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PubMed2005

Hypercholesterolemia, not metabolic syndrome, related to adhesion of monocytes to cultured endothelium in nondiabetic subjects.

The interaction of leukocytes and endothelium plays an important role in the development of atherosclerosis. Previous studies found that adhesion of leukocytes to endothelium is greater in subjects with hypercholesterolemia. It is not clear if metabolic syndrome, a contributing risk factor of cardiovascular disease, is related to this adhesion. Therefore, we conducted a study, in which 48 nondiabetic subjects were enrolled, to determine the relationship between leukocyte adhesion and the components of metabolic syndrome. After a 12-hour overnight fast, subjects' fasting blood was obtained for measurement of lipoprotein concentrations and glucose and insulin levels. Results of the number of monocyte adhesion to human umbilical vein endothelial cells were divided into high monocyte adhesion group and low monocyte adhesion group (n=24 in each group). Plasma concentrations of total cholesterol (245 +/- 5 vs 229+/- 4 mg/dL, P=.021) and low-density lipoprotein cholesterol (LDL-C) (162+/- 4 vs 146+/- 3 mg/dL, P=.003) were both higher in the high monocyte adhesion group than in the low monocyte adhesion group. Monocyte adhesion was significantly correlated to plasma concentrations of LDL-C (r=0.407, P=.002) but not to the total cholesterol (r=0.202, P=.085). However, there was no difference in monocyte adhesion to endothelium between subjects with or without metabolic syndrome, based on the modified criteria from the Adult Treatment Panel III of the National Cholesterol Education Program. Insulin resistance index, presented as homeostasis model assessment insulin resistance, and glucose or insulin responses to oral glucose tolerance test were similar between groups. Our study demonstrated that monocyte adhesion to endothelium has a stronger relationship with the plasma concentration LDL-C than with characteristics of metabolic syndrome.

Atherosclerosis↗
PubMed2004

Reduction in postoperative adhesion formation and re-formation after an abdominal operation with the use of N, O - carboxymethyl chitosan.

BACKGROUND: Postoperative adhesions have proven to be intractable complications after abdominal operations. This study assessed the efficacy of N, O - carboxymethyl chitosan (NOCC) to limit adhesion formation and re-formation in a rabbit abdominal surgery model. METHODS: In study 1 (adhesion formation), injuries to the large bowel, cecum, and abdominal sidewall were generated in rabbits. The rabbits (10/group) were randomly assigned to 1 of 5 treatment groups: Group A received no NOCC treatment; in group B, NOCC gel was applied directly to the injured site and NOCC solution was applied throughout the abdominal cavity; in group C, NOCC gel was applied near the injured site and NOCC solution was applied as above; in group D, NOCC gel was applied distant to the injury and NOCC solution was applied as above; in group E, a mixture of NOCC gel and solution was applied at the injured site. Adhesions were evaluated 14 days later. In study 2 (adhesion re-formation), adhesions were generated as above but were then lysed by careful dissection. After adhesiolysis, the rabbits (9/group) were treated with NOCC gel and solution at the site of adhesiolysis or left untreated. Adhesion re-formation was assessed 14 days later. In study 3 (mechanism of action), sterile tissue culture plates were coated with NOCC and adhesion of cultured, radiolabeled murine fibroblasts to the plates was assessed. RESULTS: In study 1, animals treated with NOCC gel and solution showed reduced adhesion formation (P<.01). NOCC gel was equally efficacious if applied on the site of injury or near the site of injury but less efficacious if applied at a site distant to the injury. In study 2, animals treated with NOCC gel and solution showed less adhesion re-formation compared with the untreated control animals (P<.01). In study 3, murine fibroblasts did not adhere to NOCC-coated tissue culture plates. CONCLUSIONS: NOCC gel and solution can reduce adhesion formation and re-formation in this rabbit model. The inability of fibroblasts to adhere to NOCC solution-coated surfaces suggests that NOCC may act as a biophysical barrier.

