Simvastatin Reduces the Expression of Adhesion Molecules in Circulating Monocytes From Hypercholesterolemic Patients Atorvastatin has hypolipidemic and anti-inflammatory effects in apoE/LDL receptor-double-knockout mice. Effects of atorvastatin on systemic inflammatory response after coronary bypass surgery Influence of a hydrophobic resin coating on the immediate and 6-month dentin bonding of three universal adhesives. Effects of Losartan and Simvastatin on Monocyte-Derived Microparticles in Hypertensive Patients With and Without Type 2 Diabetes Mellitus In Vivo and In Vitro Inhibition of Monocyte Adhesion to Endothelial Cells and Endothelial Adhesion Molecules by Eicosapentaenoic Acid Reduction of epidural scar adhesion by topical application of simvastatin after laminectomy in rats. Can statins reduce the inflammatory response to cardiopulmonary bypass? A clinical study. Anterior abdominal wall adhesions after laparotomy or laparoscopy. Simvastatin in the acute phase of ischemic stroke: a safety and efficacy pilot trial. Effect of vitamin D supplementation on inflammation: protocol for a systematic review High, but not moderate frequency and duration of exercise training induces downregulation of the expression of inflammatory and atherogenic adhesion molecules Prevention of post-surgical adhesion formation using aspirin in a rodent model: a preliminary report. Laparoscopy versus laparotomy for ovarian conservative surgery: a randomized trial in the rabbit model. Effects of solvent evaporation time on immediate adhesive properties of universal adhesives to dentin. The effect of oral simvastatin on fibrinolytic activity after colorectal surgery-a pilot study. A clinical, radiographic, and scanning electron microscopic evaluation of adhesive restorations on carious dentin in primary teeth. Experimental and clinical evaluation of a self-etching and an etch-and-rinse adhesive system. Shear bond strength of composite bonded to erbium:yttrium-aluminum-garnet laser-prepared dentin The Effect of Autologous Fibrin Tissue Adhesive on Postoperative Cerebrospinal Fluid Leak in Spinal Cord Surgery: A Randomized Controlled Trial Use of 2-Octyl-Cyanoacrylate Skin Adhesive (Dermabond) for Wound Closure following Reduction Mammaplasty: A Prospective, Randomized Intervention Study Effects of bezafibrate and simvastatin on endothelial activation and lipid peroxidation in hypercholesterolemia: evidence of different vascular protection by different lipid-lowering treatments. Silastic Splints Reduce Middle Meatal Adhesions after Endoscopic Sinus Surgery
Objective —The intercellular adhesion molecule-1 ( ICAM-1/CD54 ) and its lig and , CD11a/CD18 , mediate endothelial adhesion of leukocytes and their consecutive transmigration . Anti-inflammatory effects of statins are considered to be exerted in part through inhibition of leukocyte – endothelial interactions . We investigated the in vivo effects of simvastatin treatment in hypercholesterolemic patients and the influence of various statins on expression of cellular adhesion molecules in vitro . Methods and Results —A total number of 107 hypercholesterolemic patients were treated with 20 mg ( n=52 ) or 40 mg ( n=55 ) of simvastatin daily . After 6 weeks of treatment , peripheral blood mononuclear cells ( P BMC s ) expressed lower amounts of CD54- , CD18- , and CD11a-mRNA compared with pretreatment values . Surface expression of CD54 and CD18/CD11a on CD14 + -monocytes also decreased significantly in both groups of patients . Moreover , simvastatin , atorvastatin , and cerivastatin were found to downregulate tumor necrosis factor (TNF)-&agr ;– induced expression of CD54 and CD18/CD11a in isolated P BMC s obtained from normal donors as well as TNF-&agr ;– dependent expression of these CAMs in cultured human umbilical vein endothelial cells ( HUVECs ) . Furthermore , all three statins were found to reduce the binding of P BMC s to TNF-&agr ;– stimulated HUVECs in vitro . Conclusions —Statin-induced inhibition of expression of CD54 and CD18/CD11a in P BMC s and HUVECs with consecutive loss of adhesive function may contribute to the anti-inflammatory effects of these drugs and some of their beneficial clinical activities Statins are first-line pharmacotherapeutic agents for hypercholesterolemia treatment in humans . However the effects of statins in animal models of atherosclerosis are not very consistent . Thus we wanted to evaluate whether atorvastatin possesses hypolipidemic and anti-inflammatory effects in mice lacking apolipoprotein E/low-density lipoprotein receptor ( apoE/LDLR-deficient mice ) . Two-month-old female apoE/LDLR-deficient mice ( n=24 ) were r and omly subdivided into 3 groups . The control group of animals ( n=8 ) was fed with the western type diet ( atherogenic diet ) and in other two groups atorvastatin was added to the atherogenic diet at the dosage of either 10 mg/kg or 100 mg/kg per day for a period of 2 months . Biochemical analysis of lipids , ELISA analysis of monocyte chemotactic protein-1 ( MCP-1 ) in blood , quantification of lesion size and expression of vascular cell adhesion molecule-1 ( VCAM-1 ) and intercellular cell adhesion molecule-1 ( ICAM-1 ) in the atherosclerotic lesion by means of immunohistochemistry and Western blot analysis were performed . The biochemical analysis showed that administration of atorvastatin ( 100 mg/kg/day ) significantly decreased level of total cholesterol , lipoproteins ( VLDL and LDL ) , triacylglycerol , and moreover significantly increased level of HDL . ELISA analysis showed that atorvastatin significantly decreased levels of MCP-1 in blood and immunohistochemical and Western blot analysis showed significant reduction of VCAM-1 and ICAM-1 expression in the vessel wall after atorvastatin treatment ( 100 mg/kg/day ) . In conclusion , we demonstrated here for the first time strong hypolipidemic and anti-inflammatory effects of atorvastatin in apoE/LDLR-deficient mice . Thus , we propose that apoE/LDLR-deficient mice might be a good animal model for the study of statin effects on potential novel markers involved in atherogenesis and for the testing of potential combination treatment of new hypolipidemic substances with statins Objectives : Systemic inflammatory response occurs frequently after coronary artery bypass surgery , and it is strongly correlated with the risk of postoperative morbidity and mortality . Recent studies demonstrate that treatment with statin is associated with a significant and marked decrease in inflammation-associated variables such as the C-reactive protein , cytokines , and adhesion molecules . Therefore , we investigated the effects of preoperative atorvastatin treatment on systemic inflammatory response and perioperative morbidity after cardiopulmonary bypass . Design : Double-blinded , placebo-controlled , r and omized study . Setting : University hospital . Patients : Forty patients were r and omized to treatment with atorvastatin ( 20 mg/day , group A , n = 20 ) or placebo ( group B , n = 20 ) 3 wks before surgery . Interventions : Three-week treatment by atorvastatin 20 mg/day . Measurement and Main Results : Postoperative serum levels of both interleukin-6 and interleukin-8 increased significantly over baseline , but the peak levels observed 4 hrs postoperatively were significantly lower in the atorvastatin group . In the same fashion , CD11b expression on neutrophils was significantly lower in the statin group at 4 and 24 hrs postoperatively . Finally , neutrophil-endothelial adhesion was significantly reduced in the statin patients compared with controls . The operation time , blood loss , need for inotropic support , intubation time , and length of intensive care unit or hospital stay did not differ significantly between the two groups . The systemic inflammatory response syndrome score on postoperative days 1 and 2 was comparable in both groups . Conclusions : Pretreatment with atorvastatin significantly reduces cytokine release and neutrophil adhesion to the venous endothelium in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass OBJECTIVE To test the influence of a hydrophobic resin coating ( HC ) on the immediate ( 24h ) and 6-month ( 6 m ) microtensile dentin bond strengths ( μTBS ) and nanoleakage ( NL ) of three universal adhesives applied in self-etch ( SE ) or in etch- and -rinse ( ER ) mode . METHODS Sixty caries-free extracted third molars were assigned to 12 experimental groups result ing from the combination of the factors " adhesive system " ( Scotchbond Universal Adhesive [ SBU ] , 3 M ESPE ; All-Bond Universal [ ABU ] , Bisco Inc. ; and G-Bond Plus [ GBP ] , GC Corporation ) ; " adhesive strategy " ( SE or ER ) ; " hydrophobic resin coating " [ HC ] ( with or without Heliobond , Ivoclar Vivadent ) ; and " storage time " ( 24h or 6 m ) . Specimens were prepared for μTBS testing - ( 24h ) half of the beams were immediately tested under tension ; and ( 6 m ) the other half was stored in distilled water ( 37 ° C ) for 6 m prior to testing . For each tooth , two beams were r and omly selected for NL evaluation for both evaluation times . Data were analyzed for each adhesive system using three-way ANOVA and Tukey 's post-hoc test ( α=0.05 ) . RESULTS μTBS : ( 24h ) : In SE mode , HC result ed in statistically greater mean μTBS for all adhesives . ( 6 m ) : When HC was not used the mean μTBS for SBU/ER , ABU/ER , GBP/ER and SBU/SE decreased significantly . NL : ( 24h ) : SBU/ER , ABU/ER and GBP/SE result ed in a significant reduction in NL when HC was applied . ( 6 m ) : No significant reduction was observed for SBU/ER or for SBU/SE regardless of the use of HC . SIGNIFICANCE The application of a hydrophobic resin coating improved the 24h and the 6 m performances of all three adhesives systems in SE mode Monocyte-derived microparticles play an important role in the pathogenesis of diabetic vasculopathy , and angiotensin II receptor blocker and statin have been shown to have a beneficial effect on the angiopathies of hypertension and hyperglycemia in patients with type 2 diabetes mellitus . However , the interaction between angiotensin II receptor blocker and statin , and monocyte-derived microparticles in atherosclerosis is poorly understood . The effects of losartan and simvastatin on circulating concentrations of monocyte-derived microparticles , chemokines , and soluble adhesion markers were studied in hypertensive patients with or without type 2 diabetes mellitus . Monocyte-derived microparticles were measured by flow cytometry , and levels of serum chemokines ( MCP-1 and RANTES ) and soluble adhesion markers ( sP-selectin and sVCAM-1 ) were measured by enzyme-linked immunosorbent assay . Losartan decreased both the systolic and diastolic