Background: Adhesion formation is a widely acknowledged risk following abdominal or pelvic surgery. Adhesions in the abdomen or pelvis can cause or contribute to partial or total small bowel obstruction (SBO). These adhesions deter or prevent the passage of nutrients through the digestive tract, and may bind the bowel to the peritoneum, or other organs. Small bowel obstructions can quickly become life-threatening, requiring immediate surgery to resect the bowel, or lyse any adhesions the surgeon can safely access. Bowel repair is an invasive surgery, with risks including bowel rupture, infection, and peritonitis. An additional risk includes the formation of new adhesions during the healing process, creating the potential for subsequent adhesiolysis or SBO surgeries. Objective: Report the use of manual soft tissue physical therapy for the reversal of adhesion-related partial SBOs, and create an initial inquiry into the possibility of nonsurgical lysis of adhesions. Case Reports: Two patients presenting with SBO symptoms due to abdominal adhesions secondary to abdominal and pelvic surgery were treated with manual soft tissue physical therapy focused on decreasing adhesions. Conclusions: Successful treatment with resolution of symptom presentation of partial SBO and sustained results were observed in both patients treated.

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Polymeric reducinq agents, such as polymeric borohydride resins, can be successfully utilized in both the pre-and oost-column modes, online, a t ambient temperatures, in real-time, for the selective chemical reduction o f a large number of aldehydes. Other classes of carbonyl derivatives, such as ketones, esters, amides, etc., are totally unreactive under these same polymeric reduction conditions. This particular reducing agent i s fully compatible with conventional reversed phase HPLC columns and mobile phases, such as methanol/water, ethanol/water, and acetonitrile/ water, in varying proportions. The approach t o selective detection in HPLC described here utilizes conventional UV-VIS detection following pre-or post-column reductions that occur on-line. Alternative detection methods could just as readily be utilized. Overall reactions are rapid, quantitative, reproducible, and highly selective. In certain cases, i t i s possible t o realize improved detection limits as a result of aldehyde reductions. Difference chromatography or changes in detector responses for unresolved reactant and product can be used t o denote reactions that have occurred on the original analyte(s) of interest. Polymeric reduction columns can be slurry packed a t f a i r l y low pressures, and they are stable a t elevated HPLC back pressures for prolonged periods of time and use. The use of polymeric reagents in HPLC i s a totally qeneral approach to improved specificity, selectivity, and detection limits in a l l types of organic and inorganic analyses.

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