Abdominal Muscles↗
PubMed1998

The effect of monocyte chemotactic protein 1 in intraperitoneal adhesion formation in a mouse model.

OBJECTIVE: Intraperitoneal adhesions are a significant cause of morbidity among women of reproductive age. Monocyte chemotactic protein 1 plays a role in the chemotaxis of mononuclear cells and fibroblasts into the peritoneal injury site. To evaluate its role in intraperitoneal adhesion formation, we used an established postsurgical adhesion model in mice. STUDY DESIGN: Surgical adhesions in mice were induced by scraping and crushing peritoneal sites. We analyzed the injury sites for the temporal expression of monocyte chemotactic protein 1 messenger ribonucleic acid and cellular infiltration at 12 to 24 hours across 10 days and evaluated the effects of monocyte chemotactic protein 1 and anti-monocyte chemotactic protein 1 neutralizing antibody on adhesion formation. On induction of adhesions animals were randomly assigned to 1 of 4 groups: (1) control, (2) nonspecific immunoglobulin G, (3) monocyte chemotactic protein 1, (4) anti-monocyte chemotactic protein 1 antibody. Animals received daily intraperitoneal injections for 6 days. Adhesions were scored on day 14 and immunostained for fibroblasts and macrophages. RESULTS: Adhesions developed consistently by the fifth postoperative day. We detected an increase in monocyte chemotactic protein 1 messenger ribonucleic acid expression at 48 hours; this remained until the fourth postoperative day. By the second day macrophages were present at the injury site. Animals treated with anti-monocyte chemotactic protein 1 antibody had significantly fewer adhesions develop than did the other three groups. CONCLUSION: This study demonstrates that monocyte chemotactic protein 1 may play a role in adhesion formation. Inhibiting the action of this chemokine may help to prevent adhesions.

Animals↗
PubMed1999

Reduction of retrosternal and pericardial adhesions with rapidly resorbable polymer films.

BACKGROUND: The formation of postoperative cardiac adhesions makes a repeat sternotomy time consuming and dangerous. Many attempts have been made to solve this problem by using either drugs to inhibit fibrinolytic activity or different types of pericardial substitutes. The results have not been satisfactory. METHODS: The efficacy of bioresorbable film prototypes made of polyethylene glycol (EO) and polylactic acid (LA) (EO/LA = 1.5, 2.5, and 3.0) in the prevention of adhesions after cardiac operations in canine models was tested. After desiccation and abrasion of the epicardium, a transparent bioresorbable film was placed over the heart. The pericardium was closed to allow intrapericardial adhesions (n = 32) or left open and attached to the chest wall to induce retrosternal adhesions (n = 17). Postoperative recovery was similar among the groups. Retrosternal and pericardial adhesions were evaluated at necropsy 3 weeks later by assessing area, tenacity, and density of the adhesions. RESULTS: In the control dogs, tenacious, dense adhesions were observed. In contrast, adhesion formation was reduced at all sites covered by the films. The bioresorbable films were efficacious in the reduction of adhesion formation between epicardium and pericardium or between epicardium and sternum after cardiac operation. The EO/LA 1.5 film most effectively prevented the early adhesions. CONCLUSIONS: The bioresorbable films (EO/LA = 1.5, 2.5, and 3.0) significantly reduced adhesion formation, with EO/LA = 1.5 (Repel CV) being optimal. As the barrier was rapidly resorbed, the capsule formation induced by permanent barriers was avoided.

Absorption↗
PubMed1991

Mathematical model for the effects of adhesion and mechanics on cell migration speed.

