Efficacy of ropivacaine by the concentration of 0.25%, 0.5%, and 0.75% on surgical performance, postoperative analgesia, and patient’s satisfaction in inguinal hernioplasty: a randomized controlled trial

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Su YL

2015-09-01

Full Text Available Yinglan Su, Zhongjun Zhang, Yaoxian Zhang, Hanwei Li, Wei Shi Anesthesia Department, The Shenzhen People’s Hospital, The Secondary Clinical Medical College of Jinan University, Shenzhen, Guangdong, People’s Republic of China Background: The purpose of this study was to evaluate the use of different concentrations of ropivacaine in ultrasound-guided regional anesthesia with regard to postoperative analgesic and patient’s satisfaction in elderly patients undergoing inguinal hernioplasty in the People’s Republic of China. Methods: A total of 60 patients (>75 years of age who scheduled inguinal hernioplasty at the Shenzhen People’s Hospital from December 2013 to March 2015 were randomly assigned to three groups: 0.25% ropivacaine (n=20, 0.5% ropivacaine (n=20, and 0.75% ropivacaine (n=20. Ultrasound-guided regional anesthesia was performed before every surgery. Non-invasive blood pressure and heart rate were recorded before the operation, during the first 5 minutes of the surgical procedure, and 5 minutes after the operation of the patients, and compared between the groups. Incidence of adverse reactions, postoperative Visual Analog Scale score, and analgesic effect were also recorded and analyzed. Results: The surgical procedure and anesthesia was performed successfully in all patients. Patients with high-dose ropivacaine (0.5% and 0.75% in ultrasound-guided regional anesthesia exhibited lower arterial pressure and lower heart rate during the operation when compared to low-dose group. The interquartile range of Visual Analog Scale scores in both group C (0.75% ropivacaine and group B (0.5% ropivacaine were significantly lower (P<0.05 than in group A (0.25% ropivacaine. Accordingly, the interquartile range of satisfactory scores in both group C (0.75% ropivacaine and group B (0.5% ropivacaine were significantly higher (P<0.05 than in group A (0.25% ropivacaine. More cases in high-dose groups reported abnormal skin sensation; however, it

Bilateral inguinal hernia repair: laparoscopic or open approach?

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Feliu, X; Clavería, R; Besora, P; Camps, J; Fernández-Sallent, E; Viñas, X; Abad, J M

2011-02-01

The aim of this study was to investigate outcomes in the treatment of bilateral inguinal hernia, comparing the laparoscopic totally extraperitoneal (TEP) and open tension-free mesh repair (LICHT) approaches. We performed a prospective controlled non randomized clinical study in 128 patients with bilateral inguinal hernia over a period of 3 years. LICHT was used in 106 cases (53 patients) while TEP was employed in 150 cases (75 patients). The main outcome measurements were: recurrence rate, operating time, hospital stay and postoperative complications. There were three recurrences (2.3%): two in the LICHT group (3.8%) and one (1.3%) in the TEP group P = NS. The TEP procedure was faster than LICHT repair (48.8 ± 10.8 vs. 70.4 ± 11.2 min) P approach is an effective option for the treatment of bilateral inguinal hernia when performed by experienced surgeons.

Comparison of efficacy of spinal anaesthesia and sub-fascial local anaesthetic inguinal field block for open inguinal hernia repair-a single institutional experience

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Shafique, N.; Rashid, H.U.; Raja, M.I.; Saeed, M.

2015-01-01

The use of local anaesthetic for open inguinal hernia surgery has long been restricted to specialist centres. This study aimed to compare the efficacy of spinal anaesthesia and sub-fascial local anaesthetic (LA) for performing open hernia repair and at the same time provide better post op pain relief and early mobilization. Methods: In this randomized clinical trial, 62 male patients aged 16-72 were randomly allocated to two groups. Group A received mixture of 20ml 0.5% bupivacain, 20ml 2% lignocaine with adrenaline, 20ml normal saline (N/S), 3 ml NaHCO/sub 3/ sub-fascially for Local anaesthetic (LA) inguinal field block, while Group B received Spinal Anaesthesia (SA) with 0.5% Bupivacaine. Comparison was made in terms of Visual Analogue Score (VAS) recorded intra-operatively at 0 and 30 minutes and post operatively at 2, 4 and 12 hours at rest and on movement. Need for rescue analgesia and total analgesic consumption in both groups were calculated. Interval to pain free ambulation as well as procedural and anaesthesia related complications were compared. Results: Mean VAS in the intraoperative period were significantly high in Group A (p-value 0.011) at the start of operation and at 30 minutes (p-value <0.001). However, it did not correlate with patient satisfaction as 90% of patients in Group A successfully underwent the procedure without need for supplemental analgesia. VAS scores at rest and on movement/cough were comparable in the post op period at 2, 4 and 12 hours in both groups. Interval to pain free ambulation was significantly low in Group A (p-value 0.0012). Conclusion: Sub facial LA inguinal field block provides effective anaesthesia with optimum post op analgesia, prompt recovery and fewer systemic side effects compared to SA and can safely be used for routine open inguinal hernia surgery. (author)

Association between thoracic aortic disease and inguinal hernia.

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Olsson, Christian; Eriksson, Per; Franco-Cereceda, Anders

2014-08-21

The study hypothesis was that thoracic aortic disease (TAD) is associated with a higher-than-expected prevalence of inguinal hernia. Such an association has been reported for abdominal aortic aneurysm (AAA) and hernia. Unlike AAA, TAD is not necessarily detectable with clinical examination or ultrasound, and there are no population-based screening programs for TAD. Therefore, conditions associated with TAD, such as inguinal hernia, are of particular clinical relevance. The prevalence of inguinal hernia in subjects with TAD was determined from nation-wide register data and compared to a non-TAD group (patients with isolated aortic stenosis). Groups were balanced using propensity score matching. Multivariable statistical analysis (logistic regression) was performed to identify variables independently associated with hernia. Hernia prevalence was 110 of 750 (15%) in subjects with TAD versus 29 of 301 (9.6%) in non-TAD, P=0.03. This statistically significant difference remained after propensity score matching: 21 of 159 (13%) in TAD versus 14 of 159 (8.9%) in non-TAD, PTAD, OR 1.8 (1.1 to 2.8), P=0.015. The prevalence of inguinal hernia (15%) in TAD is higher than expected in a general population and higher in TAD, compared to non-TAD. TAD is independently associated with hernia in multivariable analysis. Presence or history of hernia may be of importance in detecting TAD, and the association warrants further study. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Lidocaine Patch (5%) in Treatment of Persistent Inguinal Postherniorrhaphy Pain

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Bischoff, Joakim M; Petersen, Marian; Uçeyler, Nurcan

2013-01-01

Evidence-based pharmacological treatment options for patients with persistent inguinal postherniorrhaphy pain are lacking.......Evidence-based pharmacological treatment options for patients with persistent inguinal postherniorrhaphy pain are lacking....

Anal Canal Cancer: Management of Inguinal Nodes and Benefit of Prophylactic Inguinal Irradiation (CORS-03 Study)

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Ortholan, Cécile; Resbeut, Michel; Hannoun-Levi, Jean-Michel; Teissier, Eric; Gerard, Jean-Pierre; Ronchin, Philippe; Zaccariotto, Audrey; Minsat, Mathieu; Benezery, Karen; François, Eric; Salem, Naji; Ellis, Steve; Azria, David; Champetier, Cédric; Gross, Emmanuel; Cowen, Didier

2012-01-01

Purpose: To evaluate the benefit of prophylactic inguinal irradiation (PII) in anal canal squamous cell carcinoma (ASCC). Methods and Materials: This retrospective study analyzed the outcome of 208 patients presenting with ASCC treated between 2000 and 2004 in four cancer centers of the south of France. Results: The population study included 35 T1, 86 T2, 59 T3, 20 T4, and 8 T stage unknown patients. Twenty-seven patients presented with macroscopic inguinal node involvement. Of the 181 patients with uninvolved nodes at presentation, 75 received a PII to a total dose of 45–50 Gy (PII group) and 106 did not receive PII (no PII group). Compared with the no PII group, patients in the PII group were younger (60% vs. 41% of patients age 2 toxicity of the lower extremity was observed. Conclusion: PII with a dose of 45 Gy is safe and highly efficient to prevent inguinal recurrence and should be recommended for all T3-4 tumors. For early-stage tumors, PII should also be discussed, because the 5-year inguinal recurrence risk remains substantial when omitting PII (about 10%).

Athletes with inguinal disruption benefit from endoscopic totally extraperitoneal (TEP) repair.

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Roos, M M; Bakker, W J; Goedhart, E A; Verleisdonk, E J M M; Clevers, G J; Voorbrood, C E H; Sanders, F B M; Naafs, D B; Burgmans, J P J

2018-06-01

Inguinal disruption, a common condition in athletes, is a diagnostic and therapeutic challenge. The aim of this study was to evaluate the effect of endoscopic totally extraperitoneal (TEP) repair in athletes with inguinal disruption, selected through a multidisciplinary, systematic work-up. An observational, prospective cohort study was conducted in 32 athletes with inguinal disruption. Athletes were assessed by a sports medicine physician, radiologist and hernia surgeon and underwent subsequent endoscopic TEP repair with placement of polypropylene mesh. The primary outcome was pain reduction during exercise on the numeric rating scale (NRS) 3 months postoperatively. Secondary outcomes were sports resumption, physical functioning and long-term pain intensity. Patients were assessed preoperatively, 3 months postoperatively and after a median follow-up of 19 months. Follow-up was completed in 30 patients (94%). The median pain score decreased from 8 [interquartile range (IQR) 7-8] preoperatively to 2 (IQR 0-5) 3 months postoperatively (p disruption, selected through a multidisciplinary, systematic work-up, benefit from TEP repair.

Inguinal hernia repair: are the results from a general hospital comparable to those from dedicated hernia centres?