blood pressure in hypertensive patients with and without type 2 diabetes mellitus . The concentrations of monocyte-derived microparticles , chemokines , and soluble adhesion molecules were higher in hypertensive patients who also had type 2 diabetes mellitus vs. those who did not . The administration of angiotensin II receptor blocker decreased the circulating concentration of all these markers . In addition , all markers were decreased by combination therapy , and monocyte-derived microparticles were decreased more with combination therapy with losartan and simvastatin than monotherapy with losartan . The administration of angiotensin II receptor blocker inhibited monocyte-derived microparticle generation and suggests that angiotensin II is intimately related to vascular changes that occur in type 2 diabetes mellitus . Combination therapy with a statin and angiotensin II receptor blocker might be valuable as anti-atherosclerotic therapy in patients with type 2 diabetes mellitus and nephropathy Objective —A large-scale , prospect i ve , r and omized clinical trial has recently revealed that the addition of highly purified eicosapentaenoic acid ( EPA ) to low-dose statin therapy significantly reduces the incidence of major coronary events . Here we investigated in vivo and in vitro effect of EPA on monocyte adhesion to endothelial cells and adhesion molecules . Methods and Results —A new en face immunohistochemistry of endothelial surface in combination with confocal microscopy revealed marked reduction of lipopolysaccharide (LPS)-induced monocyte adhesion to the aortic endothelium in parallel with the suppression of vascular cell adhesion molecule 1 ( VCAM-1 ) and nuclear translocation of nuclear factor-&kgr;B p65 in EPA-treated mice relative to vehicle-treated groups . In an in vitro adhesion assay system under physiological flow conditions , EPA inhibited LPS-induced monocyte adhesion and endothelial adhesion molecules . We found significant decrease in plasma concentrations of soluble intercellular adhesion molecule 1 ( sICAM-1 ) and sVCAM-1 in patients with the metabolic syndrome after a 3-month administration of highly purified EPA ( 1.8 g daily ) . Multivariate regression analysis revealed that EPA administration is the only independent determinant of sICAM-1 and sVCAM-1 . Conclusions —This study provides evidence that EPA inhibits monocyte adhesion to endothelial cells in parallel with the suppression of endothelial adhesion molecules in vivo and in vitro OBJECTIVE Epidural scar adhesion is one of the major causes of the failed back surgery syndrome after laminectomy . Recent studies have shown that simvastatin has potent anti-fibrotic and anti-inflammatory properties . This study evaluates the effect of the topical application of simvastatin on reducing epidural scar adhesion after laminectomy in rats . MATERIAL S AND METHODS Thirty-six male Sprague-Dawley rats were r and omly divided into three groups : control , chitosan and simvastatin group . After laminectomy was performed at L1 level , simvastatin and chitosan were applied to the laminectomy sites . The control group received no additional treatment . Four weeks later , the rats were killed and the epidural adhesion was evaluated by macroscopic assessment , hydroxyproline content analysis and histological analysis . The number of fibroblasts and the optical density of the collagen were also determined . RESULTS The results showed that simvastatin could reduce epidural scar adhesion in rats . Little epidural adhesions were seen in the laminectomy sites treated with simvastatin . The hydroxyproline content , the number of fibroblasts and the optical density of the collagen in the simvastatin group were significantly less than those of the chitosan and control group . However , dense epidural adhesion was found in control group . CONCLUSIONS Topical application of simvastatin could reduce epidural scar adhesion after laminectomy in rats . Further research is necessary to determine the optimal dosage and the safety of simvastatin OBJECTIVE In addition to lowering lipid levels , statins might reduce leukocyte-endothelial cell interactions . Therefore , we assessed whether this effect could limit the inflammatory response to cardiopulmonary bypass ( CPB ) in cardiac surgical patients . METHODS Twenty patients undergoing valve or coronary operations with tepid ( 34 degrees C ) CPB were r and omized to receive an oral dose of atorvastatin ( 40 mg the evening before and 40 mg the morning of surgery ) or to serve as controls . Pre- and post-CPB blood sample s were assayed for neutrophil CD11b surface adhesion molecule and oxidative burst . Plasma levels of interleukins 6 and 8 , P-selectin , soluble intercellular adhesion molecule-1 , and lactoferrin were measured by enzyme-linked immunosorbent assay ( ELISA ) . In addition , right atrial biopsies were taken before and at the end of CPB , and processed for the expression of the transcription nuclear factor-kappa B ( NF-kappaB ) . RESULTS The two groups did not differ with regard to pre- and intraoperative data . Except for P-selectin , postbypass values of all markers significantly increased over baseline values , but atorvastatin therapy failed to attenuate the magnitude of this increase . In the two groups , the expression of NF-kappaB significantly ( p = 0.004 ) increased over baseline