Migration of mammalian blood and tissue cells over adhesive surfaces is apparently mediated by specific reversible reactions between cell membrane adhesion receptors and complementary ligands attached to the substratum. Although in a number of systems these receptors and ligand molecules have been isolated and identified, a theory capable of predicting the effects of their properties on cell migration behavior currently does not exist. We present a simple mathematical model for elucidating the dependence of cell speed on adhesion-receptor/ligand binding and cell mechanical properties. Our model can be applied to propose answers to questions such as: does an optimal adhesiveness exist for cell movement? How might changes in receptor and ligand density and/or affinity affect the rate of migration? Can cell rheological properties influence movement speed? This model incorporates cytoskeletal force generation, cell polarization, and dynamic adhesion as requirements for persistent cell movement. A critical feature is the proposed existence of an asymmetry in some cell adhesion-receptor property, correlated with cell polarity. We consider two major alternative mechanisms underlying this asymmetry: (a) a spatial distribution of adhesion-receptor number due to polarized endocytic trafficking and (b) a spatial variation in adhesion-receptor/ligand bond strength. Applying a viscoelastic-solid model for cell mechanics allows us to represent one-dimensional locomotion with a system of differential equations describing cell deformation and displacement along with adhesion-receptor dynamics. In this paper, we solve these equations under the simplifying assumption that receptor dynamics are at a quasi-steady state relative to cell locomotion. Thus, our results are strictly valid for sufficiently slow cell movement, as typically observed for tissue cells such as fibroblasts. Numerical examples relevant to experimental systems are provided. Our results predict how cell speed might vary with intracellular contractile force, cell rheology, receptor/ligand kinetics, and receptor/ligand number densities. A biphasic dependence is shown to be possible with respect to some of the system parameters, with position of the maxima essentially governed by a balance between transmitted contractile force and adhesiveness. We demonstrate that predictions for the two alternative asymmetry mechanisms can be distinguished and could be experimentally tested using cell populations possessing different adhesion-receptor numbers.

Animals↗
PubMed1997

Adhesion-induced domain formation by interplay of long-range repulsion and short-range attraction force: a model membrane study.

We study the role of the interplay of specific and universal forces for the adhesion of giant vesicles on solid supported membranes. To model the situation of cell adhesion, we incorporated lipopolymers (phospholipids with polyethyleneoxide headgroups) as artificial glycocalix, whereas attractive lock-and-key forces are mimicked by incorporating biotinylated lipids into both membranes and by mediating the strong coupling through streptavidin. Adhesion is studied by quantitative reflection interference contrast microscopy (RICM), which enables visualization of the contact zone and reconstruction of the height profile of the membrane beyond the contact line (outside the contact zone) up to a height of 1 micron. We demonstrate that adhesion is accompanied by lateral phase separation, leading to the formation of domains of tight adhesion (adhesion plaques) separated by areas of weak adhesion exhibiting pronounced flickering. By analyzing the height profile S(x) near the contact line in terms of the tension equilibrium (Young equation) and the moment equilibrium, respectively, the adhesion energy and membrane tension can be approximately measured locally. We show that the adhesion energy is about three orders of magnitude larger for the adhesion plaques than for the weekly adhering regions. The adhesion is studied as a function of the excess area of the vesicle generated by temperature variation. A very remarkable finding is that increased excess area is not always stored in the contact area, but leads to the formation of microbuds (diameter approximately 2 microns).

Bacterial Proteins↗
PubMed1990

Oligodendrocyte-derived J1-160/180 extracellular matrix glycoproteins are adhesive or repulsive depending on the partner cell type and time of interaction.