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Cheong, Kai Xiong; Lo, Hong Yee; Neo, Jun Xiang Andy; Appasamy, Vijayan; Chiu, Ming Terk

2014-04-01

We aimed to report the outcomes of inguinal hernia repair performed at Tan Tock Seng Hospital and compare them with those performed at dedicated hernia centres. We retrospectively analysed the medical records and telephone interviews of 520 patients who underwent inguinal hernia repair in 2010. The majority of the patients were male (498 [95.8%] men vs. 22 [4.2%] women). The mean age was 59.9 ± 15.7 years. Most patients (n = 445, 85.6%) had unilateral hernias (25.8% direct, 64.3% indirect, 9.9% pantaloon). The overall recurrence rate was 3.8%, with a mean time to recurrence of 12.0 ± 8.6 months. Risk factors for recurrence included contaminated wounds (odds ratio [OR] 50.325; p = 0.004), female gender (OR 8.757; p = 0.003) and pantaloon hernias (OR 5.059; p = 0.013). Complication rates were as follows: chronic pain syndrome (1.2%), hypoaesthesia (5.2%), wound dehiscence (0.4%), infection (0.6%), haematoma/seroma (4.8%), urinary retention (1.3%) and intraoperative visceral injury (0.6%). Most procedures were open repairs (67.7%), and laparoscopic repair constituted 32.3% of all the inguinal hernia repairs. Open repairs resulted in longer operating times than laparoscopic repairs (86.6 mins vs. 71.6 mins; p hospital stays (2.7 days vs. 0.7 days; p = 0.020) and a higher incidence of post-repair hypoaesthesia (6.8% vs. 1.8%; p = 0.018). However, there were no significant differences in recurrence or other complications between open and laparoscopic repair. A general hospital with strict protocols and teaching methodologies can achieve inguinal hernia repair outcomes comparable to those of dedicated hernia centres.

Type V Collagen is Persistently Altered after Inguinal Hernia Repair

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Lorentzen, L; Henriksen, N A; Juhl, P

2018-01-01

BACKGROUND AND AIMS: Hernia formation is associated with alterations of collagen metabolism. Collagen synthesis and degradation cause a systemic release of products, which are measurable in serum. Recently, we reported changes in type V and IV collagen metabolisms in patients with inguinal...... elective cholecystectomy served as controls (n = 10). Whole venous blood was collected 35-55 months after operation. Biomarkers for type V collagen synthesis (Pro-C5) and degradation (C5M) and those for type IV collagen synthesis (P4NP) and degradation (C4M2) were measured by a solid-phase competitive...... assay. RESULTS: The turnover of type V collagen (Pro-C5/C5M) was slightly higher postoperatively when compared to preoperatively in the inguinal hernia group (P = 0.034). In addition, the results revealed a postoperatively lower type V collagen turnover level in the inguinal hernia group compared...

Validation of newly developed physical laparoscopy simulator in transabdominal preperitoneal (TAPP) inguinal hernia repair.

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Nishihara, Yuichi; Isobe, Yoh; Kitagawa, Yuko

2017-12-01

A realistic simulator for transabdominal preperitoneal (TAPP) inguinal hernia repair would enhance surgeons' training experience before they enter the operating theater. The purpose of this study was to create a novel physical simulator for TAPP inguinal hernia repair and obtain surgeons' opinions regarding its efficacy. Our novel TAPP inguinal hernia repair simulator consists of a physical laparoscopy simulator and a handmade organ replica model. The physical laparoscopy simulator was created by three-dimensional (3D) printing technology, and it represents the trunk of the human body and the bendability of the abdominal wall under pneumoperitoneal pressure. The organ replica model was manually created by assembling materials. The TAPP inguinal hernia repair simulator allows for the performance of all procedures required in TAPP inguinal hernia repair. Fifteen general surgeons performed TAPP inguinal hernia repair using our simulator. Their opinions were scored on a 5-point Likert scale. All participants strongly agreed that the 3D-printed physical simulator and organ replica model were highly useful for TAPP inguinal hernia repair training (median, 5 points) and TAPP inguinal hernia repair education (median, 5 points). They felt that the simulator would be effective for TAPP inguinal hernia repair training before entering the operating theater. All surgeons considered that this simulator should be introduced in the residency curriculum. We successfully created a physical simulator for TAPP inguinal hernia repair training using 3D printing technology and a handmade organ replica model created with inexpensive, readily accessible materials. Preoperative TAPP inguinal hernia repair training using this simulator and organ replica model may be of benefit in the training of all surgeons. All general surgeons involved in the present study felt that this simulator and organ replica model should be used in their residency curriculum.

The examination of biophysical parameters of skin (transepidermal water loss, skin hydration and pH value) in different body regions of normal cats of both sexes.

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Szczepanik, Marcin P; Wilkołek, Piotr M; Adamek, Lukasz R; Pomorski, Zbigniew J H

2011-04-01

The purpose of this study was to evaluate transepidermal water loss (TEWL), skin hydration and skin pH in normal cats. Twenty shorthaired European cats of both sexes were examined in the study. Measurements were taken from five different sites: the lumbar region, the axillary fossa, the inguinal region, the ventral abdominal region and the left thoracic region. In each of the regions, TEWL, skin hydration and skin pH were measured. The highest TEWL value was observed in the axillary fossa (18.22g/h/m(2)) and the lowest in the lumbar region (10.53g/h/m(2)). The highest skin hydration was found in the inguinal region (18.29CU) and the lowest in the lumbar region (4.62CU). The highest skin pH was observed in the inguinal region (6.64) and the lowest in the lumbar region (6.39). Statistically significant differences in TEWL were observed between the lumbar region and the left side of the thorax region (P=0.016), the axillary fossa (P=0.0004), the ventral region (P=0.005), and the inguinal region (P=0.009). There were significant differences in skin hydration between the lumbar region and the left thorax (P=0.000003), the axillary fossa (P=0.002), the ventral abdomen (P=0.03), and the inguinal region (P=0.0003) as well as between the thorax and the ventral abdomen (P=0.005). TEWL was higher in females (15g/h/m(2)) than in males (4.57g/h/m(2)). Skin hydration was higher in females (13.89CU) than in males (12.28CU). Significant differences were not found between males and females for TEWL and skin hydration. Skin pH was higher in males (6.94) than in females (6.54), which was significant (P=0.004). Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

Etiology of Inguinal Hernias

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Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

2017-01-01

BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral a...

Ligation of lymph vessels for the treatment of recurrent inguinal lymphoceles following lymphadenectomy

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Toyserkani, Navid Mohamadpour; Nielsen, Henrik Toft; Bakholdt, Vivi

2016-01-01

BACKGROUND: Recurrent lymphocele following groin dissection is generally a self-limiting condition, but in a few cases, the lymphocele persists and for this, there are not many options. Few reports have proposed the efficacy of lymph vessel ligation with patent blue as a vessel locator. We have......, and their data was retrieved from electronic patient records. RESULTS: In total, eight patients had this procedure performed for a total of ten inguinal regions. In all regions, leaking lymph vessels were easily found by the blue color and a median of 3 (range 1-5 vessels) vessels per region were ligated using...... and had the procedure performed again with immediate effect. CONCLUSIONS: Ligation of lymph vessels for the treatment of recurrent inguinal lymphoceles appears to be an appropriate treatment modality that is both quick and easy to perform with minimum risk, and in most cases, it results in immediate...

The 5s25p2 - (5s25p5d + 5s5p3 + 5s25p6s + 5s25p7s) transitions in Sb II and 5s25p - (5s5p2 + 5s2nl) transitions in Sb III

International Nuclear Information System (INIS)

Arcimowicz, B.; Joshi, Y.N.; Kaufman, V.

1989-01-01

The spectrum of antimony was photographed in the 575-2300 A region (1A 10 -10 m) using a hollow cathode and a triggered spark source. The analysis of the 5s 2 5p 2 - (5s 2 5p5d + 5s5p 3 + 5s 2 5p6s + 5s 2 5p7s) transitions in Sb II spectrum was revised and interpreted on the basis of multiconfiguration interaction calculations. Accurate wavelength measurements of Sb III lines lead to a revised ground-state 5s 2 5p 2 P interval value of 6574.5 cm -1 . (author). 15 refs., 9 tabs., 1 fig

Inguinal lymph node as the only evidence of progressive lung cancer

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Zafer Kocak

2008-09-01

Full Text Available Abstact: Tumours that metastasise to groin nodes most frequently originate in genital and reproductive organs, skin, rectum or anus, or urinary bladder1,2. However, rare cases of inguinal metastases from tumours above the diaphragm have been reported2-5 and only three of them had an inguinal metastasis which was recognised antemortem and reported in detail in the English medical literature3-5. The primary tumours of these cases were malignant mesothelioma, salivary duct and breast carcinoma. In this paper, we report a case of carcinoma of the lung metastatic to an inguinal lymph node as the only evidence of progressive lung cancer. Resumo: Os tumores que metastizam para os gânglios inguinais têm frequentemente origem nos órgãos genitais e reprodutores, na pele, no recto ou ânus, ou na bexiga1,2. Há, no entanto, algumas descrições de casos raros de metástases inguinais de tumores localizados acima do diafragma2-5, e apenas três destes apresentavam uma metástase inguinal reconhecida antes da morte. Estes casos estão detalhadamente descritos na literatura médica de língua inglesa3-5. Os tumores primários destes casos eram mesotelioma maligno e carcinomas do conduto salivar e da mama. Descrevemos um caso de carcinoma do pulmão que metastizou para gânglio inguinal, como única evidência de cancro do pulmão progressivo. Key-words: Non-small cell lung carcinoma, inguinal lymph node, metastasis, disease progression, Palavras-chave: Carcinoma do pulmão de não pequenas células, gânglio inguinal, metástase, progressão da doença

Efficacy of local anaesthesia in repair of inguinal hernia

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Rafiq, M.K.; Sultan, B.; Malik, M.A.; Khan, K.; Abbasi, M.A.