without group effect . Postoperative clinical outcomes did not differ either between the two groups . CONCLUSION These data show that acute preoperative statin therapy fails to limit the inflammatory response to CPB ; however , the data also document a major upregulation of NF-kappaB during cardiac operations , thereby providing a sound rationale for interventions targeted at inactivating this key component of the inflammatory cascade STUDY OBJECTIVE To determine the frequency of postoperative adhesions to the anterior abdominal wall peritoneum that could affect safe placement of the initial laparoscopic umbilical cannula at subsequent procedures . DESIGN Prospect i ve cohort study . SETTING Reproductive endocrinology and infertility service of a tertiary care referral hospital . PATIENTS Two hundred fifteen women , 124 with prior abdominal surgery and 91 with no prior surgery . INTERVENTIONS Surgical histories were review ed , abdominal skin scars noted , and extent of anterior abdominal wall adhesions prospect ively recorded . Statistical analysis was performed with the chi2 test . MEASUREMENTS AND MAIN RESULTS No anterior abdominal wall adhesions were present in 91 patients with no previous surgery  or 45 patients with previous laparoscopy  ( 12 had more than 1 laparoscopy ; p < 0.001 vs laparotomy ) . Seventeen ( 59 % ) of 29 patients with a midline vertical incision had anterior wall adhesions ( p < 0.05 vs suprapubic transverse incision ) . Eleven ( 28 % ) of 39 with a suprapubic transverse incision had anterior wall adhesions ( p < 0.001 vs no surgery or laparoscopy ) . Ninety-six percent of adhesions involved omentum and 29 % included bowel . CONCLUSION Prior laparotomy , whether through a midline vertical or suprapubic transverse incision , significantly increased the frequency of anterior abdominal wall adhesions , and these adhesions may complicate the placement of the laparoscopic cannula through the umbilicus Although statins are being used for secondary prevention of ischemic stroke , recent experimental data have shown new pleiotropic effects of these drugs responsible for their role in neuroprotection . We conducted a pilot , double-blind , r and omized , multicenter clinical trial to study for the first time safety and efficacy of simvastatin in the acute phase of ischemic stroke . Simvastatin/placebo was given at 3 - 12 h from symptom onset to 60 patients with cortical strokes . Efficacy on the evolution of several inflammation markers [ interleukin (IL)-6 , IL-8 , IL-10 , monocyte chemoattractant protein-1 , intercellular adhesion molecule-1 , vascular cell adhesion molecule-1 , C-reactive protein , sApo/Fas , tumor necrosis factor-alpha , E-selectin , L-selectin and nitrites+nitrates ] and neurological outcome was evaluated at baseline , day 1 , 3 , 5 , 7 and 90 . No differences were found amongst the biomarkers studied regarding treatment allocation . Although simvastatin patients improved significantly by the third day ( 46.4 % vs. 17.9 % , P = 0.022 ) , a non-significant increase in mortality and greater proportion of infections ( odds ratio 2.4 , confidence interval 1.06 - 5.4 ) in the simvastatin group were the main safety concerns . Therefore , a larger clinical trial is needed to confirm the net benefit of this therapeutic approach Introduction The extraskeletal role of vitamin D is being increasingly recognised . This has important clinical implication s , as vitamin D deficiency has reached epidemic proportions worldwide . Vitamin D has proposed anti-inflammatory properties , yet the role of vitamin D supplementation in reducing inflammation remains largely unknown . The purpose of this review is to investigate the impact of vitamin D supplementation on inflammation , and to identify relevant knowledge gaps in the field . Methods and analysis Medline , CINAHL , EMBASE and All EBM will be systematic ally search ed for r and omised controlled trials ( RCTs ) and systematic review s of RCTs , comparing vitamin D supplementation with placebo , usual care or other pharmacological or non-pharmacological interventions . One review er will assess articles for eligibility according to prespecified selection criteria , after which 2 independent review ers will perform data extraction and quality appraisal . Meta-analyses will be conducted where appropriate . Ethics and dissemination Formal ethical approval is not required as no primary data is collected . This systematic review will identify potential clinical implication s of vitamin D deficiency and supplementation , and will be disseminated through a peer- review ed publication and at conference meetings , to inform future research on the efficacy of vitamin D supplementation for inflammation and inflammatory diseases . PROSPERO registration number CRD42016037104 Background Lifestyle changes which include daily exercise training have been shown to slow the progression of coronary artery disease . We design ed a study to examine the effects of a multifactorial intervention on atherogenic adhesion molecules on the surface of monocytes in patients with coronary artery disease . Methods We r and omized 39 patients with coronary artery disease to ( i ) an intervention program which consisted of 4 weeks of daily 6 × 15 min ergometer training at submaximal intensity in addition to a 1 h/week group exercise session , followed by 5 months of home-based ergometer training of 30 min/day again in addition to a 1 h/week group exercise session or ( ii ) conventional therapy .  