We have studied the functional involvement of J1-160 and J1-180 in the interaction between oligodendrocytes and neurons, astrocytes, or L cells in short- and long-term adhesion assays using monoclonal antibodies directed against topographically distinct epitopes on the molecules. Whereas antibodies to mouse liver membranes and monoclonal antibody 597 do not interfere with neuron-oligodendrocyte or astrocyte-oligodendrocyte adhesion after 30 min of coculture, antibodies 596, 619, and 620 interfere with astrocyte to oligodendrocyte and neuron to oligodendrocyte adhesion. The adhesion of L cells to oligodendrocytes is not affected by the antibodies. When neurons or astrocytes are cultured on oligodendrocytes for more than 30 min, monoclonal antibody 619 continues to reduce adhesion of astrocytes to oligodendrocytes after 1 and 2 h. However, during this time period the antibody affects neuron to oligodendrocyte adhesion in a different manner. It does not interfere with adhesion of neurons to oligodendrocytes at 1 h and enhances the adhesion of neurons to oligodendrocytes after 2 h of coculture. After 6 and 24 h of coculture, antibody 619 does not affect the adhesion of neurons or astrocytes to oligodendrocytes, suggesting that other adhesive mechanisms are predominant at later times of interaction. At all times studied, neurons and astrocytes adhered well to the oligodendrocytes. To study the influence of the J1 molecules on neuronal interactions in the absence of other oligodendrocyte-derived cell surface components, purified J1-160 was coated as a substrate and neuron attachment was measured as a function of time. Two hours after plating neurons adhered well to J1-160, as they did to laminin, while cell detachment was subsequently observed from J1-160, but not from laminin. These results implicate J1-160 and J1-180 in a recognition process between oligodendrocytes and neurons or astrocytes, but not fibroblasts. This recognition process appears to merge into adhesion or stabilization of cell contacts for astrocytes and destabilization of cell interactions or repulsion for neurons. It is likely that these two opposite effects in cell behavior elicited by the J1 molecules result from differential intracellular responses to a cell surface trigger possibly mediated by different cell surface receptors and/or different consequences in intracellular signaling networks.

Animals↗
PubMed1999

Simultaneous analysis of eosinophil and neutrophil adhesion to plasma and tissue fibronectin, fibrinogen, and albumin.

A simple and convenient assay for the simultaneous measurement of eosinophil and neutrophil adhesion is described. Incubations were performed in microtitre plates coated with different proteins. Adhesion of eosinophils and neutrophils was determined by the use of specific radioimmunoassays for eosinophil cationic protein (ECP) and myeloperoxidase (MPO). Using this assay, Mn2+ induced a significant increase of the adhesion of eosinophils to plasma fibronectin and fibrinogen in a time-dependent fashion, while a small increase of the adhesion of neutrophils to these two proteins was observed. In contrast, a time-dependent potent increment of the adhesion of both eosinophils and neutrophils to tissue fibronectin and albumin was found. Tissue fibronectin preferentially supported eosinophil adhesion compared with that of neutrophils in the presence of Mn2+. PMA (10(-9) mol/l) induced a significant increase in the adhesion of eosinophils and neutrophils of the same pattern to all four proteins. However, when granulocytes were stimulated by Mn2+ in combination with PMA, eosinophils and neutrophils showed different patterns of response to plasma fibronectin and fibrinogen, respectively, but the same pattern of response to tissue fibronectin. f-MLP stimulated an early increase of the adhesion of neutrophils to fibrinogen, while a weak stimulation of the adhesion of eosinophils to plasma fibronectin and fibrinogen and of neutrophils to plasma fibronectin was observed. Co-stimulation with f-MLP and Mn2+ did not induce any additive effects on granulocyte adhesion. In conclusion, the assay allows rapid quantification of eosinophil and neutrophil adhesion and can be used to directly compare the response of neutrophils and eosinophils. The assay is thus suitable for studies aimed at identifying agents with a selective effect on either of the cells.

Cell Adhesion↗
PubMed1998

Intercellular adhesion molecule-1 regulation in the canine lung after cardiopulmonary bypass.

