Prevention of Peritoneal Adhesions by Non-Thermal Dielectric Barrier Discharge Plasma Treatment on Mouse Model: A Proof of Concept Study

Purposes: Formation of peritoneal adhesions is a common consequence of abdominopelvic surgeries and remarkably increases the mortality and morbidity. Moreover, peritoneal adhesions linked to chronic abdominopelvic pain and infertility in women. Various attempts for prevention of peritoneal adhesions were reported. However, these methods either remain insufficient to prevent formation of peritoneal adhesions or carry some practical limitations and thus, there is a need for novel techniques that could effectively decrease the formation of peritoneal adhesions. The aim of the present prospective, randomized, controlled, and single blinded study was to evaluate the effect of non-thermal atmospheric plasma (NTAP) treatment on prevention of peritoneal adhesions. Materials and Methods: Sixteen male CD-1 mice were randomly divided into two groups: control and plasma. Excisional and abrasion adhesion models were generated on the peritoneal side wall and cecum, respectively. Ten days after creating adhesion models, mice were sacrificed and adhesion formations were evaluated macroscopically using Knightly’s and Linsky’s grading systems to assess the intensity and extent of adhesions, respectively. Zühlke’s grading system was used for microscopic assessment of adhesions. Results: The mean scores for peritoneum and cecum in control group according to Knightly’s grading system were determined as 3.3 and 2.6, respectively. In NTAP-treated group, Knightly’s score was determined as 1.6 and 0.5 for peritoneum and cecum, respectively. NTAP treatment reduced Linsky’s score from 3.8 to 1.3 and 2.1 to 1.1 on peritoneum and cecum. Finally, in microscopic evaluation, NTAP treatment reduced Zühlke’s score from 3.4 to 1.5 and 2.6 to 1.3 for peritoneum and cecum, respectively. Conclusions: The results of the present proof of concept study suggest that NTAP could be a novel method to reduce and/or prevent the formation of peritoneal adhesions after abdominopelvic surgeries

Machine learning to predict the antimicrobial activity of cold atmospheric plasma-activated liquids

Plasma is defined as the fourth state of matter, and non-thermal plasma can be produced at atmospheric pressure under a high electrical field. The strong and broad-spectrum antimicrobial effect of plasma-activated liquids (PALs) is now well known. The antimicrobial effects of PALs depend on many different variables, which complicates the comparison of different studies and determining the most dominant parameters for the antimicrobial effect. The proven applicability of machine learning (ML) in the medical field is encouraging for its application in the field of plasma medicine as well. Thus, ML applications on PALs could present a new perspective to better understand the influences of various parameters on their antimicrobial effects. In this paper, comparative supervised ML models are presented by using previously obtained data to predict the in vitro antimicrobial activity of PALs. A comprehensive literature search was performed, and 12 distinct features related to PAL-microorganism interactions were collected from 33 relevant articles to automatically predict the antimicrobial activity of PALs. After the required normalization, feature encoding, and resampling steps, two supervised ML methods, namely classification and regression, are applied to the data to obtain microbial inactivation (MI) predictions. For classification, MI is labeled in four categories, and for regression, MI is used as a continuous variable. Sixteen different classifiers and 14 regressors are implemented to predict the MI value. Two different robust cross-validation strategies are conducted for classification and regression models to evaluate the proposed method: repeated stratified k -fold cross-validation and k -fold cross-validation, respectively. We also investigate the effect of different features on models. The results demonstrated that the hyperparameter-optimized Random Forest Classifier (oRFC) and Random Forest Regressor (oRFR) provided superior performance compared to other models for classification and regression. Finally, the best test accuracy of 82.68% for oRFC and R ^2 of 0.75 for the oRFR are obtained. Furthermore, the determined most important features of predictive models are in line with the outcomes of PALs reported in the literature. An ML framework can accurately predict the antimicrobial activity of PALs without the need for any experimental studies. To the best of our knowledge, this is the first study that investigates the antimicrobial efficacy of PALs with ML. Furthermore, ML techniques could contribute to a better understanding of plasma parameters that have a dominant role in the desired antimicrobial effect. Moreover, such findings may contribute to the definition of a plasma dose in the future

Atmosferik Soğuk Plazma ile Modifiye Edilen Titanyum Yüzeylerde Osteojenik Hücre Aktivitelerinin Değerlendirilmesi