All patients received a statin .  Monocyte-bound cellular adhesion molecules LFA-1 ( CD11a ) , MAC-1 ( CD11b ) , VLA-4 ( CD49d ) and L-selectin ( CD62L ) were assessed by fluorescence activated cell sorting analysis . Results After 4 weeks the multifactorial intervention led to a significant improvement of maximal work capacity , lipid profile , body mass index , blood pressure , fasting glucose and hemoglobin A1c . This was associated with a reduced expression of MAC-1 and VLA-4 . After 5 months of a home-based intervention the beneficial effects of the cardiovascular risk profile were still apparent , whereas the effects on the expression of adhesion molecules were blunted . Conclusion In patients treated with statins , 4 weeks of high frequency and long duration exercise training led to a diminished expression of atherogenic adhesion molecules MAC-1 und VLA-4 . After 5 months of home-based exercise training of moderate frequency and duration , these effects were blunted . Our data suggest that our patients in cardiac rehabilitation programs might further benefit from the antiatherogenic effects of an even higher amount of exercise training Pelvic adhesions are one of the major factors which significantly and adversely affect surgery outcome due to intra- and postoperative morbidity and reduce future female fertility . Using a rodent model , we evaluated the efficacy of aspirin , a non-steroidal anti-inflammatory drug , in the prevention of adhesion formation . A total of 72 female Wistar rats received a st and ardized primary traumatic lesion to the right uterine horn . They were r and omly divided into eight groups : group I ( control ) had no treatment and group II received a single pre-operative 0.70 mg aspirin . All the succeeding groups ( III-VIII ) received aspirin in doses of 0.35 , 0.70 , or 1.40 mg every 6 h for either 48 or 96 h in addition to the pre-operative aspirin ( 0.70 mg ) . All animals were killed 4 weeks later and adhesions were assessed using a modified adhesion scoring scale . The lowest adhesion score was found in the group treated with 0.35 mg of aspirin for 96 h , and the highest was found among the groups treated with either 0.70 or 1.40 mg for 48 - 96 h respectively ( P < 0.05 ) . These results are in line with the hypothesis that administration of a low dose of aspirin selectively inhibits the production of thromboxane A2 , whereas basal prostacyclin bio synthesis is preserved . This phenomenon might contribute to reducing postoperative adhesion formation in a rat model . Thus , future studies into the prevention of adhesion formation may require the additional use of a non-steroidal anti-inflammatory drug , for which aspirin deserves further attention , before extrapolation into human therapy OBJECTIVE Our purpose was to compare postoperative adhesion formation and reproductive outcome after the same ovarian surgical procedure performed by laparoscopy or laparotomy by means of microsurgical techniques . STUDY DESIGN Twenty-eight New Zeal and White female rabbits were r and omly assigned to laparotomy or laparoscopy for the same st and ardized surgical procedure : both ovaries were grasped with atraumatic forceps and longitudinally incised on the antimesenteric side from the cortex to the hilum with a microelectrode delivering a tissue power density of 66,666 W/cm . The rabbits were then mated , and 2 weeks later a second-look laparotomy was performed by a blinded observer for the evaluation of postoperative adhesions , number of corpora lutea in each ovary , number of embryos in the ipsilateral uterine horn , and nidation index for each side . RESULTS At second look no statistically significant differences were found in postoperative adhesion formation , number of corpora lutea , number of embryos , and nidation index between the laparoscopy and the laparotomy groups . CONCLUSION Laparoscopy or laparotomy for ovarian conservative surgery do not appear significantly different in postoperative adhesion formation and reproductive outcome in the rabbit model OBJECTIVE To evaluate the microtensile bond strengths ( μTBS ) and nanoleakage ( NL ) of three universal or multi-mode adhesives , applied with increasing solvent evaporation times . METHODS One-hundred and forty caries-free extracted third molars were divided into 20 groups for bond strength testing , according to three factors : ( 1 ) Adhesive - All-Bond Universal ( ABU , Bisco , Inc. ) , Prime&Bond Elect ( PBE , Dentsply ) , and Scotchbond Universal Adhesive ( SBU , 3 M ESPE ) ; ( 2 ) Bonding strategy - self-etch ( SE ) or etch- and -rinse ( ER ) ; and ( 3 ) Adhesive solvent evaporation time - 5s , 15s , and 25s . Two extra groups were prepared with ABU because the respective manufacturer recommends a solvent evaporation time of 10s . After restorations were constructed , specimens were stored in water ( 37 ° C/24h ) . Resin-dentin beams ( 0.8mm(2 ) ) were tested at 0.5mm/min ( μTBS ) . For NL , forty extracted molars were r and omly assigned to each of the 20 groups . Dentin disks were restored , immersed in ammoniacal silver nitrate , sectioned and processed for evaluation under a FESEM in backscattered mode . Data from μTBS were analyzed using two-way ANOVA ( adhesive