OBJECTIVE(S): Neutrophil sequestration in the lung after cardiopulmonary bypass has been shown to be dependent on the adhesion molecule CD18. Thus we sought to determine whether endothelial expression of intercellular adhesion molecule-1 (a ligand for CD18) in pulmonary capillaries mediates neutrophil adhesion in this setting. METHODS: Seven adult mongrel dogs underwent 90 minutes of hypothermic cardiopulmonary bypass with 60 minutes of cardioplegic arrest. After warming, dogs were reperfused for up to 9 hours and lung biopsy specimens were obtained. Lung tissue was examined by Northern and Western blot analysis and by immunohistologic methods. Three sham-operated dogs served as time-matched controls. RESULTS: Northern blots demonstrated increased expression of intercellular adhesion molecule-1 messenger ribonucleic acid within 5 minutes of cessation of bypass (or approximately 30 minutes after aortic crossclamp release), which persisted at 9 hours of recovery and was not present in controls. Western blots showed intercellular adhesion molecule-1 protein expression before bypass but a measurable increase in intercellular adhesion molecule-1 protein in four of seven dogs in the bypass group by the ninth hour of recovery. Pulmonary neutrophil accumulation 9 hours after cardiopulmonary bypass was greater in those dogs with an increased intercellular adhesion molecule-1 protein expression. Immunoelectron microscopy demonstrated the pulmonary capillary endothelium capable of increased intercellular adhesion molecule-1 protein expression at the 9-hour time point. CONCLUSIONS: Cardiopulmonary bypass resulted in intercellular adhesion molecule-1 induction in the canine lung during recovery. An increased expression of intercellular adhesion molecule-1 protein in the lung was associated with an increased accumulation of neutrophils in affected animals. Thus intercellular adhesion molecule-1 expression may serve as a mechanism that predisposes the lungs to inflammatory cell-mediated injury postoperatively.

Animals↗
PubMed2003

Aprotinin restores the adhesive capacity of dysfunctional platelets.

The post-operative coagulopathy associated with cardiopulmonary bypass (CPB) is known to be predominantly related to platelet dysfunction. The use of the serine protease inhibitor aprotinin dramatically reduces CPB associated hemorrhage and is thought to act primarily through the inhibition of plasmin without directly influencing platelets. Our data indicate that there is a direct effect of aprotinin on platelet adhesion, which has not been previously reported. We found that when aprotinin was added to blood samples with poorly adhesive platelets, platelet adhesion significantly increased as measured by the percent coverage of denuded arterial segments in the Baumgartner perfusion chamber. In preliminary experiments using expired platelet concentrates or fresh whole blood, the addition of aprotinin induced a positive increase of 22+/-7.5 and 14+/-6.2 percentage point in platelet adhesion, respectively. A simulated CPB model that recirculated a unit of anticoagulated whole blood for 2 h was used (n=14) to induce a platelet adhesion defect similar to that seen in clinical CPB. At initiation of recirculation, platelet adhesion was 55+/-9.5% but dropped to 13+6.5% coverage after 2 h simulated CPB. The addition of aprotinin to the post-recirculation samples induced a significant restoration of platelet adhesion back to 38+/-11% coverage. When epsilon amino-caproic acid with soybean trypsin inhibitor was added to post recirculation samples, there was no similar effect on adhesion scores. To compare these findings with surgical CPB, we collected one blood sample at the beginning and two at the end of CPB from each of seven open-heart patients. Aprotinin was added to one of each of the post-CPB samples. Platelet adhesion at the onset of surgical CPB was only 39+/-11% in this patient group but dropped to 7+/-7% by the end. Similar to the model, the addition of aprotinin post-CPB restored adhesion to 29+/-11%. These results suggest some action of aprotinin other than its antiplasmin effect, and that platelet adhesion in general can be promoted by aprotinin.

Animals↗
PubMed1996

Cell adhesion: the molecular basis of tissue architecture and morphogenesis.

A variety of cell adhesion mechanisms underlie the way that cells are organized in tissues. Stable cell interactions are needed to maintain the structural integrity of tissues, and dynamic changes in cell adhesion participate in the morphogenesis of developing tissues. Stable interactions actually require active adhesion mechanisms that are very similar to those involved in tissue dynamics. Adhesion mechanisms are highly regulated during tissue morphogenesis and are intimately related to the processes of cell motility and cell migration. In particular, the cadherins and the integrins have been implicated in the control of cell movement. Cadherin mediated cell compaction and cellular rearrangements may be analogous to integrin-mediated cell spreading and motility on the ECM. Regulation of cell adhesion can occur at several levels, including affinity modulation, clustering, and coordinated interactions with the actin cytoskeleton. Structural studies have begun to provide a picture of how the binding properties of adhesion receptors themselves might be regulated. However, regulation of tissue morphogenesis requires complex interactions between the adhesion receptors, the cytoskeleton, and networks of signaling pathways. Signals generated locally by the adhesion receptors themselves are involved in the regulation of cell adhesion. These regulatory pathways are also influenced by extrinsic signals arising from the classic growth factor receptors. Furthermore, signals generated locally be adhesion junctions can interact with classic signal transduction pathways to help control cell growth and differentiation. This coupling between physical adhesion and developmental signaling provides a mechanism to tightly integrate physical aspects of tissue morphogenesis with cell growth and differentiation, a coordination that is essential to achieve the intricate patterns of cells in tissues.

