Abstract: The present invention relates to a self-adhesive dressing comprising a layer (1) of spunlace nonwoven material and attached thereto a layer (2) of adhesive. In accordance with the invention, the dressing is stretchable in a first direction (MD) corresponding to the machine direction of the nonwoven material and in a second direction (CD) perpendicular to the first direction, in conjunction with which the resistance to stretching is less than 10 N/25 mm in both the first (MD) and the second (CD) directions in the case of stretching of less than or equal to 5%.

Abstract: A dressing product comprises a dressing sheet (102), such as a thin film, one first surface of which is coated with an adhesive (106), such as a pressure sensitive hydrocolloid adhesive, which is applicable to an anatomical surface of a living being, such as a skin portion of a human. A carrier system, which provides a support for the dressing sheet, defines a gripping section for handling of the carrier system by human fingers. The carrier system may include one or more foil members (216;218;220;222) and supporting sheets (212) for facilitating application and for providing a non-touch application system, i.e. a system which may be handled by an operator without the operator touching the dressing sheet (102) or at least the adhesive surface (106) thereof. A protective sheet having an opening for application of a pharmaceutical product to the adhesive prior to application of the dressing sheet is disclosed.

Abstract: An adhesive for medical patches or for transdermal therapeutic systems which contains a component or a combination of at least two components, such as (a) polyvinyl alcohols, (b) cellulose derivatives, (c) polyethers, (d) acid anhydrides and their acids and salts, as well as (e) non-pressure-sensitive adhesive polyacrylates. The adhesive has a tackiness which is activated and/or increased by contact with moisture or by absorption of moisture.

Abstract: A protective foot pad includes a sheet of protective material having a main body portion in the shape of the ball of a human foot and a locating tab extending from the main body portion for location between the first and second toes of the foot, an adhesive on one surface of the sheet for adhering the sheet to the foot, and a removable release liner covering the adhesive until the pad is to be adhered to the foot. The pad is especially suited for protecting the bare foot of a dancer, who will use the pad by removing the release liner to expose the adhesive, placing the exposed adhesive on the bottom of his or her foot to cover at least a portion of the ball of the foot, with the tab extending between the first and second toes, and bending the locating tab over the skin between the first and second toes. The main body portion can include one or more lateral extensions that adhere to the side of the foot.

Abstract: The disclosed two-component device includes a first component comprising a first adhesive-backed anchoring member and one or more first connecting members, produced separately from the first adhesive-backed anchoring member. The first connecting member is attached to the first adhesive-backed anchoring member, extending from One edge thereof in a first direction. Also disclosed is a second component comprising a second adhesive-backed anchoring member and one or more second connecting members, produced separately from the second adhesive-backed anchoring member. The second component is attached to the second adhesive-backed anchoring member, extending from one edge thereof in a second direction generally opposite to the first direction. Adhesive for attaching the one or more first connecting members to the second anchoring member and adhesive for attaching the one or more second connecting members to the first anchoring member is provided. Methods of use are also disclosed.

Abstract: A scar treatment silicone dressing used for attaching onto wound of skin, comprising: a surface layer, a connection layer, a silicone layer, and a protection film. The surface layer is moisture permeable and water resistant thus providing protection function, and on one of its sides is disposed a silicone layer through a connection layer. The silicone layer is provided with penetrating through holes for controlling dissipation of moisture of skin wounds, as such assisting skin exiting perspiration to said surface layer via said through holes, hereby reducing the possibility that the acidic metabolite in perspiration getting in touch with the skin for long period of time in causing irritations/inflammations of the skin; meanwhile, it is also capable of preventing over-dissipation of moisture from the surface of skin, thus it will not adversely affect the repair and reconstruction of the scar tissue.

Abstract: To provide a patch containing fentanyl for mucous membrane of the oral cavity (oral transmucosal fentanyl), which rapidly increases the serum concentration of the drug, is easy in handling and is superior in safety. The patch can be prepared by laminating on one side of a drug layer which contains fentanyl or its salt as an active ingredient, methyl vinyl ether-maleic anhydride copolymer as an adhesive, and at least one substance selected from the group consisting of hydroxypropylcellulose, hydroxypropylmethylcellulose and hydroxyethylcellulose as a thickener, a support layer hardly soluble or insoluble in water, and a backing in this order.

