More than 50 years have passed since it was first recognized that the surface properties, and predominantly the surface energies of materials controlled their interactions with all biological phases via their spontane...More than 50 years have passed since it was first recognized that the surface properties, and predominantly the surface energies of materials controlled their interactions with all biological phases via their spontaneous acquisition of proteinaceous “conditioning films” of differing degrees of denaturation but usually of the same substances within any given system. This led to the understanding that useful engineering control of such interactions could thus be manifested through adjustments to those surface properties, giving significant control and utility to the biomaterials developer without requiring detailed discovery of the biological specifications of the components involved. Thus, effective selection of adhesive versus abhesive (non-stick, non-retention) outcomes for such useful appliances as dental implants versus substitute blood vessels, or water-resistant bonded structures versus clean, nontoxic ship bottoms is now facilitated with little biological background required. A historical overview is presented, followed by a brief survey of the forces involved and most useful analyses applied. Utility for blood-contacting materials is described in contrast to utility for bone- and tissue-contacting materials, demonstrating practical uses in controlling cell-surface interactions and preventing biofouling. New research directions being explored are noted, urging applications of this prior knowledge to replace the use of toxicants.展开更多
Adhesive small bowel obstruction(ASBO)is the most frequently encountered surgical disorder of the small intestine.Up to 80%of ASBO cases resolve spontaneously and do not require invasive treatment.It is important to i...Adhesive small bowel obstruction(ASBO)is the most frequently encountered surgical disorder of the small intestine.Up to 80%of ASBO cases resolve spontaneously and do not require invasive treatment.It is important to identify such patients that will benefit from conservative treatment in order to prevent unnecessarily exposing them to the risks associated with surgical intervention,such as morbidity and further adhesion formation.For the remaining ASBO patients,timely surgical intervention is necessary to prevent small bowel strangulation,which may cause intestinal ischemia and bowel necrosis.While early identification of these patients is key to decreasing ASBO-related morbidity and mortality,the non-specific signs and laboratory findings upon clinic presentation limit timely diagnosis and implementation of appropriate clinical management.Combining the clinical presentation findings with those from other diagnostic imaging modalities,such as abdominal X-ray,computed tomography-scan and water-soluble contrast studies,will improve diagnosis of ASBO and help clinicians to better evaluate the potential of conservative management as a safe strategy for a particular patient.Nonetheless,patients who present with moderate findings by all these approaches continue to represent a challenge.A new diagnostic strategy is urgently needed to further improve our ability to identify early signs of strangulated bowel,and this diagnostic modality should be able to indicate when surgical management is required.A number of potential serum markers have been proposed for this purpose,including intestinal fatty acid binding protein andα-glutathione S transferase.On-going research is attempting to clearly define their diagnostic utility and to optimize their potential role in determining which patients should be managed surgically.展开更多
文摘More than 50 years have passed since it was first recognized that the surface properties, and predominantly the surface energies of materials controlled their interactions with all biological phases via their spontaneous acquisition of proteinaceous “conditioning films” of differing degrees of denaturation but usually of the same substances within any given system. This led to the understanding that useful engineering control of such interactions could thus be manifested through adjustments to those surface properties, giving significant control and utility to the biomaterials developer without requiring detailed discovery of the biological specifications of the components involved. Thus, effective selection of adhesive versus abhesive (non-stick, non-retention) outcomes for such useful appliances as dental implants versus substitute blood vessels, or water-resistant bonded structures versus clean, nontoxic ship bottoms is now facilitated with little biological background required. A historical overview is presented, followed by a brief survey of the forces involved and most useful analyses applied. Utility for blood-contacting materials is described in contrast to utility for bone- and tissue-contacting materials, demonstrating practical uses in controlling cell-surface interactions and preventing biofouling. New research directions being explored are noted, urging applications of this prior knowledge to replace the use of toxicants.
文摘Adhesive small bowel obstruction(ASBO)is the most frequently encountered surgical disorder of the small intestine.Up to 80%of ASBO cases resolve spontaneously and do not require invasive treatment.It is important to identify such patients that will benefit from conservative treatment in order to prevent unnecessarily exposing them to the risks associated with surgical intervention,such as morbidity and further adhesion formation.For the remaining ASBO patients,timely surgical intervention is necessary to prevent small bowel strangulation,which may cause intestinal ischemia and bowel necrosis.While early identification of these patients is key to decreasing ASBO-related morbidity and mortality,the non-specific signs and laboratory findings upon clinic presentation limit timely diagnosis and implementation of appropriate clinical management.Combining the clinical presentation findings with those from other diagnostic imaging modalities,such as abdominal X-ray,computed tomography-scan and water-soluble contrast studies,will improve diagnosis of ASBO and help clinicians to better evaluate the potential of conservative management as a safe strategy for a particular patient.Nonetheless,patients who present with moderate findings by all these approaches continue to represent a challenge.A new diagnostic strategy is urgently needed to further improve our ability to identify early signs of strangulated bowel,and this diagnostic modality should be able to indicate when surgical management is required.A number of potential serum markers have been proposed for this purpose,including intestinal fatty acid binding protein andα-glutathione S transferase.On-going research is attempting to clearly define their diagnostic utility and to optimize their potential role in determining which patients should be managed surgically.