Animals↗
PubMed1999

Adhesion-related hospital readmissions after abdominal and pelvic surgery: a retrospective cohort study.

BACKGROUND: Adhesions after abdominal and pelvic surgery are important complications, although their basic epidemiology is unclear. We investigated the frequency of such complications in the general population to provide a basis for the targeting and assessment of new adhesion-prevention measures. METHODS: We used validated data from the Scottish National Health Service medical record linkage database to identify patients undergoing open abdominal or pelvic surgery in 1986, who had no record of such surgery in the preceding 5 years. Patients were followed up for 10 years and subsequent readmissions were reviewed and outcomes classified by the degree of adhesion. We also assessed the rate of adhesion-related admissions in 1994 for the population of 5 million people. FINDINGS: 1209 (5.7%) of all readmissions (21,347) were classified as being directly related to adhesions, with 1169 (3.8%) managed operatively. Overall, 34.6% of the 29,790 patients who underwent open abdominal or pelvic surgery in 1986 were readmitted a mean of 2.1 times over 10 years for a disorder directly or possibly related to adhesions, or for abdominal or pelvic surgery that could be potentially complicated by adhesions. 22.1% of all outcome readmissions occurred in the first year after initial surgery, but readmissions continued steadily throughout the 10-year period. In 1994, 4199 admissions were directly related to adhesions. INTERPRETATION: Postoperative adhesions have important consequences to patients, surgeons, and the health system. Surgical procedures with a high risk of adhesion-related complications need to be identified and adhesion prevention carefully assessed.

Abdomen↗
PubMed1998

Adhesion of some probiotic and dairy Lactobacillus strains to Caco-2 cell cultures.

The adhesion of 12 different Lactobacillus strains was studied using Caco-2 cell line as an in vitro model for intestinal epithelium. Some of the strains tested have been used as probiotics, and most of them are used in the dairy and food industry. Human and bovine enterotoxigenic Escherichia coli strains were used as positive and negative control, respectively. Bacterial adhesion to Caco-2 cell cultures was quantitated using radiolabelled bacteria. The adherence of bacteria was also observed microscopically after Gram staining. Viability of bacteria prior to adhesion was verified using flow cytometry. Among the tested strains, L. casei (Fyos) was the most adhesive strain and L. casei var. rhamnosus (Lactophilus) was the least adhesive strain, approximately 14 and 3% of the added bacteria adhered to Caco-2 cell cultures, respectively. The corresponding values for positive and negative control E. coli strains were 14 and 4%, respectively. The Lactobacillus strains tested could not be divided into distinctly adhesive or non-adhesive strains, since there was a continuation of adhesion rates. The four most adhesive strains were L. casei (Fyos), L. acidophilus 1 (LC1), L. rhamnosus LC-705 and Lactobacillus GG (ATCC 53103). No significant differences in the percentage adhesion were observed between these strains. Adhesion of all the strains was dependent on the number of bacteria used, since an approximately constant number of Caco-2 cells was used, indicating that the Caco-2 cell binding sites were not saturated. Viability of bacteria was high since approximately 90% of the bacteria were viable with the exception of L. acidophilus 1 which was 74% viable. Microscopic evaluations agreed with the radiolabelled binding as evidenced by observing more bacteria in Gram-stained preparations of good adhering strains compared to poorly adhering strains.