2017-01-01

Local anaesthesia has been identified as the most favourable anaesthesia for elective inguinal hernia repair with respect to complication rate, cost effectiveness and overall patients' satisfaction. This study was conducted to determine the efficacy of local anaesthesia in inguinal hernia in terms of pain relief, wound infection and hospital stay. Methods: In this randomized controlled trial (RCT), 60 patients with inguinal hernia were included at the General Surgical 'B' Unit, Ayub Teaching Hospital Abbottabad. Results: The day-case rates were significantly higher when patients underwent surgery under LA compared to GA (82.6 percent versus 42.6 percent). The incidence of urinary retention was higher in the GA group (p<0.05). There were 17 (2.9 percent) re-admissions overall. The reasons for re-admission included haematoma (n=6), severe pain (n=4), infection (n=3), fainting (n=2) and urinary retention (n=2). Conclusion: This study demonstrates that local anaesthesia for inguinal hernia repair has better efficacy as compared to general anaesthesia. (author)

Lymphatic mapping inguinal and sentinel lymph node biopsy in anal canal cancers to avoid prophylactic inguinal irradiation; Le marquage lymphatique et la biopsie du ganglion sentinelle inguinal dans les cancers du canal anal pour eviter l'irradiation inguinale prophylactique

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Bobin, J.Y. [Centre Hospitalier Universitaire Lyon-Sud, Service de Chirurgie Oncoloque, 69 - Pierre-Benite (France); Gerard, J.P.; Chapet, O.; Romestaing, P. [Centre Hospitalier Universitaire Lyon-Sud, Dept. de Radiotherapie et Oncologie, 69 - Pierre-Benite (France); Isaac, S. [Centre Hospitalier Universitaire Lyon-Sud, Dept. d' Anatomopathologie, 69 - Pierre-Benite (France)

2003-11-01

Thirty-five patients with clinically N0 cancers of the canal anal, 33 epidermoid carcinomas et 2 melanomas were histologically staged with inguinal sentinel lymphode biopsy (ISN). With the combined technique, blue dye and radiocolloid the ISN was identified in 100 % of the cases. The ISN was invaded in 7 cases/33 for epidermoid tumors and 2/2 for melanomas. After 18 months of follow-up, no inguinal recurrence could be seen in ISN pN0 cases. In conclusion, ISN biopsy is a reliable procedure to stage anal,, canal cancers. It should prevent unnecessary prophylactic inguinal irradiation for pN0 ISN. Inguinal irradiation is only indicated in pN1 ISN. (author)

Lichtenstein versus Onstep for inguinal hernia repair

DEFF Research Database (Denmark)

Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

2013-01-01

Inguinal hernia is a common condition that affects millions of people world-wide every year. In Denmark (population of 5.5 million), more than 10,000 repairs of inguinal hernias are performed annually. The optimal surgical procedure for mesh placement and fixation is still being debated because o...

Double autologous lymph node transplantation (ALNT) at the level of the knee and inguinal region for advanced lymphoedema of the lower limb (elephantiasis).

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Gómez Martín, C; Murillo, C; Maldonado, A A; Cristóbal, L; Fernández-Cañamaque, J L

2014-02-01

Primary lower-limb lymphoedema is a chronic, progressive and debilitating condition with a difficult management, especially in advanced cases (elephantiasis). Recently, autologous lymph node transplantation (ALNT) appears to be a promising treatment for extremity lymphoedema. A case of a double ALNT for an advanced primary lower-limb lymphoedema is here reported: a contralateral inguinal lymph node flap was transferred to the knee and, in a second surgery, a thoracic lymph node flap was transplanted to the inguinal region. Clinical outcomes at 5 months postoperatively are very satisfactory with reduction in limb circumferences and improvement in skin quality and social impairment. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Ultrasonographic and clinical findings of inguinal hernia containing the ovary or omentum in girls

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Shin, Su Mi; Chai, Jee Won [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of)

2016-09-15

To characterize the ultrasonographic and clinical findings of inguinal hernia containing the ovary or omentum in girls. We studied 46 girls (49 cases) who were diagnosed with inguinal hernia on ultrasonography between March 2009 and December 2015. The ultrasonographic findings were retrospectively analyzed with respect to location, age at detection, contents of hernia, diameter of the canal of Nuck, and incidence of reducibility, incarceration and strangulation. The clinical findings included the number of cases that underwent operation, contents of hernia discovered during operation, and duration between ultrasonographic diagnosis and operation. The two groups in which inguinal hernia contained the ovary and omentum were statistically compared. Of the 49 cases, the contents of hernia were the ovary or tube in 14 cases, omentum in 32 cases, and bowel in 3 cases. The ovarian herniation group was significantly younger (10.1 months vs. 4.9 years, p < 0.001), had a lower incidence of reducibility (n = 3 vs. n = 29, p < 0.001), higher incidence of incarceration (n = 4 vs. n = 0, p = 0.006), and a shorter duration between ultrasonographic diagnosis and operation (5.7 days vs. 55.8 days, p = 0.032) than the omental herniation group. The ovarian herniation group was younger, had a lower incidence of reducibility, higher incidence of incarceration, and a shorter duration between ultrasonographic diagnosis and operation.

Ultrasonographic and clinical findings of inguinal hernia containing the ovary or omentum in girls

International Nuclear Information System (INIS)

Shin, Su Mi; Chai, Jee Won

2016-01-01

To characterize the ultrasonographic and clinical findings of inguinal hernia containing the ovary or omentum in girls. We studied 46 girls (49 cases) who were diagnosed with inguinal hernia on ultrasonography between March 2009 and December 2015. The ultrasonographic findings were retrospectively analyzed with respect to location, age at detection, contents of hernia, diameter of the canal of Nuck, and incidence of reducibility, incarceration and strangulation. The clinical findings included the number of cases that underwent operation, contents of hernia discovered during operation, and duration between ultrasonographic diagnosis and operation. The two groups in which inguinal hernia contained the ovary and omentum were statistically compared. Of the 49 cases, the contents of hernia were the ovary or tube in 14 cases, omentum in 32 cases, and bowel in 3 cases. The ovarian herniation group was significantly younger (10.1 months vs. 4.9 years, p < 0.001), had a lower incidence of reducibility (n = 3 vs. n = 29, p < 0.001), higher incidence of incarceration (n = 4 vs. n = 0, p = 0.006), and a shorter duration between ultrasonographic diagnosis and operation (5.7 days vs. 55.8 days, p = 0.032) than the omental herniation group. The ovarian herniation group was younger, had a lower incidence of reducibility, higher incidence of incarceration, and a shorter duration between ultrasonographic diagnosis and operation

Condrossarcoma de ramo púbico superior simulando hérnia inguinal

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Fabio Terabe

Full Text Available Primary pelvic tumors are relatively rare, representing no more than 5% of primary bone tumors. We presented a case of a chondrosarcoma of the superior pubic ramus initially managed as an inguinal hernia and then operated under oncological principles. Special attention is attributed to the importance for the correct diagnosis and surgical treatment given the low efficacy of adjuvant treatments for this type of neoplasia.

Spinal anesthesia is safe in laparoscopic total extraperitoneal inguinal hernia repair. A retrospective clinical trial.

Science.gov (United States)

Yildirim, Dogan; Hut, Adnan; Uzman, Sinan; Kocakusak, Ahmet; Demiryas, Suleyman; Cakir, Mikail; Tatar, Cihad

2017-12-01

Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is an effective and safe method for the treatment of inguinal hernia. There are very few studies on regional anesthesia methods in TEP surgery. To compare TEP inguinal hernia repair performed when the patient was treated under spinal anesthesia (SA) with that performed under general anesthesia (GA). All total of 80 patients were studied between December 2015 and March 2017. Hyperbaric bupivacaine and fentanyl were used for SA, to achieve a sensorial level of T3. Propofol, sevoflurane, rocuronium, fentanyl, and tracheal intubation were used for GA. Intraoperative events related to SA, surgical times, intra- and postoperative complications, and pain scores were recorded. The mean operative time in the SA TEP group was 70.2 ±6.7 min, which was significantly longer than the mean operative time in the GA TEP group of 67.2 ±6.2 min (p < 0.038). The mean pain scores in the SA TEP group were 0.23 ±0.42 at the first hour, 1.83 ±0.64 at 6 h and 1.28 ±0.45 at 24 h. These scores were significantly lower than the corresponding scores of 5.18 ±0.84 (p < 0.001), 2.50 ±0.55 (p < 0.001) and 1.58 ±0.55 in the GA TEP group. Generally, patients were more satisfied with SA than GA (p < 0.004). Spinal anesthesia TEP is significantly less painful in the early postoperative period, leading to earlier ambulation than GA TEP. Additionally, SA TEP results in significantly less need for analgesics and better patient satisfaction results. SA TEP seems to be a better alternative than the existing GA TEP.

Postoperative nausea and vomiting (PONV) in outpatient repair of inguinal hernia.

Science.gov (United States)

Palumbo, Piergaspare; Usai, Sofia; Amatucci, Chiara; Pulli, Valentina Taurisano; Illuminati, Giulio; Vietri, Francesco; Tellan, Guglielmo

2018-01-01

Nausea and vomiting are among the most frequent complications following anesthesia and surgery. Due to anesthesia seems to be primarily responsible for post operative nausea and vomiting (PONV) in Day Surgery facilities, the aim of the study is to evaluate how different methods of anesthesia could modify the onset of postoperative nausea and vomiting in a population of patients undergoing inguinal hernia repair. Ninehundredten patients, aged between 18 and 87 years, underwent open inguinal hernia repair. The PONV risk has been assessed according to Apfel Score. Local anesthetic infiltration, performed by the surgeon in any cases, has been supported by and analgo-sedation with Remifentanil in 740 patients; Fentanyl was used in 96 cases and the last 74 underwent deep sedation with Propofol . Among the 910 patients who underwent inguinal hernia repair, PONV occurred in 68 patients (7.5%). Among patients presenting PONV, 29 received Remifentanil, whereas 39 received Fentanyl. In the group of patients receiving Propofol, no one presented PONV. This difference is statistically significant (p < .01). Moreover, only 50 patients of the total sample received antiemetic prophylaxis, and amongst these, PONV occurred in 3 subjects. Compared to Remifentanil, Fentanyl has a major influence in causing PONV. Nonetheless, an appropriate antiemetic prophylaxis can significantly reduce this undesirable complication. Key words: Day Surgery, Fentanyl, Inguinal, Hernia repair, Nausea, Vomiting.

Resident postgraduate year does not influence rate of complications following inguinal herniorrhaphy.

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Renteria, Oswaldo; Mokdad, Ali A; Imran, Jonathan; Huerta, Sergio

2017-11-01

Previous data indicate that patients who undergo surgery with a postgraduate year 3 (PGY-3) resident as the junior surgeon have a lower rate of recurrence compared with PGY-1 and PGY-2 after an open inguinal herniorrhaphy. Lower PGY level was also associated with increased operative time. We hypothesize that when controlling for surgeon, technique, and hernia type, the outcomes for inguinal herniorrhaphy are the same independent of PGY level. A retrospective review of all open unilateral inguinal hernia repairs done by residents who assisted the same senior surgeon at the Veterans Affairs North Texas Health Care System was performed. Seven hundred fifty-two open unilateral inguinal hernia were identified: mean patient age = 60.6 ± 12.7 y; mean body mass index = 27.0 ± 10.8 kg/m 2 ; American Society of Anesthesia III-IV = 51%; and Nyhus type 2 = 44.7%, 3a = 41.6%, and 3b = 13.7%. Residents involved were PGY-1 (17.2%), PGY-2/3 (71.1%), and PGY-4/5 (11.7%). Postoperative complications for intern, junior (PGY-2 and PGY-3), and senior residents (PGY-4 and PGY-5) were 4%, 9%, and 6%, respectively (P = 0.14). Compared to interns, junior residents finished the operation 3.9 min faster (95% confidence interval = -7.5, -0.3). There was no time difference between interns and senior residents completing the operations after controlling for hernia type. Logistic regression did not identify PGY level as an independent predictor of complications or recurrence. There was a slight decrease in operative time when the repair was done with junior-level residents. PGY level did not influence outcomes for open, unilateral inguinal herniorrhaphy when controlled for hernia type and technique. Published by Elsevier Inc.

Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy.

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Jones, Lisa J; Craven, Paul D; Lakkundi, Anil; Foster, Jann P; Badawi, Nadia

2015-06-09

combined regional and general anaesthesia, in former preterm infants undergoing inguinal herniorrhaphy in early infancy. At least two of three review authors (LJ, JF, AL) independently extracted data and performed analyses. Authors were contacted to obtain missing data. The methodological quality of each study was assessed according to the criteria of the Cochrane Neonatal Review Group. Data were analysed using Review Manager 5. Meta-analyses were performed with calculation of risk ratios (RR) and risk difference (RD), along with their 95% confidence intervals (CI) where appropriate. Seven small trials comparing spinal with general anaesthesia in the repair of inguinal hernia were identified. Two trial reports are listed as 'Studies awaiting classification' due to insufficient information on which to base an eligibility assessment. There was no statistically significant difference in the risk of postoperative apnoea/bradycardia (typical RR 0.72, 95% CI 0.48 to 1.06; 4 studies, 138 infants), postoperative oxygen desaturation (typical RR 0.82, 95% CI 0.61 to 1.11; 2 studies, 48 infants), the use of postoperative analgesics (RR 0.42, 95% CI 0.15 to 1.18; 1 study, 44 infants), or postoperative respiratory support (typical RR 0.09, 95% CI 0.01 to1.64; 3 studies, 98 infants) between infants receiving spinal or general anaesthesia. When infants who had received preoperative sedatives were excluded, the meta-analysis supported a reduction in the risk of postoperative apnoea in the spinal anaesthesia group (typical RR 0.53, 95% CI 0.34 to 0.82; 4 studies, 129 infants). Infants with no history of apnoea in the preoperative period and receiving spinal anaesthesia (including a subset of infants who had received sedatives) had a reduced risk of postoperative apnoea and this reached statistical significance (typical RR 0.34, 95% CI 0.14 to 0.81; 4 studies, 134 infants). Infants receiving spinal rather than general anaesthesia had a statistically significant increased risk of anaesthetic

Laparoscopic inguinal hernia repair by the hook method in emergency setting in children presenting with incarcerated inguinal hernia.

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Chan, Kin Wai Edwin; Lee, Kim Hung; Tam, Yuk Him; Sihoe, Jennifer Dart Yin; Cheung, Sing Tak; Mou, Jennifer Wai Cheung

2011-10-01

The development of laparoscopic hernia repair has provided an alternative approach to the management of incarcerated inguinal hernia in children. Different laparoscopic techniques for hernia repair have been described. However, we hereby review the role of laparoscopic hernia repair using the hook method in the emergency setting for incarcerated inguinal hernias in children. A retrospective review was conducted of all children who presented with incarcerated inguinal hernia and underwent laparoscopic hernia repair using the hook method in emergency setting between 2004 and 2010. There were a total of 15 boys and 1 girl with a mean age of 30 ± 36 months (range, 4 months to 12 years). The hernia was successfully reduced after sedation in 7 children and after general anesthesia in 4 children. In 5 children, the hernia was reduced by a combined manual and laparoscopic-assisted approach. Emergency laparoscopic inguinal hernia repair using the hook method was performed after reduction of the hernia. The presence of preperitoneal fluid secondary to recent incarceration facilitated the dissection of the preperitoneal space by the hernia hook. All children underwent successful reduction and hernia repair. The median operative time was 37 minutes. There was no postoperative complication. The median hospital stay was 3 days. At a median follow-up of 40 months, there was no recurrence of the hernia or testicular atrophy. Emergency laparoscopic inguinal hernia repair by the hook method is safe and feasible. Easier preperitoneal dissection was experienced, and repair of the contralateral patent processus vaginalis can be performed in the same setting. Copyright © 2011 Elsevier Inc. All rights reserved.

Male Fertility After Inguinal Hernia Mesh Repair

DEFF Research Database (Denmark)

Kohl, Andreas Pagh; Andresen, Kristoffer; Rosenberg, Jacob

2017-01-01

OBJECTIVE:: To determine whether patients who receive an inguinal hernia repair father the same number of children as the background population. BACKGROUND:: Although the effect of inguinal hernia repair on male fertility has previously been investigated through indirect measures, no previous...... studies have evaluated the final measure of male fertility, which is the number of children fathered by patients. METHODS:: Prospectively collected data on 32,621 male patients between the ages of 18 and 55 years who received 1 or more inguinal hernia repairs during the years 1998 to 2012 were found in 5...... hernia repair using Lichtenstein technique or laparoscopic approach did not father fewer children than expected. Thus, inguinal hernia repair using Lichtenstein or laparoscopic approach did not impair male fertility....

Complicated childhood inguinal hernias in UITH, Ilorin

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Kayode T Bamigbola

2012-01-01

Full Text Available Background: Complicated inguinal hernias pose a threat to the life of the child as well as increase the morbidity associated with management of an otherwise straightforward condition. The aim of this study was to determine the presentation, treatment and management outcome of complicated inguinal hernias in children. Materials and Methods: A retrospective study of all children 15 years and less managed for complicated inguinal hernia between 2002 and 2010. Data obtained included demographic characteristics, presentation, operative findings and outcome. Results: Complicated hernia rate was 13.9%.There were 41 children, 38 boys (92.7% and 3 girls. Ages ranged between 4 days and 15 years (Median = 90days. Most were infants (48.8%, n = 20 and neonates accounted for 19.5% (n = 8. Median duration of symptoms prior to presentation was 18 h (range = 2-96 h. Seven patients had been scheduled for elective surgery. Hernia was right sided in 68.3% (n = 28. Symptoms included vomiting (68.3%, abdominal distension (34.1% and constipation (4.9%; one patient presented with seizures. In 19 (46.3% patients hernia was reducible while 22(53.7% had emergency surgery. Associated anomalies included undescended testis (12.2%, umbilical hernia (14.6%. Intestinal resection rate was 7.3% and testicular gangrene occurred in 14.6%. Mean duration of surgery was 60.3 ± 26.7 min. Wound infection occurred in six patients (14.6%. Overall complication rate was 24.4%, 30% in infants. The mortality rate was 2.4% (n = 1. Conclusions: Morbidity associated with complicated inguinal hernia is high in neonates and infants. Delayed presentation is common in our setting. Educating the parents as well as primary care physicians on the need for early presentation is necessary.

A novel description of a syndrome consisting of 7q21.3 deletion including DYNC1I1 with preserved DLX5/6 without ectrodactyly: a case report.

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Ramos-Zaldívar, Héctor M; Martínez-Irías, Daniel G; Espinoza-Moreno, Nelson A; Napky-Rajo, José S; Bueso-Aguilar, Tulio A; Reyes-Perdomo, Karla G; Montes-Gambarelli, Jimena A; Euceda, Isis M; Ponce-Barahona, Aldo F; Gámez-Fernández, Carlos A; Moncada-Arita, Wilberg A; Palomo-Bermúdez, Victoria A; Jiménez-Faraj, Julia E; Hernández-Padilla, Amanda G; Olivera, Denys A; Robertson, Kevin J; Leiva-Sanchez, Luis A; Herrera-Paz, Edwin Francisco

2016-06-13

Chromosomal region 7q21.3 comprises approximately 5.2 mega base pairs that include genes DLX5/6, SHFM1, and DYNC1I1 associated with split hand/split foot malformation 1. So far, there are reports of eight families with deletion of DYNC1I1 and preserved DLX5/6 associated with ectrodactyly. From these families, only three patients did not present ectrodactyly and, unlike our patient, no other cases have been described as having craniofacial dysmorphology, mitral valve prolapse, kyphoscoliosis, inguinal herniae, or personality disorder. There is no designation described in the literature for patients with syndromic manifestations without ectrodactyly, which hinders diagnosis. We report the case of a 44-year-old mestizo (combined European and Amerindian descent) man with a 3191 kilo base pairs deletion and International System for Human Cytogenetic Nomenclature array 7q21.3 (93,389,222-96,579,845)x1. Clinical manifestations included micrognathia, retrognathia, wormian bones, auditory canal stenosis, depressed nasal bridge, epicanthal fold, fullness of upper eyelid, long philtrum, low-set ears, sensorineural hearing loss, kyphoscoliosis, bilateral inguinal herniae, mild mitral valve prolapse, and paranoid personality disorder. His isolated DNA was analyzed using a CytoScan HD Microarray system. Chromosome Analysis Suite software was utilized for the microarray analysis. All copy number changes were determined using the human genome build 19 (hg19/NCBI build 37). Cases of deletions within chromosome 7q21.3 that include the split hand/split foot malformation 1 region represent a diagnostic challenge when not presenting ectrodactyly despite being syndromic. Due to the heterogeneity of the region, a better method to group and classify these patients is needed to facilitate their clinical diagnosis. For this purpose, we suggest that patients with 7q21.3 deletion including DYNC1I1 and preserved DLX5/6 without ectrodactyly, accompanied by craniofacial dysmorphology

Toxicity of fatty acid 18:5n3 from Gymnodinium cf. mikimotoi: II. Intracellular pH and K+ uptake in isolated trout hepatocytes.

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Fossat, B; Porthé-Nibelle, J; Sola, F; Masoni, A; Gentien, P; Bodennec, G

1999-01-01

Effects of octadecapentaenoic acid 18:5n3 and other related polyunsaturated fatty acids present in gymnodinium cf. mikimotoi were tested in isolated trout hepatocytes. These exotoxins decreased intracellular pH followed by a slow recovery to initial value and alkalinization of acidic compartments, suggesting an inhibition of vacuolar H(+)-ATPases. Moreover, addition of 18:5n3 to the extracellular medium induced a decrease of K+ uptake into hepatocytes as a result of Na,K-ATPase inhibition. However, high concentrations (10(-5)-10(-3) M) are necessary to induce these effects.