Abstract: A self-adherent window dressing includes a fabric layer bounded by an edge. The fabric layer has an adhesive side, an opposite non-adhesive side, and an opening therein to allow for viewing therethrough. The opening is defined by a peripheral edge. A transparent film layer closes the opening and has first and second opposing sides. The film layer first side is non-adhesive and is mounted on the fabric layer adhesive side to close the opening in the fabric layer. The film layer second side has a skin adhering adhesive portion and an adhesive-free portion. The adhesive-free portion is disposed partially in the opening and extending beyond the peripheral edge of the opening. The film layer adhesive-free portion is adapted not to stick to a patient's skin, a connector, a catheter, or other medical device disposed between the film layer adhesive-free portion and skin.

Abstract: A multi layered wound dressing which comprises an adhesive layer, an absorbent layer overlying said adhesive layer on the surface furthest from the wound, and a moisture transmitting cover layer overlying the absorbent layer, the dressing having a total thickness of less than 1.5 mm.

Abstract: An apparatus for cleansing and promoting tissue growth in wounds, in which irrigant fluid optionally containing cell nutrients and/or other physiologically active material from a reservoir connected to a conformable wound dressing and wound exudate from the dressing are recirculated by a device for moving fluid through a flow path which passes through the dressing, a biodegradable scaffold in contact with the wound bed and a means for fluid cleansing and back to the dressing. The apparatus has means for supplying thermal energy to the fluid in the wound. The cleansing means (which may be a single-phase, e.g. micro-filtration, system or a two-phase, e.g. dialytic system) removes materials deleterious to wound healing, and the cleansed fluid, still containing materials that are beneficial in promoting wound healing, is returned to the wound bed. The dressing and a method of treatment using the apparatus.

Abstract: The liquid, polymer-containing coating materials of this invention comprise a polymer of a polymerizable, nitrogen-containing, hydrophilic monomer, which may give thermoresponsive properties, and which is copolymerized with a hydrophobic, polymerizable siloxy-containing monomer, in a solvent system of a volatile hydrophobic (non-polar) liquid that is non-stinging to a user. The material forms a coating or bandage in the form of a film when applied to a surface or the skin of a user.

Abstract: A patch having a layer structure that a pressure sensitive adhesive layer is provided on one surface of a base layer, wherein the base layer is an elastomer film having a thickness of 1 to 10 ?m, the thickness of the pressure sensitive adhesive layer is 1 to 15 ?m, the total thickness of the base layer and the pressure sensitive adhesive layer is within a range of from 2 to 20 ?m, the 10% tensile load of the patch in each of machine and transverse directions is 0.01 to 1.2 N/10 mm, assuming that the 10% tensile load value of the patch in the machine direction is X (N/10 mm), the thickness value of the patch is Y (?m), and the thickness value of the base layer is Z (?m), the patch satisfies the relationship of XY=0.02 to 15, or XZ=0.01 to 7, and the pressure sensitive adhesive layer exhibits adhesive strength of 0.1 N/10 mm or more.

Abstract: A plaster including a pressure-sensitive adhesive layer containing a readily dissolvable agar and at least one additive selected from the group consisting of polyacrylamides, polyvinyl alcohols, polyvinyl pyrrolidones, sodium alginate, ammonium alginate, carboxymethylcelluloses, sodium carboxymethylcelluloses, methylcelluloses, gum arabics, tragacanth gums, and xanthene rubbers, is provided.

Abstract: The present invention provides medical articles having a fluid control film component which comprise a sheet having microchannels that permit directional flow of a liquid. Articles incorporating the fluid control film include: wound dressings, wound drains, tympanostomy fluid wicks, intravenous access site dressings, drug delivery dressings, and sweat collection patches.

Abstract: Hydrocolloid-containing pressure-sensitive adhesive compositions for medical use are disclosed which contain networks of fibrillated polymeric fibers that have surface areas of at least 4 square meters per gram and which have superior properties of low cold flow and high cohesive strength.

Abstract: A wound dressing for post-operative sites comprising: a thin film layer covered on one side with an adhesive and an absorbent layer adhered to the adhesive side of the thin film layer, the absorbent layer being capable of absorbing exudate to allow the wound to be viewed through the dressing.