Diş eksikliklerinin tedavisinde dental implant uygulamaları günümüzde sıklıkla tercih edilmektedir. Ancak dental implantların kemik ile entegrasyonu (osseointegrasyon) için beklenmesi gereken sürenin uzun olması bu tedavi yönteminin en önemli dezavantajı olarak karşımıza çıkmaktadır. Literatürde, osseointegrasyon için beklenen sürenin kısaltılması amacıyla yapılmış çok sayıda çalışma karşımıza çıkmaktadır. Osseointegrasyon süresinin kısaltılması amacıyla yüzey hidrofilitesini arttırarak hücre tutunma oranını yükselten Atmosferik Soğuk Plazma (ASP) uygulaması titanyum implantlar için uygulanmakta ve olumlu sonuçlar alındığı iddia edilmektedir. Bu çalışmada yüzey temas açısını düşürmek ve osteoblast hücrelerin yüzeye tutulumunu artırmak için titanyum disklerin yüzeyine ASP uygulandı. Farklı zaman aralıklarında uygulanan ASP öncesinde ve sonrasında temas açısı ölçümleri yapıldı. ASP uygulamasının osteoblast hücre hareketi üzerine etkileri immünohistokimyasal ve SEM analizi ile değerlendirildi. Uygulama sonrasında temas açısı değerlerinde anlamlı bir şekilde düşüş meydana geldi. Atmosferik soğuk plazma uygulaması osteblast hücreler üzerinde oksidatif stres meydana getirmeden disk yüzeyinde çoğlamasıını ve tutulumunu artırdı

Prevention of bacterial colonization on non-thermal atmospheric plasma treated surgical sutures for control and prevention of surgical site infections.

Surgical site infections have a remarkable impact on morbidity, extended hospitalization and mortality. Sutures strongly contribute to development of surgical site infections as they are considered foreign material in the human body. Sutures serve as excellent surfaces for microbial adherence and subsequent colonization, biofilm formation and infection on the site of a surgery. Various antimicrobial sutures have been developed to prevent suture-mediated surgical site infection. However, depending on the site of surgery, antimicrobial sutures may remain ineffective, and antimicrobial agents on them might have drawbacks. Plasma, defined as the fourth state of matter, composed of ionized gas, reactive oxygen and nitrogen species, free radical and neutrals, draws attention for the control and prevention of hospital-acquired infections due to its excellent antimicrobial activities. In the present study, the efficacy of non-thermal atmospheric plasma treatment for prevention of surgical site infections was investigated. First, contaminated poly (glycolic-co-lactic acid), polyglycolic acid, polydioxanone and poly (glycolic acid-co-caprolactone) sutures were treated with non-thermal atmospheric plasma to eradicate contaminating bacteria like Staphylococcus aureus and Escherichia coli. Moreover, sutures were pre-treated with non-thermal atmospheric plasma and then exposed to S. aureus and E. coli. Our results revealed that non-thermal atmospheric plasma treatment effectively eradicates contaminating bacteria on sutures, and non-thermal atmospheric plasma pre-treatment effectively prevents bacterial colonization on sutures without altering their mechanical properties. Chemical characterization of sutures was performed with FT-IR and XPS and results showed that non-thermal atmospheric plasma treatment substantially increased the hydrophilicity of sutures which might be the primary mechanism for the prevention of bacterial colonization. In conclusion, plasma-treated sutures could be considered as novel alternative materials for the control and prevention of surgical site infections

Development of Transvaginal Uterus Amputation Device for Laparoscopic Hysterectomies in Gynecologic Surgeries

Hysterectomy, that is removal of uterus, is one of the most common major operations in gynecologic surgeries. Laparoscopy technique is preferred in hysterectomy because of its advantages such as lower intra-operative blood loss, decreased surrounding tissue/organ damage, less operating time, lower postoperative infection and frequency of fever, shorter duration of hospitalization and post-operative returning time to normal activity. During total laparoscopic hysterectomy, first uterine vessels and ligaments are cauterized respectively, and then cervicovaginal connections are cauterized and coagulated to remove uterus completely. Uterine manipulators are used during laparoscopy to maximize the endoscopic vision of surgeons by moving related organs. However, conventional uterine manipulators have important drawbacks particularly to move uterus in three dimensions and to show cervicovaginal landmark during laparoscopic circular cauterization and amputation of the uterine cervix. A new transvaginal uterine manipulator may overcome these two important drawbacks of these currently available devices. For this reason, a3D scanned technique was used to get uterus sizes and computer aided design software is used in designing of the new manipulator and then 3D printer was used in prototyping. Special light emitting diodes (LEDs) were mounted on the cervical cap of the manipulator to guide light beams from inside of cervicovaginal tissue to abdominal cavity to facilitate the visualization of tissue landmarks. Moreover, performances of different caps and LED systems will be evaluated. Furthermore, after integration of self-cutting and self-suturing mechanisms into our system, final prototype will be produced by using titanium which is biologically and mechanically appropriate. Therefore, aim of this study was to design and produce a new uterine manipulator with three dimensional movements, LED illumination, self-cutting and self-suturing systems to facilitate laparoscopic hysterectom