Long-term follow-up after mesh removal and selective neurectomy for persistent inguinal postherniorrhaphy pain

DEFF Research Database (Denmark)

Bischoff, J M; Enghuus, Casper Nørskov; Werner, M U

2013-01-01

PURPOSE: Persistent inguinal pain, influencing daily activities, is seen in about 5 % of patients following inguinal herniorrhaphy. Surgical treatment of patients with persistent postherniorrhaphy pain has been associated with pain relief and improvement in functional status. However, the detailed...... and functional ability when comparing preoperative and postoperative assessments. RESULTS: Pain intensities (average, maximum, and during activity) were significantly lower at all time points during follow-up compared to preoperative values (p ...

Transumbilical endoscopic surgery for incarcerated inguinal hernias in infants and children.

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Zhou, Xuewu; Peng, Lei; Sha, Yongliang; Song, Daiqiang

2014-01-01

To describe transumbilical laparoscopic herniorrhaphy after unsuccessful attempted manual reduction of incarcerated inguinal hernias in infants and children. In our two hospitals, two-trocar transumbilical endoscopic surgery (TUES) is the standard technique used to repair incarcerated inguinal hernias in infants and children. Seventeen patients (aged 8months to 2.5years; median, 15months; 15 boys, 2 girls) with incarcerated inguinal hernias underwent urgent laparoscopy after unsuccessful attempted manual reduction. Two 3- or 5-mm trocars were inserted into the abdomen through two intraumbilical incisions, under laparoscopic guidance. The hernia was reduced by combined external manual pressure and internal pulling with bowel forceps. After inspection of the bowel, a round needle with a 2-0 nonabsorbable suture was introduced into the peritoneal cavity through the anterior abdominal wall near the internal inguinal ring. The hernial orifice was closed with an extraperitoneal purse-string suture around the internal inguinal ring, and tied with an intraperitoneal knot. A similar procedure was performed on the contralateral side if the processus vaginalis was patent. The TUES procedure was successful in all patients. No conversions to open surgery were required. The mean operating time was 30min (range, 25-40min). All patients were discharged on the second postoperative day. No complications such as postoperative bleeding, hydrocele, or scrotal edema were observed. The mean follow-up period was 15months. No cases of testicular atrophy, hypotrophy, or hernia recurrence were reported. Our preliminary experience with using TUES for the treatment of incarcerated inguinal hernias in infants and children had satisfactory outcomes. This technique appeared to be safe, effective, and reliable, and had excellent cosmetic results. Published by Elsevier Inc.

Screening and identification of p,p¢-DDT degrading soil isolates

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Vorasan Sobhon

2008-04-01

Full Text Available DDT is an organochlorine pesticide that can persist in the environment resulting in environmental problem with chronic effects on human and animal health. The determination of p,p¢-DDT in soil samples from 23 agricultural areas in Songkhla Province found DDT residue in the ranges of 0.17-9.84 ng/g soil. After repeated culturing in mineral salts-yeast extract medium (MSYM with an addition of 25 ppm p,p¢-DDT (DDT25, 167 morphologically different bacterial strains were isolated. Out of 167 isolates, only 5 strains showed p,p¢-DDT degrading ability as indicated by clear zone around the colony when grown on nutrient agar supplemented up to 100 ppm p,p¢-DDT. These 5 isolates include SB1A01, SB2A02, SB1A10, SB1A12 and SB1B05. Growth of these isolates in MSYM+DDT25 after 10 days indicated reductions of p,p¢-DDT by 30.5, 20.3, 37.4, 30.4 and 32.2%, respectively. Based on the morphological characteristics and 16S rDNA analysis, isolate SB1A10 which showed the highest degradation ability was found to be 99% identical (1360/1362 to Staphylococcus haemolyticus.

Outcome of laproscopic totally extraperitoneal hernioplasty for inguinal hernia

International Nuclear Information System (INIS)

Hanif, H.; Memon, S.H.

2015-01-01

Background: Hernioplasty for Inguinal hernia is one of the commonest operations performed in general surgical wards. More recently, interest has waxed and waned regarding the minimally invasive approach to hernioplasty. This study was carried out to assess the management outcome of minimally invasive hernioplasty (Totally extra-peritoneal approach) as the treatment of choice for uncomplicated (incomplete and reducible) inguinal hernia. Method: In this quasi experimental study patients aged between 14-83 years who were otherwise fit and willing for total extra-peritoneal laparoscopic repair were recruited prospectively over a 10 month period. Thirty-seven such patients were operated and followed up in the hernia clinics. Six cases were later excluded for lack of proper follow-up. Results: The typical patient was middle-aged male with right-sided inguinal hernia. Mean operating time was 53.3 minutes. No conversion was undertaken; however, there was one case of small bowel injury that went unrecognized on-table but necessitated subsequent laparotomy. Overall morbidity was 13.5 percentage. Mean length of hospitalization was 2.89 days. Mean duration to normal routine life was 9.25 days. Overall, 70.9 percentage of patients expressed satisfaction with the surgery. Conclusion: Totally extra-peritoneal mesh repair is a new and safe technique for hernioplasty with acceptable rates of morbidity and it is procedure of choice for recurrent and bilateral inguinal hernias and also used as alternate to open hernioplasty for uncomplicated (incomplete and reducible) inguinal hernia. (author)

SEGMENTAL EPIDURAL ANAESTHESIA FOR INGUINAL HERNIA REPAIR

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Sachidanand

2015-09-01

Full Text Available BACKGROUND: Epidural anaesthesia is suitable as a sole agent for lower abdominal surgery and surgery on lower limbs. It has some definite advantages over spinal anaesthesia like avoidance of post spinal headache, minimal chances of meningitis, and minimal chances of nausea and vomiting in postoperative period. But administration of conventional dosage of local epidural anaesthetics (15ml and above for surgical anaesthesia frequently results in multiple hemodynamic changes, including decreases in chronotropism, inotro pism, dromotropism, systemic vascular resistance, cardiac output, and myocardial oxygen consumption. The segmental epidural block denotes the use of a small volume enough to block only the segments involved in the field of surgery. AIM: To study the effect iveness of segmental epidural anaesthesia for inguinal hernia repair. DESIGN: R andomized control study. METHODS: 100 pts belonging to ASA PS I & II posted for inguinal hernia repair given 5ml of 0.5% bupivacaine through epidural route at L1 - L2 level and a fter conforming the adequacy and level of analgesia, the surgery was commenced. If the patient complained of pain during needle prick, then injected local anaesthetic (0.5% Bupivacaine with an incremental dosage of 1ml at a time, till the complete onset o f analgesia Pulse Rate and Blood Pressure were recorded at an interval of 1 minute for first 5 minutes and then every 5 minutes till the end of the surgery. Oxygen saturation and ECG monitoring was done continuously. Onset of analgesia, level of analgesia ( P re & post operatively, duration of analgesia, total dosage of local anaesthetic used were recorded. Complications like bradycardia, hypotension, respiratory depression, shivering, nausea and vomiting, sweating and inadvertent dural puncture were recorde d. RESULTS: 53% of patients had excellent quality of analgesia and relaxation. 34% patients had good quality analgesia and relaxation, mild discomfort while handling sac

A capsaicin (8%) patch in the treatment of severe persistent inguinal postherniorrhaphy pain

DEFF Research Database (Denmark)

Bischoff, Joakim M; Ringsted, Thomas K; Petersen, Marian

2014-01-01

BACKGROUND: Persistent pain after inguinal herniorrhaphy is a disabling condition with a lack of evidence-based pharmacological treatment options. This randomized placebo-controlled trial investigated the efficacy of a capsaicin 8% cutaneous patch in the treatment of severe persistent inguinal...... postherniorrhaphy pain. METHODS: Forty-six patients with persistent inguinal postherniorrhaphy pain were randomized to receive either a capsaicin 8% patch or a placebo patch. Pain intensity (Numerical Rating Scale [NRS 0-10]) was evaluated under standardized conditions (at rest, during movement, and during pressure....... The primary outcome was comparisons of summed pain intensity differences (SPIDs) between capsaicin and placebo treatments at 1, 2 and 3 months after patch application (significance level P placebo treatments, was observed at 1 month after...

Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years.

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Dulucq, Jean-Louis; Wintringer, Pascal; Mahajna, Ahmad

2009-03-01

Two revolutions in inguinal hernia repair surgery have occurred during the last two decades. The first was the introduction of tension-free hernia repair by Liechtenstein in 1989 and the second was the application of laparoscopic surgery to the treatment of inguinal hernia in the early 1990s. The purposes of this study were to assess the safety and effectiveness of laparoscopic totally extraperitoneal (TEP) repair and to discuss the technical changes that we faced on the basis of our accumulative experience. Patients who underwent an elective inguinal hernia repair at the Department of Abdominal Surgery at the Institute of Laparoscopic Surgery (ILS), Bordeaux, between June 1990 and May 2005 were enrolled retrospectively in this study. Patient demographic data, operative and postoperative course, and outpatient follow-up were studied. A total of 3,100 hernia repairs were included in the study. The majority of the hernias were repaired by TEP technique; the repair was done by transabdominal preperitoneal (TAPP) repair in only 3%. Eleven percent of the hernias were recurrences after conventional repair. Mean operative time was 17 min in unilateral hernia and 24 min in bilateral hernia. There were 36 hernias (1.2%) that required conversion: 12 hernias were converted to open anterior Liechtenstein and 24 to laparoscopic TAPP technique. The incidence of intraoperative complications was low. Most of the patients were discharged at the second day of the surgery. The overall postoperative morbidity rate was 2.2%. The incidence of recurrence rate was 0.35%. The recurrence rate for the first 200 repairs was 2.5%, but it decreased to 0.47% for the subsequent 1,254 hernia repairs According to our experience, in the hands of experienced laparoscopic surgeons, laparoscopic hernia repair seems to be the favored approach for most types of inguinal hernias. TEP is preferred over TAPP as the peritoneum is not violated and there are fewer intra-abdominal complications.