Animals↗
PubMed2000

Ossicular chain reconstruction using a new tissue adhesive.

HYPOTHESIS: A new medical-grade cyanoacrylate tissue adhesive will improve the results of ossicular chain reconstruction in a rat model. BACKGROUND: An ideal tissue adhesive has long been awaited by otologists. Studies examining the older cyanoacrylates have demonstrated variable efficacy and toxicity. Octylcyanoacrylate is a new tissue adhesive that has many ideal properties for otologic surgery. METHODS: Thirteen female C-D rats were anesthetized, and preoperative auditory brainstem response (ABR) testing was performed. A left antrotomy was performed, and the incus was removed. In the adhesive group, the incus was dipped in octylcyanoacrylate and interposed between the tympanic membrane and the stapes; no adhesive was used in the control group. At 8 weeks, postoperative ABR was performed, the integrity of the ossicular chain inspected, and histopathologic analysis of the temporal bones performed. Statistical comparison of ABR results was performed with the Mann-Whitney test. RESULTS: Seven rats were randomized to the adhesive group and six to the control group, of which four survived. There were no histopathologic differences in the temporal bones of the animals other than the presence of mild foreign body reaction around the ossicular chain of the animals in the adhesive group. The ossicular chain was not intact in two of the four controls, whereas the rest were intact at 8 weeks. Postoperative air conduction ABR results (mean dB sound pressure level) (62.5 control versus 34.3 adhesive, p = 0.010) and air-bone gaps (47.5 control versus 18.9 adhesive, p = 0.008) were significantly better in the adhesive group. CONCLUSIONS: This new medical-grade tissue adhesive improves the hearing results of ossicular chain reconstruction, with no apparent histotoxicity in this animal model.

Animals↗
PubMed1999

Ultrastructural study on adhesions in internal derangement of the temporomandibular joint.

PURPOSE: This study examined the ultrastructural characteristics of adhesions in the upper joint compartment of temporomandibular joint (TMJ). MATERIALS AND METHODS: Tissue biopsy specimens of adhesions were obtained during arthroscopic operation on 36 joints in 22 patients with internal derangement (ID). The biopsy specimens were examined by light and transmission electron microscopy. RESULTS: Adhesions were grossly divided into two types based on arthroscopic observation: 1) a band-like type, which connected the articular fossa and TMJ disc, and 2) a pseudowall-like type, which faced the synovial fluid and was lined by articular tissue. Two types of collagen arrangement were observed at the electron microscopic level: orderly arranged collagen bundles and randomly arranged collagen bundles. Orderly arranged collagen bundles were prominent in the band-like adhesions. In pseudowall-like adhesions, mainly the randomly arranged collagen bundles were seen. However, in some dense fiber parts, orderly arranged collagen bundles also were observed. In other pseudowall-like adhesions, only orderly arranged collagen bundles were seen. Elastic fibers were abundant in some pseudowall-like adhesions with randomly arranged collagen bundles. There were no elastic fibers in the band-like adhesions, some dense fiber parts of the pseudowall-like adhesion, pseudowall-like adhesions consisting of only orderly arranged collagen bundles, and in the synovial membrane. CONCLUSION: The different arrangement of collagen fibers and presence or absence of elastic fibers were observed in the two types of adhesions. These findings served to show that extracellular components correspond to a dysfunction involving an ID of TMJ.

Adult↗
PubMed1997

Adaptation and radiographic evaluation of four adhesive systems.