vs. drying time ) for each strategy , and Tukey 's test ( α=0.05 ) . NL data were computed with non-parametric tests ( Kruskal-Wallis and Mann-Whitney tests , α=0.05 ) . RESULTS Increasing solvent evaporation time from 5s to 25s result ed in statistically higher mean μTBS for all adhesives when used in ER mode . Regarding NL , ER result ed in greater NL than SE for each of the evaporation times regardless of the adhesive used . A solvent evaporation time of 25s result ed in the lowest NL for SBU-ER . SIGNIFICANCE Residual water and /or solvent may compromise the performance of universal adhesives , which may be improved with extended evaporation times BACKGROUND Studies conducted in animal models have shown that statins ( 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors ) reduce adhesion formation by upregulating fibrinolysis . The aim of this study was to determine the effect of orally administered statins on the promoters and inhibitors of the fibrinolytic pathway . METHODS In a previously described double-blinded clinical trial , 144 patients undergoing elective colorectal resection , or reversal of Hartmann 's procedure were r and omized to receive 40 mg once daily oral simvastatin 3 - 7 d before surgery or placebo . For the purpose s of the present study , peritoneal drain fluid was collected postoperatively from patients to measure active tissue plasminogen activator ( tPA ) , tissue plasminogen activator total antigen , active plasminogen activator inhibitor-1 ( PAI-1 ) , plasminogen activator inhibitor total antigen ( PAI-1TA ) , plasminogen activator inhibitor-1 and tissue plasminogen activator complex ( PAI-1/tPA ) . These were analyzed using ELISA . The number of hospitalizations and complications related to small bowel obstruction ( SBO ) were recorded at 2 y after surgery . RESULTS A total of 95 patients ( 72 % ) had sufficient peritoneal drain fluid suitable for ELISA analysis . Of them , 46 patients ( 48 % ) were from the oral simvastatin group . Mean tPA and tPA total antigen concentrations in peritoneal fluid were similar between the two groups . Mean PAI-1 and PAI-1 TA concentrations in the statin and placebo group were also similar . Mean PAI-1/tPA complex concentration was similar between the two groups . The number of hospitalizations from SBOs were 5 and 4 in the statin and placebo groups respectively ( P = 0.46 ) . The overall mortality at 2-year post-surgery was similar between the two groups ( P = 0.59 ) . CONCLUSIONS In this pilot study involving humans , oral simvastatin had no measured effect on the peritoneal fibrinolytic pathway in the first 24 h after colorectal surgery . Analysis of clinical outcomes also showed that oral simvastatin did not reduce hospitalizations for SBO in the 2 y after surgery . Further studies may be useful to evaluate whether fibrinolytic pathways beyond 24 h are altered after systemic administration of statins and to evaluate the use of higher doses of statins , perhaps used intraperitoneally rather than systemically OBJECTIVE The purpose of this project was to evaluate the performance of a dentin adhesive system on carious and noncarious primary dentin in vivo . METHOD AND MATERIAL S Forty-eight primary molars with carious lesions were r and omly assigned to 2 different treatments : group 1 ( control , n = 24)--All identifiable , irreversibly infected dentin was removed prior to the application of the bonding agent and restorative material ; group 2 ( experimental , n = 24)--Irreversibly infected dentin was partially removed prior to the application of the bonding agent and restorative material . The control and experimental teeth were clinical ly monitored every 3 months and evaluated 12 months after restoration . The teeth were extracted around the time of exfoliation and processed for scanning electron microscopy . RESULTS Retention rate , marginal integrity , and pulpal symptoms were identical in both groups . Radiographically , the radiolucent area associated with the experimental restorations did not increase with time in 75 % of the cases . For the control group , the adhesive system formed a hybrid layer . In the experimental group , there was morphologic evidence of the formation of an acid-resistant " altered hybrid layer . " An acid-resistant tissue , result ing from the interdiffusion of adhesive resin within the area of carious dentin , was observed adjacent to and under the altered hybrid layer . CONCLUSION Application of an adhesive restorative system to irreversibly infected dentin did not affect the clinical performance of the restoration PURPOSE To assess the one-step self-etching adhesive iBond Gluma inside ( 1-SE ) and the two-step etch- and rinse adhesive Gluma Comfort Bond ( 2-ER ) , both used in combination with the fine particle hybrid composite Venus , in a laboratory and in a prospect i ve clinical study . MATERIAL S AND METHODS In the in vitro study , tooth-composite interaction , microleakage , and adhesive failure of 8 Class V restorations per system were evaluated by light and scanning electron microscopy . In the in vivo study , 90 paired Class III/IV restorations were scored over 48 months ( modified USPHS criteria ) . Cumulative failure rates ( CFR ) were calculated . RESULTS In vitro , microleakage and adhesive failure at enamel margins were significantly increased with 1-SE in comparison with 2-ER . With 1-SE , micromechanical interlocking at enamel was reduced and pores within the adhesive layer arose . In vivo , after 48 months with 1-SE , decreased marginal integrity and an increased number of dark marginal color lines were observed . CONCLUSION Because the results of the 4-year clinical study showed lower esthetics and marginal integrity for the 1-SE adhesive , its use should be viewed critically , which is in line with the reduced enamel-adhesive-composite interaction found in vitro The purpose of this study was to evaluate the dentin bond strength to resin composite following erbium : yttrium-aluminum-garnet ( Er : YAG ) laser preparation using different adhesive systems . Seventy dentin specimens prepared from human molar teeth were r and omly assigned to seven groups of ten . The first five groups were prepared with an Er : YAG laser 2940 nm at the manufacturer ’s recommended setting s and ( 1 ) acid etched , and etch- and -rinse adhesive Excite was applied ; ( 2 ) Excite was applied ; ( 3 ) two-step self-etching adhesive AdheSE was applied ; ( 4 ) laser etched ( 120 mJ/10 Hz ) , and Excite was applied ; ( 5 ) laser etched , and AdheSE was applied . The last two groups were added as controls ( prepared with a diamond bur ) : ( 6 ) acid etched , and Excite was applied ; ( 7 ) AdheSE was applied . Nanohybrid composite cylinders 4 mm × 2 mm were bonded to the dentin surfaces . After the specimens had been stored in distilled water and had undergone thermocycling , the shear bond strength was tested and the data were analyzed statistically . The Duncan multiple comparison test showed that specimens prepared with a diamond bur and with acid and Excite applied showed the highest mean bond strength ( 13.01 ± 2.09 MPa ) , followed by those prepared with Er : YAG and with AdheSE applied ( 11.5 ± 3.59 MPa ) and those prepared with a diamond bur and with AdheSE applied ( 10.75 ± 1.95 MPa ) , but there were no significant differences among them ( P > 0.05 ) . Er : YAG-prepared specimens , with acid , Excite ( 3.28 ± 0.95 MPa ) and specimens that were laser etched and with AdheSE applied ( 3.37 ± 0.63 MPa ) showed the lowest mean values for bond strength ( P < 0.05 ) . The results suggested that dentin surfaces prepared with Er : YAG laser may provide comparable composite resin bond strengths depending on the adhesives used Study Design . A prospect i ve r and omized study evaluating the efficacy of autologous fibrin tissue adhesive for decreasing postoperative cerebrospinal fluid ( CSF ) leak in spinal cord surgery . Objective . To compare postoperative CSF leak in 3 groups ( i.e. , autologous fibrin tissue adhesive used , commercial fibrin glue used , and no fibrin tissue adhesive used ) of patients undergoing spinal surgery who needed dural incision . Summary of Background Data . Spinal cord operations , particularly when dural incision is inevitable , sometimes involve postoperative CSF leak . Because CSF leak is a serious complication , countermeasure is necessary to prevent it after dural suture . Commercial fibrin tissue adhesive was formerly used . Because the possibility of prion infection was widely noticed , commercial fibrin tissue adhesive containing animal components has been used less often . Methods . In 13 of 39 cases in which dural incision would be made , 400 mL whole blood was drawn , and autologous fibrin tissue adhesive was made of plasma . Cases were divided into 3 groups : ( 1 ) dural closure alone , ( 2 ) use of autologous fibrin tissue adhesive after dural closure , and ( 3 ) use of commercial fibrin tissue adhesive after dural closure . The primary outcome measure was determined as postoperative ( 3 days ) volume of drainage fluid , and results were analyzed using the analysis of variance . The secondary outcome measure was general blood test , coagulation assay , and plasma fibrinogen , and these were analyzed also using the analysis of variance . Results . There was a significant difference in the primary outcome between the autologous and control groups . No complications such as infection or continuous CSF leak were observed in any case . The mean volume of drainage fluid was 586.2 mL in the group with autologous fibrin tissue adhesive and 1026.1 mL in the group without fibrin tissue adhesive . The volume of drainage fluid was significantly lower in the former group than that in the latter group . There was no statistical difference between the volumes of the group with autologous adhesive and with commercial adhesive ( 639.2 mL ) . Conclusions . We used autologous fibrin tissue adhesive as a new sealant after dural closure instead of commercial fibrin tissue adhesive . No definitive CSF leak was observed , and the volume of drainage fluid was significantly lower in the group with autologous fibrin tissue adhesive than that in the group without fibrin tissue adhesive . The use of autologous fibrin tissue adhesive was superior to that of commercial fibrin tissue adhesive in cost Background : 2-Octyl-cyanoacrylate skin adhesive may be used for surgical wound closure . However , its use in plastic surgery has not been properly assessed . Methods : The authors conducted a prospect i ve , r and omized , controlled clinical intervention study in which the scar characteristics after use of skin adhesive were compared with those after suture closure .  