Mesh Plug Repair of Inguinal Hernia; Single Surgeon Experience

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Ahmet Serdar Karaca

2013-10-01

Full Text Available Aim: Mesh repair of inguinal hernia repairs are shown to be an effective and reliable method. In this study, a single surgeon%u2019s experience with plug-mesh method performs inguinal hernia repair have been reported. Material and Method: 587 patients with plug-mesh repair of inguinal hernia, preoperative age, body / mass index, comorbid disease were recorded in terms of form. All of the patients during the preoperative and postoperative hernia classification of information, duration of operation, antibiotics, perioperative complications, and later, the early and late postoperative complications, infection, recurrence rates and return to normal daily activity, verbal pain scales in terms of time and postoperative pain were evaluated. Added to this form of long-term pain ones. The presence of wound infection was assessed by the presence of purulent discharge from the incision. Visual analog scale pain status of the patients was measured. Results: 587 patients underwent repair of primary inguinal hernia mesh plug. One of the patients, 439 (74% of them have adapted follow-ups. Patients%u2019 ages ranged from 18-86. Was calculated as the mean of 47±18:07. Follow-up period of the patients was found to be a minimum of 3 months, maximum 55 months. Found an average of 28.2±13.4 months. Mean duration of surgery was 35.07±4.00 min (min:22mn-max:52mn, respectively. When complication rates of patients with recurrence in 2 patients (0.5%, hematoma development (1.4% in 6 patients, the development of infection in 11 patients (2.5% and long-term groin pain in 4 patients (0.9% appeared. Discussion: In our experience, the plug-mesh repair of primary inguinal hernia repair safe, effective low recurrence and complication rates can be used.

Etiology of Inguinal Hernias: A Comprehensive Review

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Stina Öberg

2017-09-01

Full Text Available BackgroundThe etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias.ResultsLateral and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias. Patients with medial hernias seem to have a more profoundly altered connective tissue architecture and homeostasis compared with patients with lateral hernias. However, connective tissue alteration may play a role in development of both subtypes. Inguinal hernias have a hereditary component with a complex inheritance pattern, and inguinal hernia susceptible genes have been identified that also are involved in connective tissue homeostasis.ConclusionThe etiology of lateral and medial hernias are at least partly different, but the final explanations are still lacking on certain areas. Further investigations of inguinal hernia genes may explain the altered connective tissue observed in patients with inguinal hernias. The precise mechanisms why processus vaginalis fails to obliterate in certain patients should also be clarified. Not all patients with a patent processus vaginalis develop a lateral hernia, but increased intraabdominal pressure appears to be a contributing factor.

Pressure effects on some argon spectral lines belonging to the 3p54p-3p5nd (n=5-7) transitions

International Nuclear Information System (INIS)

Wolnikowski, J.; Wawrzynski, J.; Bielski, A.; Szudy, J.

1987-01-01

Low pressure broadening and shift of four spectral lines of argon: 518.7 nm (3p 5 4p-3p 5 5d'), 522.1 nm (3p 5 4p-3p 5 7d), 549.6 nm (3p 5 4p-3p 5 6d) and 603.2 nm (3p 5 4p-3p 5 5d) have been investigated by means of a Fabry-Perot interferometer. The values of the pressure broadening and shift coefficients for argon-argon, argon-neon and argon-helium interactions in the low-current glow discharge conditions are determined. For all lines in the pure argon a red shift and in the argon-neon and argon-helium mixtures a blue shift has been found. The results cannot be interpreted on the basis of the existing simple interaction potential models within the framework of the adiabatic impact broadening theory. (orig.)

Post Operative Pain Control in Inguinal Hernia Repair: Comparison ...

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drug to be used for local wound infiltrations following inguinal hernia repair. Results: A total of 52 ... intramuscularly or via intravenously 2,3. The local ..... suppository and local marcaine injection on inguinal hernia surgery. Arch crit care.

The Danish Inguinal Hernia Database

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Friis-Andersen H

2016-10-01

Full Text Available Hans Friis-Andersen1,2, Thue Bisgaard2,3 1Surgical Department, Horsens Regional Hospital, Horsens, Denmark; 2Steering Committee, Danish Hernia Database, 3Surgical Gastroenterological Department 235, Copenhagen University Hospital, Hvidovre, Denmark Aim of database: To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. Study population: Patients ≥18 years operated for groin hernia. Main variables: Type and size of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. Descriptive data: According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time. All institutions have continuous access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles the medical management of the database. Results: The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015. A total of 49 peer-reviewed national and international publications have been published from the database (June 2015. Conclusion: The Danish Inguinal Hernia Database is fully active monitoring surgical quality and contributes to the national and international surgical society to improve outcome after groin hernia repair. Keywords: nation-wide, recurrence, chronic pain, femoral hernia, surgery, quality improvement

Observation of the strongest 5s2 5p6 5d-(5s2 5p5 5d6s+5s25p6 7p) transitions in Au XI to Bi XV ions

International Nuclear Information System (INIS)

Churilov, S.S.; Joshi, Y.N.

2001-01-01

The spectra of gold till bismuth were studied in the 90-135 A region. Nine most intense lines belonging to the 5s 2 5p 6 5d-5s 2 5p 5 5d6s array were identified in Au XI to Bi XV ions. The 5s 2 5p 6 7p 2 P 3/2,1/2 levels in Au XI and the 5s 2 5p 6 7p 2 P 3/2 level in Hg XII were also identified. The observed wavelengths and intensities agree quite well with the Hartree-Fock calculations. (orig.)

Laparoscopic inguinal preperitoneal injection--novel technique for inguinal hernia repair: preliminary results of experimental study.

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Kozlov, Yury; Novogilov, Vladimir; Rasputin, Andrey; Podkamenev, Alexey; Krasnov, Pavel; Weber, Irina; Solovjev, Alexey

2012-04-01

Inguinal hernia repair is the most common procedure in pediatric surgery. Suture techniques for laparoscopic inguinal hernia repair in children are easy to perform and popular with a low recurrence rate. The aim of this study was to evaluate the effect of laparoscopic preperitoneal injection of three-dimensional gel on closing of the inguinal hernia sac (IHS) in laboratory animals. With the animals under general anesthesia, we performed peritoneoscopy in 12 male Chinchilla rabbits weighing 1200-1400 g. The endoscope was introduced into the abdominal cavity, and bilateral deep inguinal rings were identified. A Tuohy needle with the injectable polymeric bulking agent DAM+™ (three-dimensional polyacrylamide gel with silver ions [Argiform(®) from Bioform(®)]) was introduced preperitoneally. The implant was then injected across the entire orifice of the deep inguinal rings and draped over the cord structures. After completion of bilateral repairs, the rabbits were extubated and observed in the animal laboratory. Then the second laparoscopy was performed 6 months later, and the deep inguinal rings were inspected. The postoperative course was uneventful in all the animals. At the second laparoscopy no reopening of the entire orifice of the deep inguinal rings was noted. Accurate placement of the polymeric agent and adequate coverage of the vas deferens were accomplished in all the animals. This study demonstrates that the biopolymeric implant gives good postoperative results and a stable trend of closing the IHS in long-term follow-up. In conclusion, we hope that injectable polymeric bulking agents can be used for treatment of inguinal hernias of pediatric patients after additional animal and human research.

Endoscopic repair of primary versus recurrent male unilateral inguinal hernias: Are there differences in the outcome?

Science.gov (United States)

Köckerling, F; Jacob, D; Wiegank, W; Hukauf, M; Schug-Pass, C; Kuthe, A; Bittner, R

2016-03-01

To date, there are no prospective randomized studies that compare the outcome of endoscopic repair of primary versus recurrent inguinal hernias. It is therefore now attempted to answer that key question on the basis of registry data. In total, 20,624 patients were enrolled between September 1, 2009, and April 31, 2013. Of these patients, 18,142 (88.0%) had a primary and 2482 (12.0%) had a recurrent endoscopic repair. Only patients with male unilateral inguinal hernia and with a 1-year follow-up were included. The dependent variables were intra- and postoperative complications, reoperations, recurrence, and chronic pain rates. The results of unadjusted analyses were verified via multivariable analyses. Unadjusted analysis did not reveal any significant differences in the intraoperative complications (1.28 vs 1.33%; p = 0.849); however, there were significant differences in the postoperative complications (3.20 vs 4.03%; p = 0.036), the reoperation rate due to complications (0.84 vs 1.33%; p = 0.023), pain at rest (4.08 vs 6.16%; p primary versus recurrent male unilateral inguinal hernia showed significant differences to the disadvantage of the recurrent operation. Therefore, endoscopic repair of recurrent inguinal hernias calls for particular competence on the part of the hernia surgeon.

Acute Osteomyelitis of the Symphysis Pubis after Inguinal Hernia Surgery

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Recep Tekin

2015-01-01

Full Text Available Osteomyelitis of pubic symphysis is infectious inflammatory condition of the symphysis pubis and rare complication of surgery around inguinal and groin region. It should be kept in mind in the differential diagnosis of lower pelvic pain and should be sought in cases of pelvic insufficiency fractures. Herein, we present a case of a 55-year-old man with osteomyelitis of the symphysis pubis following inguinal hernia surgery for diagnosis and management of this rare condition.

Etiology of Inguinal Hernias

DEFF Research Database (Denmark)

Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

2017-01-01

BACKGROUND: The etiology of inguinal hernias remains uncertain even though the lifetime risk of developing an inguinal hernia is 27% for men and 3% for women. The aim was to summarize the evidence on hernia etiology, with focus on differences between lateral and medial hernias. RESULTS: Lateral...... and medial hernias seem to have common as well as different etiologies. A patent processus vaginalis and increased cumulative mechanical exposure are risk factors for lateral hernias. Patients with medial hernias seem to have a more profoundly altered connective tissue architecture and homeostasis compared...... mechanisms why processus vaginalis fails to obliterate in certain patients should also be clarified. Not all patients with a patent processus vaginalis develop a lateral hernia, but increased intraabdominal pressure appears to be a contributing factor....

Inguinodynia in patients submitted to conventional inguinal hernioplasty.

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Dias, Bruno Garcia; Santos, Marcelo Protásio Dos; Chaves, Ana Barbara DE Jesus; Willis, Mariana; Gomes, Marcio Couto; Andrade, Fernandes Tavares; Melo, Valdinaldo Aragão DE; Santos, Paulo Vicente Dos

2017-01-01

to evaluate the incidence of chronic pain and its impact on the quality of life of patients submitted to inguinal hernioplasty using the Lichtenstein technique. this was a descriptive, cross-sectional study of patients operated under spinal anesthesia from February 2013 to February 2015 and who had already completed six postoperative months. We questioned patients about the presence of chronic inguinal pain and, if confirmed, invited them to a consultation in which we assessed the pain and its impact on quality of life. out of 158 patients submitted to the procedure, we identified 7.6% as having inguinodynia. Of these, there was an impact on the quality of life in 25%. the incidence of inguinodynia after hernioplasty with repercussion in quality of life was similar to the one of found in the world literature. avaliar a incidência de dor crônica e o seu impacto na qualidade de vida de pacientes submetidos à hernioplastia inguinal pela técnica de Lichtenstein. trata-se de estudo transversal descritivo, de pacientes operados de hérnia inguinal pela técnica de Lichtenstein sob anestesia raquidiana, no período de fevereiro de 2013 a fevereiro de 2015, e que já haviam completado seis meses de pós-operatório. Os pacientes foram questionados sobre a presença de dor inguinal crônica e, caso confirmada, convidados a uma consulta na qual foi feita análise da qualidade da dor e seu impacto na qualidade de vida. do total de 158 pacientes submetidos ao procedimento, 7,6% foram identificados como portadores de inguinodinia. Destes, houve impacto na qualidade de vida em 25%. observou-se incidência de inguinodinia pós-hernioplastia com repercussão na qualidade de vida semelhante à literatura mundial.