Abstract: A wound dressing includes a substantially transparent upper layer, an absorbent layer comprising a plurality of apertures arranged in a lattice pattern, and a low-adherent wound contact layer provided with a plurality of apertures arranged in a lattice pattern such the apertures of this layer are congruent with the apertures of the absorbent layer.

Abstract: An apparatus for cleansing wounds with means for stressing the wound bed and optionally tissue surrounding the wound, in which irrigant fluid from a reservoir connected to a conformable wound dressing and wound exudate from the dressing are recirculated by a device for moving fluid through a flow path which passes through the dressing and a means for fluid cleansing and back to the dressing. The cleansing means (which may be a single-phase, e.g. micro-filtration, system or a two-phase, e.g. dialytic system) removes materials deleterious to wound healing, and the cleansed fluid, still containing materials that are beneficial in promoting wound healing, is returned to the wound bed. The means for stressing the wound bed and optionally tissue surrounding the wound promotes wound healing. The dressing and a method of treatment using the apparatus.

Abstract: A wound dressing defining skin facing areas having different degrees of skin adherence. The dressing comprises a backing layer defining a center portion and a border portion surrounding the center portion. A carrier layer is secured to the border portion of the backing layer within the border portion and includes a first skin adherent facing layer. An absorbent core is connected to a surface of the backing layer within the center portion and a second skin adherent facing layer is disposed along a surface of the absorbent core. The first facing layer has greater skin adhesive properties than the second facing layer.

Abstract: An adhesive pad kit for footwear has a schematic having an indication of footwear. The adhesive pad kit has at least two pairs of thin adhesive backed pads. Each pad in the first pair has a predetermined shape having a length and a width. The length is at least four times the width. The indication depicts an operative location for at least one of the pads on the footwear.

Abstract: A PIV window dressing assembly with integral, built-in tubing anchors for the protection of a PIV catheter insertion site is disclosed that is interchangeably usable on both a right or left-hand side insertion site and that resists detachment from a patient's skin during use. The dressing assembly includes a fabric layer that is bounded by an edge. The fabric layer has an adhesive side, an opposite non-adhesive side, and at least one opening therein to allow for viewing therethrough. At least one reinforcement member is disposed between the fabric layer edge and the opening. The reinforcement member is adhered to the fabric layer adhesive side. A transparent film layer having an adhesive skin adhering side and an opposite non-adhesive side closes each of the openings in the fabric layer. The film layer non-adhesive side is adhered to the fabric layer adhesive side.

Abstract: The invention relates to a wound dressing comprising a microbial-derived cellulose for treatment of specific types of chronic wounds, including pressure sores, venous and diabetic ulcers. The wound dressing is capable of donating liquid to dry substrates is also capable of absorbing exudating wounds.

Abstract: A wound dressing comprising an absorbent pad, an adhesive layer, and a backing layer is described, along with a dressing support layer configured to retain and deliver the wound dressing to a wound, the dressing support layer having a radial configuration that forms a plurality of alternating covered and uncovered portions of the backing layer along the perimeter of the wound dressing.

Abstract: The invention relates to a wound dressing comprising a microbial-derived cellulose for treatment of specific types of chronic wounds, including pressure sores, venous and diabetic ulcers. The wound dressing is capable of donating liquid to dry substances is also capable of absorbing exudating wounds.

Abstract: An elongated, strip-like film bandage, includes a plastics film (1), which on its one side is coated with a skin-friendly adhesive (2), a protective layer (3) detachably fixed to the adhesive coating, and a stiffening layer (4), which is detachably fixed to the plastics film on the opposite side to the adhesive coating. The bandage is bellows-folded into a stack such that the bandage is divided into a number of parts (6-15) stacked one on top of the other, and three such parts of the bandage, which are mutually adjacent, are connected to one another on two opposite sides of the stack.

Abstract: A sutureless biopsy closure that includes an adhesive member adapted to be disposed over a biopsy region prior to the performance of the biopsy; at least one adhesive strip including one end supported on the adhesive member and a second free end forming a tab. The tab is adapted to extend over the biopsy region to seal the wound.

Abstract: One aspect is a method of tattoo aftercare including preparing a cover assembly for application over a newly-created tattoo. A film is applied over the tattoo and the film is left in place over the tattoo for at least 12 hours.