OBJECTIVES: The purpose of this study was to compare microleakage, gap formation, thickness of the adhesive layer and its radiographic appearance associated with four adhesive restorative procedures for class I cavities. METHODS: Adhesive systems with easy handling characteristics were selected for the restoration of class I cavities in extracted third molars. Bitewing radiographs were taken of each tooth and four observers were asked to assess the presence of the adhesive layer. Microleakage, gap width and the thickness of the adhesive layer of each restoration were measured upon sectioning of the teeth. RESULTS: Microleakage in the experimental restorations was minimal. The thickness of the adhesive layers and gap formation varied among different adhesive systems. The adhesive system with self-etching primer produced the highest percentage gap-free restorations. Thick adhesive layers could be detected on the radiograph. ROC analysis of the results validates the diagnosis from the radiograph. CONCLUSIONS: The four restorative systems performed well in the prevention of microleakage. The use of a resin modified glass-ionomer cement base did not prevent gap formation compared with the all-etch bonding systems used in this study. The presence of an adhesive layer contributed to the prevention of gap formation, independently of the bonding system used. Thick adhesive layers could be detected on the radiograph.

Acid Etching, Dental↗
PubMed2004

Pain mapping of adhesions.

STUDY OBJECTIVE: To determine the nature and location of adhesions and their relationship to abdominal pain in patients undergoing awake microlaparoscopy. DESIGN: Retrospective analysis (Canadian Task Force classification II-1). SETTING: University teaching hospital. PATIENTS: Thirty women ages 26-49 years with chronic pelvic pain were studied over a 9-month period. INTERVENTION: Patients were kept awake during their laparoscopy to determine the site and degree of pain when the adhesions were palpated. MEASUREMENTS AND MAIN RESULTS: Patients with abdominal pain and a history suggestive that the pain was due to adhesions underwent an awake laparoscopy. Visual analog scores were used to evaluate the pain on palpation of the adhesion as it related to the nature of the adhesion as well as the location of the adhesion. Filmy adhesions that allowed for movement between two structures had the highest association with pain. Fixed adhesions that did not allow movement had the lowest pain scores. Adhesions that had a relationship to the peritoneum had a high association with pain. CONCLUSION: Filmy adhesions between a movable structure, such as an ovary, and the peritoneum had the highest pain scores. Fixed or dense adhesions, no matter where they were located, had the lowest pain scores.

Abdominal Pain↗
PubMed2003

Chance of adhesion formation after laparoscopic salpingo-ovariolysis: is there a place for second-look laparoscopy?

STUDY OBJECTIVE: To evaluate the chance of adhesion formation after laparoscopic salpingo-ovariolysis and determine the efficacy of early second-look laparoscopy (SLL). DESIGN: Prospective, randomized study (Canadian Task Force classification I). SETTING: Shiraz University hospitals. SUBJECT: Ninety women with mean duration of infertility of 7.2 years. INTERVENTIONS: Operative laparoscopy, with early SLL with adhesiolysis in 46 (group 1) and no SLL in 44 women (group 2). MEASUREMENTS AND MAIN RESULTS: Adnexal adhesions were evaluated according to American Society for Reproductive Medicine adhesion classification. Separation of newly reformed adhesions was performed at the time of SLL. Patients were followed for a year after operation without other infertility treatment. At the time of operation in group 1, adnexal adhesions were graded as severe (class D) in 19 women, moderate (class C) in 31, mild (class B) in 28, and minimal (class A) in 14. Respective figures in group 2 were 10, 30, 34, and 14. After salpingo-ovariolysis these figures were 12, 10, 20, and 50 in group 1 and 6, 14, 17, and 51 in group 2. In group 1 in whom early second-look laparoscopy was performed, at the start of the operation these figures were 17, 20, 21, and 34, and after operation 12, 8, 20, and 52, respectively. There were 11 term pregnancies in group 1 and 15 in group 2. No women with severe adhesions in either group conceived. In group 1, chances of term pregnancy were 18.75% for those with moderate adhesions, 35.71% for women with mild adhesions, and 42.86% in patients with minimal adhesions. Respective figures in group 2 were 26.67%, 41.18%, and 57.14%. CONCLUSION: The chance of moderate and severe adhesion reformation after laparoscopic salpingo-ovariolysis was 40.2%. Although separation of these adhesions could be performed more easily at the time of early SLL, the chance of pregnancy did not increase compared with that in patients who did not undergo SLL.

Adult↗