Gânglio inguinal como única evidência de cancro progressivo do pulmão

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Zafer Kocak

2008-09-01

Full Text Available Resumo: Os tumores que metastizam para os gânglios inguinais têm frequentemente origem nos órgãos genitais e reprodutores, na pele, no recto ou ânus, ou na bexiga 1,2. Há, no entanto, algumas descrições de casos raros de metástases inguinais de tumores localizados acima do diafragma2−5, e apenas três destes apresentavam uma metástase inguinal reconhecida antes da morte. Estes casos estão detalhadamente descritos na literatura médica de língua inglesa3−5. Os tumores primários destes casos eram mesotelioma maligno e carcinomas do conduto salivar e da mama. Descrevemosum caso de carcinoma do pulmão que metastizou para gânglio inguinal, como única evidência de cancro do pulmão progressivo.Rev Port Pneumol 2008; XIV (5: 709-713 Abstact: Tumours that metastasise to groin nodes most frequently originate in genital and reproductive organs, skin, rectum or anus, or urinary bladder 1,2. However, rare cases of inguinal metastases from tumours above the diaphragm have been reported 2−5 and only three of them had an inguinal metastasis which was recognised antemortem and reported in detail in the English medical literature 3−5. The primary tumours of these cases were malignant mesothelioma, salivary duct and breast carcinoma. In this paper, we report a case of carcinoma of the lung metastatic to an inguinal lymph node as the only evidence of progressive lung cancer.Rev Port Pneumol 2008; XIV (5: 709-713 Palavras-chave: Carcinoma do pulmão de não pequenas células, gânglio inguinal, metástase, progressão da doença, Key-words: Non-small cell lung carcinoma, inguinal lymph node, metastasis, disease progression

Ilio inguinal block: do we know the correct dose?

African Journals Online (AJOL)

Adele

TRAVEL FELLOWSHIP. Introduction. Although Ilio-inguinal nerve blocks are commonly used, the dose advocated varies between 0.3-0.5ml/kg. Despite these doses a failure rate of up to 20-30% has been described using the standard technique. These failures may be due to inadequate understanding of the anatomy, faulty ...

Risk factors for inguinal hernia in women: a case-control study. The Coala Trial Group.

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Liem, M S; van der Graaf, Y; Zwart, R C; Geurts, I; van Vroonhoven, T J

1997-11-01

Potential risk factors for inguinal hernia in women were investigated and the relative importance of these factors was quantified. In women, symptomatic but nonpalpable hernias often remain undiagnosed. However, knowledge on this subject only concerns hernia and operation characteristics, which have been obtained by review of case series. Virtually nothing is known about risk factors for inguinal hernia. The authors performed a hospital-based case-control study of 89 female patients with an incident inguinal hernia and 176 age-matched female controls. Activity since birth with two validated questionnaires was measured and smoking habits, medical and operation history, Quetelet index (kg/m2), and history of pregnancies and deliveries were recorded. Response for cases was 81% and for controls 73%. Total physical activity was not associated with inguinal hernia (univariate odds ratio (OR) = 0.8, 95% confidence interval (CI) 0.6-1.1), but high present sports activities was associated with less inguinal hernia (multivariate OR = 0.2, 95% CI 0.1-0.7). Obesity (Quetelet index > 30) was also protective for inguinal hernia (OR = 0.2, 95% CI 0.04-1.0). Independent risk factors were positive family history (OR = 4.3, 95% CI 1.9-9.7) and obstipation (OR = 2.5, 95% CI 1.0-6.7). In particular, smoking, appendectomy, other abdominal operations, and multiple deliveries were not associated with inguinal hernia in females. The protective effect of present sports activity may be explained by optimizing the resistance of the abdominal musculature protecting the relatively small inguinal weak spot in the female. The individual predisposition for inguinal hernia may be quantified by these risk factors, and, with this in mind, the authors advise that further evaluation might be needed for the patient with unexplained inguinal pain.

Pep3p/Pep5p complex: a putative docking factor at multiple steps of vesicular transport to the vacuole of Saccharomyces cerevisiae.

OpenAIRE

Srivastava, A; Woolford, C A; Jones, E W

2000-01-01

Pep3p and Pep5p are known to be necessary for trafficking of hydrolase precursors to the vacuole and for vacuolar biogenesis. These proteins are present in a hetero-oligomeric complex that mediates transport at the vacuolar membrane. PEP5 interacts genetically with VPS8, implicating Pep5p in the earlier Golgi to endosome step and/or in recycling from the endosome to the Golgi. To understand further the cellular roles of Pep3p and Pep5p, we isolated and characterized a set of pep3 conditional ...

Inguinal metastases from testicular cancer

DEFF Research Database (Denmark)

Daugaard, Gedske; Karas, Vladimir; Sommer, Peter

2006-01-01

To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease.......To evaluate the incidence of inguinal metastases in patients with testicular cancer and relapse after initial stage I disease....

Inguinal syndrome with penoscrotal elephantiasis

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Aggarwal Kamal

2002-11-01

Full Text Available Bilateral inguinal adenitis and penoscrotal elephantiasis are uncommonly encountered presentations of Lymphogranuloma venereum. Herein, we report a male who presented with bilateral inguinal bubos alongwith penoscrotal elephantiasis that developed within 6 months of the primary lesion.

Inguinal and subinguinal micro-varicocelectomy, the optimal surgical management of varicocele: a meta-analysis

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Jun Wang

2015-02-01

Full Text Available Conventional meta-analyses have shown inconsistent results for the efficacy of various treatments of varicoceles. Therefore, we performed a multiple-treatment meta-analysis to assess the effectiveness and safety of 10 methods of varicocelectomy and embolization/sclerotherapy. We systematically reviewed 35 randomized controlled trials and observational studies, from 1966 to August 5, 2013, which compared any of the following treatments for varococeles: laparoscopic, retroperitoneal, open inguinal and subinguinal varicocelectomy, microsurgical subinguinal and inguinal varicocelectomy, percutaneous venous embolization, Tauber antegrade sclerotherapy, retrograde sclerotherapy and expectant therapy (no treatment. Inguinal and subinguinal microsurgery, open inguinal, laparoscopic varicocelectomy showed a significant advantage over expectant therapy in terms of pregnancy rates (odds ratio (OR: 3.48, 2.68, 2.92 and 2.90, respectively. Compared with retroperitoneal open surgery, inguinal microsurgery showed an improvement of sperm density (mean difference (MD: 10.60, 95% confidence interval (CI: 1.92-19.60 and sperm motility (MD: 9.09, 95% CI: 4.88-13.30. Subinguinal and inguinal microsurgery outperformed retroperitoneal open surgery in terms of recurrence (OR: 0.05, 0.06 respectively. Tauber antegrade sclerotherapy and subinguinal microsurgery were associated with the lowest risk of hydrocele formation. The odds of overall complication, compared with retroperitoneal open varicocelectomy, were lowest for inguinal microsurgery (OR = 0.07, 95% CI: 0.02-0.19, followed by subinguinal microsurgery (OR = 0.09, 95% CI: 0.02-0.19. Inguinal and subinguinal micro-varicocelectomy had the highest pregnancy rates, significant increases in sperm parameters, with low odds of complication. These results warrant additional properly conducted randomized controlled clinical studies with larger sample sizes.

Acute testicular ischemia caused by incarcerated inguinal hernia.

Science.gov (United States)

Orth, Robert C; Towbin, Alexander J

2012-02-01

Acute testicular ischemia caused by an incarcerated inguinal hernia usually affects infants. There are few reports of diagnosis using US, and the effect of long-standing reducible hernias on testicular growth in infants and children is unknown. The objectives of this study were to determine the incidence of testicular ischemia secondary to an incarcerated inguinal hernia at scrotal sonography and to determine the effect on testicular size at diagnosis. A hospital database was used to locate scrotal sonography examinations documenting an inguinal hernia, and images were reviewed for signs of testicular ischemia. Testicular volumes were compared using the Wilcoxon signed rank test. A total of 147 patients were identified with an inguinal hernia (age 1 day to 23 years, average 6 years). Ten patients (6.8%) had associated testicular ischemia (age 3 weeks to 6 months, average 9 weeks) and showed a statistically significant increase in ipsilateral testicular size compared to the contralateral testicle (P = 0.012). Patients without testicular ischemia did not show a significant difference in testicular size, regardless of patient age. An incarcerated inguinal hernia should be considered as a cause of acute testicular ischemia in infants younger than 6 months of age.

Herniorrafia inguinal em crianças: valor da anestesia local associada Inguinal hernia repair in children: importance of local anesthesia association

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José Guilherme Minossi

2002-07-01

Full Text Available OBJETIVO: Descrever uma técnica de anestesia local no tratamento de hérnias inguinais em crianças. MÉTODO: Foram operadas 48 crianças com hérnias inguinais sob anestesia local na Santa Casa de Misericórdia de Cerqueira César, SP, sendo 34 do sexo masculino e 14 do sexo feminino, com idades entre 3 meses e 12 anos. Apenas quatro crianças tinham hérnia bilateral. A anestesia local foi realizada com lidocaína a 1% na dose de 5 mg/kg de peso através do bloqueio dos nervos abdominogenitais próximos à espinha ilíaca ântero-superior, à altura do anel inguinal externo e na pele ao redor da incisão. A sedação foi feita com cetamina na dose de 1 a 2 mg/kg e diazepam 0,2 a 0,4 mg/kg de peso. RESULTADOS: Todas as cirurgias puderam ser realizadas com tranqüilidade com este método, com exceção de uma criança em que o bloqueio não foi efetivo e a anestesia complementada com inalação de halogenado, sob máscara. Como complicações pós-operatórias, ocorreram três hematomas, sendo um de parede e dois em bolsa escrotal, todos com boa evolução. CONCLUSÕES: O uso da anestesia local associada à sedação é procedimento simples e seguro para realizar herniorrafias inguinais em crianças.AIM: To describe an anesthetic technique, as well as the results of surgical treatment of the inguinal hernia in children. PATIENTS/METHODS: Forty-eight patients were submitted to inguinal hernia repair under local anesthesia at "Santa Casa de Misericórdia de Cerqueira César", State of São Paulo, Brazil. There were 34 male and 14 female patients, range from 3 months to 12 years old. Local anesthesia was performed with a dose of 5 mg/kg body weight of 1% lidocaine through iliohypogastric and ilioinguinal nerve blocks, medially to the anterior superior iliac spine, and at level of the pubic tubercle. Sedation was done with an association of ketamine (1 to 2 mg/kg and diazepam (0,2 to 0,4 mg/kg. RESULTS: In all patients except one the procedure was

Isolated local-regional recurrence of breast cancer following mastectomy: Radiotherapeutic management

International Nuclear Information System (INIS)

Halverson, K.J.; Perez, C.A.; Kuske, R.R.; Garcia, D.M.; Simpson, J.R.; Fineberg, B.

