preoperative evaluation of severity of inversion and was confirmed by the surgical findings. In grade I, the nipple is easily pulled out manually and maintains its projection quite well. Grade I nipples are believed to have minimal fibrosis; thus, manual traction and a single, buried purse-string suture are enough for the correction. The majority of inverted nipples belong to grade II, i.e., the nipples can be pulled out but cannot maintain projection and tend to go back again. These nipples are thought to have moderate fibrosis beneath the nipple. Blunt dissections for surgical release were carried out until the inversion did not recur after releasing the traction. The lactiferous ducts could be identified and preserved, permitting proper release of fibrotic bands in the grade II group. The purse-string suture was used. In grade III, to which the least number of inverted-nipple cases belong, the nipple can hardly be pulled out manually. Severe fibrosis made it impossible to reach optimal release of the fibrotic band with the preservation of the ducts. The fibrotic bands are widely dissected, and the lactiferous ducts are cut, especially in the central portion. Two or three deepithelialized dermal flaps may be used to make up for soft-tissue deficiency; a purse-string suture is also used. This grading system will be useful for patient classification and analysis, systematic planning, and application of the proper surgical procedures.     

Long term recovery of median nerve repair using laser‐activated chitosan adhesive films

Sutures remain the standard peripheral nerve repair technique, whether applied directly or indirectly to nerve tissue. Unfortunately, significant postoperative complications can result, such as inflammation, neuroma formation and foreign body reactions. Photochemical‐tissue‐bonding (PTB) using rose Bengal (RB) integrated into a chitosan bioadhesive is an alternative nerve repair device that removes the need for sutures. Rats were arranged into three groups: RB‐chitosan adhesives‐repair, end‐to‐end epineural suture‐repair (surgical standard) and sham laser‐irradiated control. Groups were compared through histological assessment, electrophysiological recordings and grip motor strength. RB‐chitosan adhesive repaired nerves displayed comparable results when compared to the standard suture‐repair based on histological and electrophysiological findings. Functionally, RB‐chitosan adhesive was associated with a quicker and more pronounced recovery of grip force when compared to the suture‐repair. (© 2013 WILEY‐VCH Verlag GmbH &Co. KGaA, Weinheim)