Abstract: A wound dressing includes a tube (9) for evacuating fluid from a wound and an air-tight and liquid-tight envelope layer (10) of flexible material, which envelope layer has a central region, in which the tube emerges beneath the envelope layer, and a peripheral region, which extends beyond the central region, the tube from the central region running outwards into the peripheral region beneath the envelope layer and out from this. The tube (9) is enclosed in a pressure-distributing material piece (11) which surrounds the tube, extends along the tube in the peripheral region, and also extends laterally beyond the tube viewed in the longitudinal direction of the tube.

Abstract: The present invention relates to a film base material for an adhesive skin patch, which includes an elastomer film unevenly having unevenness on at least one surface thereof, in which, in one unevenness in which the distance perpendicular to the surface of the elastomer film between the top of the unevenness and the bottom thereof is the longest among the plurality of unevenness, the distance is within the range of from 1 to 5 ?m; in another unevenness in which the distance perpendicular to the surface of the elastomer film between the top of the unevenness and the bottom thereof is the shortest among the plurality of unevenness, the distance is within the range of from 0.1 to 0.9 ?m; and the 10-point average roughness of the surface is within the range of from 0.5 ?m to 3 ?m, and which is decreased in glossy texture on the surface thereof and inconspicuous when it is applied to the skin or the like; and the adhesive skin patch including the film base material.

Abstract: A self-adherent window dressing includes a fabric layer bounded by an edge. The fabric layer has an adhesive side, an opposite non-adhesive side, and an opening therein to allow for viewing therethrough. A reinforcement member is adhered to at least a portion of the fabric layer. A transparent film layer closes the opening and has first and second opposing sides. The film layer first side is non-adhesive and is mounted on the fabric layer adhesive side to close the opening in the fabric layer. The film layer second side has a skin adhering adhesive portion and an adhesive-free portion. The adhesive-free portion is disposed inwardly of the opening. The film layer adhesive-free portion is adapted not to stick to a wound, connector, or catheter disposed between the film layer adhesive-free portion and skin.

Abstract: An adhesive patch containing an adhesive patch main part containing a support and an adhesive layer laminated on the support, wherein the adhesive patch main part comprises a peripheral part, a central part, and an intermediate part between the peripheral part and the central part, the intermediate part of the adhesive patch main part has a thickness greater than that of the central part of the adhesive patch main part, and the central part of the adhesive patch main part has a thickness greater than that of the peripheral part of the adhesive patch main part, and a production method thereof.

Abstract: An element dispensing package suitable for dispensing adhesive strips or bandages. Each element is contained within an envelope formed by opposed upper and lower sheets. The lower sheet has a release liner secured thereto to protect the element while it is within the dispenser. The element is releasably secured to a pull cover and is separated from the lower sheet and release liner when the envelope is opened. The pull cover has one or more gripping means to facilitate dispensing of the element contained within the package. Additionally, the lower sheet and upper sheet have optional gripping means to facilitate dispensing of the element contained within the package.

Abstract: An integrated wound dressing system and method including a bandage and a self-contained receptacle that stores treatment material for the care and treatment of wounds. The treatment material is easily accessible and can be removed from the receptacle through an exit. The treatment material can then be used to control bleeding and/or clean the wound before dressing. The bandage may include a layer of plastic that acts as an occlusion barrier to reduce heat loss and maintain moisture levels at the wound site. The occlusion barrier also acts to prevent the passage of air into or out of the wound site. The bandage also includes fasteners that act to prevent unintentional unraveling and to secure the bandage during final packaging. These fasteners help facilitate the wrapping of amputations, stumps, and extremities. The integrated wound dressing system provides an all-in-one system for treating and dressing wounds and reduces the time required to do so.

Abstract: An adhesive bandage is provided. The adhesive bandage includes: (a) an absorbent pad having an absorbent surface; (b) an adhesive tape attached to the absorbent pad, the adhesive tape being configured for attaching to a skin region so as to position the absorbent surface against a portion of the skin region; (c) a display being positioned on an outer surface of the adhesive bandage the display being configured and positioned so as to be viewable by an individual when the adhesive tape is attached to the skin region; and (d) a power source attached to or integrated with the adhesive tape, the power source being for powering the display, the display being for increasing an acceptability of use of the adhesive bandage by the individual when powered. Furthermore, the present invention provides an adhesive bandage with a display, the display being for displaying a skin condition value and for increasing an acceptability of use of the adhesive bandage by the individual when powered.