Bilateral reduction mammaplasty was performed in 50 patients . The method of closure ( sutures versus skin adhesive ) applied to each breast was determined r and omly , using each patient as her own control . Scars were assessed by the patient and by a blinded panel , at 1 week , 6 weeks , and 6 months after surgery , using a visual analogue scale , the modified Holl and er Wound Evaluation Scale , and the Patient and Observer Scar Assessment Scale . Results : Both patients and panelists expressed an overall preference for the adhesive side as of 1 week after surgery . Patients ’ visual analogue scale scores for scar comfort and scar appearance and panelists ’ visual analogue scale scores for aesthetic outcome were significantly better for the adhesive side after 6 weeks and 6 months ( p < 0.05 ) , as was the total Holl and er Wound Evaluation Scale score of the panelists after 6 weeks ( p < 0.02 ) . The total Patient and Observer Scar Assessment Scale score after 6 months was significantly better for the adhesive side according to the patients ( p < 0.01 ) , but not according to the panelists ( p = 0.11 ) . Conclusion : The authors conclude that 2-octyl-cyanoacrylate is a sound alternative for wound closure Hypercholesterolemia is combined with enhanced lipid peroxidation , which can promote atherogenesis by inducing endothelial adhesion molecule expression . Statins may protect vascular endothelium in hypercholesterolemia by reducing enhanced plasma levels of low-density lipoprotein and decreasing oxidative stress . Herein , we describe increased circulating levels of soluble intercellular adhesion molecule-1 , vascular cell adhesion molecule-1 , and E-selectin and total 8-iso-prostagl and in F(2 alpha ) ( 8-iso-PGF(2 alpha ) ) concentrations , as indexes of endothelial activation and lipid peroxidation , respectively , in 67 hypercholesterolemic patients compared with 32 normocholesterolemic subjects .  Significant cholesterol reductions were achieved in hypercholesterolemic patients after 6 months under either simvastatin ( 40 mg/d ) or bezafibrate ( 800 mg/d ) treatment , given according to a r and omized double-blind trial . Simvastatin but not bezafibrate simultaneously reduced soluble adhesin and total 8-iso-PGF(2 alpha ) concentrations also . Vitamin E supplementation ( 400 IU/d ) further reduced indexes of endothelial activation and lipid peroxidation in simvastatin-treated patients and significantly reduced the above indexes in bezafibrate-treated patients . Changes in circulating soluble adhesion molecule levels were directly correlated with changes in total 8-iso-PGF(2 alpha ) concentrations in simvastatin-treated patients also receiving vitamin E supplementation . All together , our data demonstrated that hypercholesterolemia was combined with endothelial activation and lipid peroxidation , which were efficaciously counteracted by simvastatin but not bezafibrate treatment . Thus , a different vascular protection can be achieved by different lipid-lowering treatments Background Adhesions frequently form between the middle turbinate and lateral nasal wall after  endoscopic sinus surgery ( ESS ) and are a possible cause for surgical failure . Many absorbable and nonabsorbable spacers have been tried to improve healing . This study was design ed to ascertain whether placement of a thin silastic splint into the middle meatus after sinus surgery for 2 weeks reduces adhesion formation and whether a reduction in the adhesion rate improves patient outcomes in the early postoperative phase . Methods Forty-two patients who were scheduled to undergo ESS for chronic rhinosinusitis were r and omized to have a silastic splint placed into the middle meatus on one side of the nose but not the other at the completion of surgery . Splints were removed 2 weeks postoperatively . Symptom scores were recorded for each side of the nose up to 12 weeks after surgery and ethmoid cavities were grade d at the 6- and 12-week visits along with assessment of adhesions . Patients were blinded to which side was splinted as was the surgeon assessing ethmoid cavities at 6 and 12 weeks . Results Thirty-three patients completed 12 weeks of follow-up . Nasal obstruction and facial pain/discomfort were significantly higher on splinted sides for the first 2 weeks . More interventions were performed to debride adhesions in nonsplinted sides . Endoscopy revealed no adhesions at 12 weeks for sides treated with a splint whereas 9 of 33 nonsplinted sides had persistent adhesions . There were no significant differences in symptom or ethmoid cavity scores at 6 or 12 weeks between sides treated with splints versus sides treated without splints or between sides with adhesions versus without adhesions . Conclusion Middle meatal silastic splints reduce adhesions after ESS but increase early nasal obstruction and discomfort . Their use did not significantly change symptom or ethmoid cavity scores at 12 weeks
In conclusion , statins were effective in preventing postoperative adhesion , as assessed based on gross and microscopic adhesion scores in rats
Adhesion is a significant concern after surgery .
Many research ers studied the anti-adhesive effect of statin , of which results were inconsistent .
Thus , we purpose d to perform a systematic review and meta- analysis to evaluate the effect of statins on postoperative adhesion in an experimental study .