A roundish fused alumina particles having a mean particle size of 5 to 4,000 \u03bcm and a roundness of 0. Images formed on the image bearing member are transferred in a superposed manner onto the transferring medium, which is being conveyed. In other embodiments, the suturing instruments are capable of housing multiple needle and suture assemblies andor reloading the needle and suture assembly without removing the instrument from the surgical site.