Abstract: A wound management accessory (10) and a method of dressing a wound (28,30) in the vicinity of an external orthopaedic fixator pin (24) are provided. The accessory (10) has a resilient body with a sleeve (12) defining an inner bore (18) that is shaped and dimensioned to fit around the circumference of the fixator pin (24) with an interference fit. The body also defines a flange (14) extending radially from the bore. The method comprises applying the accessory (10) to the pin (24) by passing the pin through the bore (18), covering the wound (28,30) at least in part with an occlusive adherent film (34), attaching at least the flange (14) of the accessory to the film in a generally sealing manner and applying a negative pressure to the wound beneath the film.

Abstract: An adhesion inhibiting surgical barrier. The surgical barrier includes a wound-facing polymeric coating comprising an enteric polymer; and at least one flexible substrate, the at least one flexible substrate having at least one exterior surface, wherein the polymeric coating is applied to the at least one flexible substrate to substantially cover the at least one exterior surface thereof. A method of inhibiting the formation of adhesions in a patient who has undergone a surgical procedure and a method of repairing a gastric or duodenal perforation are also described herein.

Abstract: A wound therapy device which may include a gasket distally spaced from an absorptive pad and an edge of a backing material. The device may also include an adaptor and tube portion with a connector located distally from a port hole in the backing material. In addition, a method of manufacturing a wound therapy device including using a port hole as a registration point.

Abstract: A hospital type of bandage integrates an absorbent pad and non-stick layer with a fluid-impermeable outer layer and an adhesive in a single composite structure. In a preferred embodiment the invention further includes means which may be used to turn the bandage inside out upon removal, so that surfaces once contacting a patient are no longer externally exposed. A bandage according to the invertible embodiment preferably includes a pocket formed on the side of the bandage facing away from the patient after application, this pocket being large enough to accommodate at least a portion of a human hand, and inside this pocket and located opposite the entrance is a means for grasping which may be pulled outwardly through pocket opening, thereby inverting the entire structure. Various forms of devices for grasping are possible as alternatives, including a string, a tab and a tab with one or more finger-receiving holes.

Abstract: A reinforced closure anchor includes a fabric layer having an adhesive side, an opposite non-adhesive side, and an outer edge. An anchor member layer having a reinforcing structure, an adhesive side, and an opposite non-adhesive side is disposed on the fabric layer. The anchor member non-adhesive side is adhered to the fabric layer adhesive side. The anchor member is disposed within the outer edge of the fabric layer.

Abstract: A wound treatment device for treating damaged body tissue comprising an encapsulating member having a size and shape capable of being attached to a patient to encapsulate a wound. A fluid communication member is provided for introducing treatment fluid within the encapsulating means for treatment of the wound. The fluid communication member is connected with a supply means for supplying treatment fluid thereto. The fluid communication member is capable of simultaneously transmitting multiple treatment fluids from the supply means into said encapsulating member. The inner surface of the wall of the encapsulating member is textured to allow fluid flow across the wound. The encapsulating member is also formed from a clear material to permit continuous visual inspection of the wound while maintaining a sterile environment.

Abstract: The invention relates to a dressing for a wound, containing a first layer which is formed by an absorbent matrix and an antimicrobially active substance. The substance is provided on a surface of the matrix in a chemically or physically bonded matter. The surface of the matrix with the substance is coated with a hydrophilic polymer.

Abstract: A hemostatic device for promoting the clotting of blood includes a gauze substrate, a clay material disposed on the gauze substrate, and also a polyol such as glycerol or the like disposed on the gauze substrate to bind the clay material. When the device is used to treat a bleeding wound, at least a portion of the clay material comes into contact with blood emanating from the wound to cause the clotting. A bandage that can be applied to a bleeding wound to promote the clotting of blood includes a flexible substrate and a gauze substrate mounted thereon. The gauze substrate includes a clay material and a polyol. A hemostatic sponge also includes a gauze substrate and a dispersion of hemostatic material and a polyol on a first surface of the substrate.

Abstract: Adhesive devices used as wound dressings, ingredient delivery devices and IV hold-downs include a handling layer comprised of a layer of conductive material and at least one layer of non-conductive material, adhered to the non-adhesive coated side of an adhesive coated polymeric film layer, by an electrostatic charge, rather than by an adhesive.

