An Accelerated Wound-Healing Surgical Suture Engineered with an Extracellular Matrix.

A suture is a ubiquitous medical device to hold wounded tissues together and support the healing process after surgery. Surgical sutures, having incomplete biocompatibility, often cause unwanted infections or serious secondary trauma to soft or fragile tissue. In this research, UV/ozone (UVO) irradiation or polystyrene sulfonate acid (PSS) dip-coating is used to achieve a fibronectin (FN)-coated absorbable suture system, in which the negatively charged moieties produced on the suture cause fibronectin to change from a soluble plasma form into a fibrous form, mimicking the actions of cellular fibronectin upon binding. The fibrous fibronectin coated on the suture can be exploited as an engineered interface to improve cellular migration and adhesion in the region around the wounded tissue while preventing the binding of infectious bacteria, thereby facilitating wound healing. Furthermore, the FN-coated suture is found to be associated with a lower friction between the suture and the wounded tissue, thus minimizing the occurrence of secondary wounds during surgery. It is believed that this surface modification can be universally applied to most kinds of sutures currently in use, implying that it may be a novel way to develop a highly effective and safer suture system for clinical applications.

Effects of Silicone Oil on Electrowetting to Actuate a Digital Microfluidic Drop on Paper.

The effects of an immiscible, lubricating polydimethylsiloxane fluid, referred to as silicone oil, on the static deformation and on the dynamic motion of a water drop on paper induced by electrowetting were investigated. The deformation of a drop on a hydrophobic film of amorphous fluoropolymers top-coated with less hydrophobic silicone oil was much more predictable, reversible and reproducible than on the uncoated surface. In the dynamic tribological experiment for a sliding drop along an inclined surface, a significant decrease in the friction coefficient, with an unexpected dependency of the contact area, was observed. Based on the curve fitting analysis, the shear stress and the net friction force were estimated quantitatively. Because of the tribological effect and the reduced shear friction force of the oil film, the static and the dynamic electrowetting states of the water drop were enhanced.

Percutaneous vertebroplasty at C7 for the treatment of painful metastases -A case report-.

The cervical spine is a less common site for metastatic disease than is the thoracolumbar spine. Percutaneous vertebroplasty (PVP) in the cervical spine can be performed using an anteromedial or lateral approach. A 51-year-old woman with breast cancer had been experiencing severe weight-bearing neck pain for 2 months, even after undergoing radiation therapy. Imaging studies revealed an osteolytic compression fracture in the C7 vertebra. For performing PVP at C7 using the anteromedial approach, a needle was inserted from the left side of the patient's neck. The needle was advanced to the anterior 1/3 anterior 1/3 or 1/2 of the vertebral body by hammering, and approximately 2 ml of cement was injected. Immediately after the operation, the patient could move her neck without pain. In conclusion, PVP using an anterolateral approach may be an option for treating metastatic osteolytic vertebral lesions in the cervical spine for alleviating intractable axial neck pain.

Removal of a vertebral metastatic tumor compressing the spinal nerve roots via a single-port, transforaminal, endoscopic approach under monitored anesthesia care.

Spinal cord or nerve root compression from an epidural metastasis occurs in 5-10% of patients with cancer and in up to 40% of patients with preexisting nonspinal bone metastases. Most metastatic spine diseases arise from the vertebral column, with the posterior half of the vertebral body being the most common initial focus, and/or the paravertebral region, tracking along the spinal nerves to enter the spinal column via the intervertebral foramina. An 82-year-old man diagnosed with sigmoid colon cancer and liver metastases experienced intractable pain described as being like an electric shock on the right T11 dermatome. Imaging studies revealed a huge metastatic mass destroying the right posterior T11 body and pedicle and compressing the right posterior spinal cord and nerve roots. Even after using neuropathic medication and a neural blockade, the extreme paroxysmal pain continued. Considering his elderly, debilitated state and life expectancy, removal of the vertebral metastatic tumor compressing the spinal nerve roots via a single-port, transforaminal, endoscopic approach and percutaneous vertebroplasty (PVP) under monitored anesthetic care (MAC), rather than 3-port endoscopic surgery and corpectomy with or without fusion under general anesthesia with lung deflation, was decided upon and scheduled prior to radiotherapy. A needle was placed into the intervertebral foramen under fluoroscopy in the same manner as a transforaminal epidural block at T11. A guidewire was inserted into the needle after the needle stylet had been removed. An obturator dilator was inserted over the guidewire, and a working sleeve was inserted over the dilator. After the dilator was removed, a spinal endoscope with a 2.7 mm working channel was placed over the guidewire. Careful removal of the tumor emboli during verbal interaction with the patient was performed under MAC using dexmedetomidine, fentanyl, and ketorolac. PVP at T11 was performed through the right osteolytic pedicle. The paroxysmal pain disappeared immediately after the operation without any complications. Removal of a vertebral metastatic tumor compressing the spinal nerve roots via a single-port, transforaminal, endoscopic approach under monitored anesthesia care without lung deflation may be an effective and safe modality for minimally invasive pain management of a single-level spinal tumor metastasis causing intractable radicular pain in patients with cancer who have generalized debilitation.