Abstract: A method and apparatus for reducing or eliminating pain after surgical procedures related to mucosal tissue, including tonsillectomy, adenoidectomy, or other pharyngeal operations. Certain embodiments provide a biodegradable film or covering that serves as a mechanical barrier to reduce pain caused, for example, by friction between solid food and healing tissue in the first few days after surgery. Some embodiments may include one or more therapeutic substances for locally reducing pain, facilitating healing and/or otherwise treating mucosal tissue at or near a tonsil bed.

Abstract: A crosslinkable macromer system and related methods of preparing the system and using the system in the form of a crosslinked matrix between a tissue site and an implant article such as a tissue implant or on the porous surface of a prosthetic device. The macromer system includes two or more polymer-pendent polymerizable groups and one or more multifunctional initiator groups. The polymerizable groups and the initiator group(s), when polymer-pendent, can be pendent on the same or different polymeric backbones. The macromer system provides advantages over the use of polymerizable macromers and separate, low molecular weight initiators, including advantages with respect to such properties as nontoxicity, efficiency, and solubility. A macromer system of the invention can be used as an interface between the tissue site and implant article in a manner sufficient to permit tissue growth through the crosslinked matrix and between the tissue site and implant.

Abstract: A packaged article including an adhesive-sided article, such as an adhesive bandage, and packaging formed of top and bottom backing sheets with a release layer disposed either directly on the bottom backing sheet facing the adhesive side of the article or on release paper carried on the bottom backing sheet. The facing surfaces of the top backing sheet and bottom backing sheet peripherally surrounding the adhesive-sided article have cohesive surfaces. An adhesive strip, preferably a double-sided adhesive strip, attaches the non-adhesive side of the adhesive-sided article to the top backing sheet. The top sheet is used as an applicator for placing the article onto a target surface, such as a patient's skin. The cohesive surface of the top sheet surrounding the article does not adhere to the target surface. A release layer applied directly on the bottom backing sheet eliminates additional material and waste.

Abstract: A delivery system for applying a wound dressing includes a thin film elastomeric wound dressing having a lower surface for application to the wound area and an upper surface, a release member releasably attached to the lower surface of the wound dressing, a delivery member including a lower surface releasably attached relative to the upper surface of the wound dressing and an upper surface, and being dimensioned to support the wound dressing and thereby facilitate application of the wound dressing to the wound area, and a tab member at least partially disposed between the wound dressing and the delivery member. The wound dressing defines a longitudinal axis and has longitudinal edges along the longitudinal axis and transverse edges traversing the longitudinal axis. The lower surface of the wound dressing may have a pressure sensitive adhesive for securing of the wound dressing relative to the wound area. The tab member is releasably attached relative to the lower surface of the delivery member.

Abstract: A bandage is for use in covering a tip of a digit. The bandage includes a backing material and an absorbent material. The backing material includes a coupling mechanism, and is substantially planar. The absorbent material is coupled to the backing material and includes a first portion and a second portion. The first portion includes a first end, a second end, and a body extending therebetween. The body has a width that is narrower than a width of the digit, wherein the width of the digit is measured adjacent to the tip of the digit. When the bandage is applied to the digit, the first portion is configured to extend generally axially over a portion of the digit and the second portion is configured to extend at least partially circumferentially about a portion of the digit.

Abstract: A composite dressing including a first polymeric layer, a second polymeric layer, a metal oxide, and a pharmaceutical active material is provided. The second polymeric layer is biocompatible and is disposed on a surface of the first polymeric layer. The metal oxide is distributed inside or on at least one surface of the first polymeric layer, while the pharmaceutical active material is distributed inside or on at least one surface of the second polymeric layer.

Abstract: The invention relates to a film structure (10, 30, 40, 60) comprising a polymer film (1) and an application system enabling the film structure to be handled in a simple manner. The application system is arranged on a first side of the polymer film (1) and comprises at least one supporting film (14, 20, 34, 44c, 64c) to which at least one gripping strip (15, 25, 35, 45, 65) is applied. The supporting film (14, 20, 34, 44c, 64a) comprises a first side facing towards the polymer film (1) and a second side facing away from the polymer film (1), the second side of the support film (14, 20, 34, 44c, 64a) comprising at least one adhesive region (18, 28, 38, 48, 68).