1990-01-01

Two hundred twenty-four patients with their first, isolated local-regional recurrence of breast cancer were irradiated with curative intent. Patients who had previous chest wall or regional lymphatic irradiation were not included in the study. With a median follow-up of 46 months (range 24 to 241 months), the 5- and 10-year survival for the entire group were 43% and 26%, respectively. Overall, 57% of the patients were projected to be loco-regionally controlled at 5 years. The 5-year local-regional tumor control was best for patients with isolated chest wall recurrences (63%), intermediate for nodal recurrences (45%), and poor for concomitant chest wall and nodal recurrences (27%). In patients with solitary chest wall recurrences, large field radiotherapy encompassing the entire chest wall resulted in a 5- and 10-year freedom from chest wall re-recurrence of 75% and 63% in contrast to 36% and 18% with small field irradiation (p = 0.0001). For the group with recurrences completely excised, tumor control was adequate at all doses ranging from 4500 to 7000 cGy. For the recurrences less than 3 cm, 100% were controlled at doses greater than or equal to 6000 cGy versus 76% at lower doses. No dose response could be demonstrated for the larger lesions. The supraclavicular failure rate was 16% without elective radiotherapy versus 6% with elective radiotherapy (p = 0.0489). Prophylactic irradiation of the uninvolved chest wall decreased the subsequent re-recurrence rate (17% versus 27%), but the difference is not statistically significant (p = .32). The incidence of chest wall re-recurrence was 12% with doses greater than or equal to 5000 cGy compared to 27% with no elective radiotherapy, but again was not statistically significant (p = .20). Axillary and internal mammary failures were infrequent, regardless of prophylactic treatment

Surgical repair of incarcerated inguinal hernia in children: laparoscopic or open?

Science.gov (United States)

Nah, S A; Giacomello, L; Eaton, S; de Coppi, P; Curry, J I; Drake, D P; Kiely, E M; Pierro, A

2011-01-01

The management of Incarcerated Inguinal Hernia (IIH) in children is challenging and may be associated with complications. We aimed to compare the outcomes of laparoscopic vs. open repair of IIH. With institutional ethical approval (09SG13), we reviewed the notes of 63 consecutive children who were admitted to a single hospital with the diagnosis of IIH between 2000 and 2008. Data are reported as median (range). Groups were compared by chi-squared or t-tests as appropriate. · Open repair (n=35): There were 21 children with right and 14 with left IIH. 2 patients also had contralateral reducible inguinal hernia. Small bowel resection was required in 2 children. · Laparoscopic repair (n=28): All children had unilateral IIH (19 right sided, 9 left sided). 15 children (54%) with no clinical evidence of contralateral hernia, had contralateral patent processus vaginalis at laparoscopy, which was also repaired. The groups were similar with regard to gender, age at surgery, history of prematurity, interval between admission and surgery, and proportion of patients with successful preoperative manual reduction. However, the duration of operation was longer in the laparoscopy group (p=0.01). Time to full feeds and length of hospital stay were similar in both groups. Postoperative follow-up was 3.5 months (1-36), which was similar in both groups. 5 patients in the group undergoing open repair had serious complications: 1 vas transaction, 1 acquired undescended testis, 2 testicular atrophy and 1 recurrence. The laparoscopic group had a single recurrence. Open repair of incarcerated inguinal hernia is associated with serious complications. The laparoscopic technique appears safe, avoids the difficult dissection of an oedematous sac in the groin, allows inspection of the reduced hernia content and permits the repair of a contralateral patent processus vaginalis if present. © Georg Thieme Verlag KG Stuttgart · New York.

Amyad's hernia while reparing the bilateral inguinal hernia

OpenAIRE

Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

2015-01-01

Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

Amyad's hernia while reparing the bilateral inguinal hernia

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Arif Aslaner

2015-01-01

Full Text Available Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

Peniskarzinom mit exulzerierten Lymphknotenmetastasen links inguinal

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Presich K

2003-01-01

Full Text Available Im Oktober 2001 wurde ein 53jähriger Patient mit ausgedehnten exulzerierten Lymphknotenmetastasen rechts inguinal an einer auswärtigen chirurgischen Abteilung vorgestellt. Im Rahmen der Durchuntersuchung fand sich eine verhärtete, von einem nicht retrahierbaren Präputium verdeckte Glans als mögliches Primum. Eine Circumcision sowie Biopsie aus der Glans ergaben das histologische Ergebnis eines invasiven, schwach verhornenden Plattenepithelkarzinoms mittleren Differenzierungsgrades (G2-G3. In einer Unterbauch-Computertomographie wurde rechts inguinal ein ausgedehnter, ca. 10 cm messender, teils solider, teils nekrotischer Prozeß, bis an die großen Gefäße heranreichend, beschrieben. Die linke Leiste war unauffällig.

Analysis of the reaction 3He + p → p + p + d at 2,5 GeV/c 3He nucleus momentum

International Nuclear Information System (INIS)

Blinov, A.V.; Chuvilo, I.V.; Drobot, V.V.

1984-01-01

The experimental data on the reaction 3 He+p → p+p+d obtained by the exposition of an 80 cm liquid hydrogen bubble chamber to the 3 He nucleus beam at 2.5 GeV/c momentum are considered. The angular, momentum and invariant mass distributions, which have been measured, are compared with theoretical calculations performed using the pole model. On the whole a satisfactory agreement between theoretical and experimental data is found in the kinematical region, where pd- rescattering effects are negligible. It is concluded, that 3 He nuclear wave function calculated by means of nonrelativistic potential models falls too sharply with the spectator momenta as compared with the data

Persistent Mullerian duct syndrome presenting as an inguinal hernia : A case report

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Amit Dangi

2016-10-01

Full Text Available A brief report of persistent mullerian duct syndrome (PMDS with 46XY karyotype which is one of the rarest variety of disorders of sexual differentiation (DSD accounting only 5% cases of all is being presented. A 21 years old male with left inguinal hernia and absent right testis presented in surgical outdoor and was operated. On exploration female genital organs like uterus and fallopian tubes along with contralateral testis were present in left inguinal canal as a content of sliding left inguinal hernia.

Social isolation stress induces ATF-7 phosphorylation and impairs silencing of the 5-HT 5B receptor gene

Science.gov (United States)

Maekawa, Toshio; Kim, Seungjoon; Nakai, Daisuke; Makino, Chieko; Takagi, Tsuyoshi; Ogura, Hiroo; Yamada, Kazuyuki; Chatton, Bruno; Ishii, Shunsuke

2010-01-01

Many symptoms induced by isolation rearing of rodents may be relevant to neuropsychiatric disorders, including depression. However, identities of transcription factors that regulate gene expression in response to chronic social isolation stress remain elusive. The transcription factor ATF-7 is structurally related to ATF-2, which is activated by various stresses, including inflammatory cytokines. Here, we report that Atf-7-deficient mice exhibit abnormal behaviours and increased 5-HT receptor 5B (Htr5b) mRNA levels in the dorsal raphe nuclei. ATF-7 silences the transcription of Htr5B by directly binding to its 5′-regulatory region, and mediates histone H3-K9 trimethylation via interaction with the ESET histone methyltransferase. Isolation-reared wild-type (WT) mice exhibit abnormal behaviours that resemble those of Atf-7-deficient mice. Upon social isolation stress, ATF-7 in the dorsal raphe nucleus is phosphorylated via p38 and is released from the Htr5b promoter, leading to the upregulation of Htr5b. Thus, ATF-7 may have a critical role in gene expression induced by social isolation stress. PMID:19893493

Spinal anesthesia for inguinal hernia repair in infants: a feasible and safe method even in emergency cases.

Science.gov (United States)

Lambertz, A; Schälte, G; Winter, J; Röth, A; Busch, D; Ulmer, T F; Steinau, G; Neumann, U P; Klink, C D

2014-10-01

Inguinal hernia repair is the most frequently performed surgical procedure in infants and children. Especially in premature infants, prevalence reaches up to 30% in coincidence with high rates of incarceration during the first year of life. These infants carry an increased risk of complications due to general anesthesia. Thus, spinal anesthesia is a topic of growing interest for this group of patients. We hypothesized that spinal anesthesia is a feasible and safe option for inguinal hernia repair in infants even at high risk and cases of incarceration. Between 2003 and 2013, we operated 100 infants younger than 6 months with inguinal hernia. Clinical data were collected prospectively and retrospectively analyzed. Patients were divided into two groups depending on anesthesia procedure (spinal anesthesia, Group 1 vs. general anesthesia, Group 2). Spinal anesthesia was performed in 69 infants, and 31 infants were operated in general anesthesia, respectively. In 7 of these 31 infants, general anesthesia was chosen because of lumbar puncture failure. Infants operated in spinal anesthesia were significantly smaller (54 ± 4 vs. 57 ± 4 cm; p = 0.001), had a lower body weight (4,047 ± 1,002 vs. 5,327 ± 1,376 g; p emergent incarcerated hernia repairs were performed in spinal anesthesia (p = 0.429). Spinal anesthesia is a feasible and safe option for inguinal hernia repair in infants, especially in high-risk premature infants and in cases of hernia incarceration.

Single site and conventional totally extraperitoneal techniques for uncomplicated inguinal hernia repair: A comparative study.

Science.gov (United States)

de Araújo, Felipe Brandão Corrêa; Starling, Eduardo Simão; Maricevich, Marco; Tobias-Machado, Marcos

2014-10-01

To demonstrate the feasibility of endoscopic extraperitoneal single site (EESS) inguinal hernia repair and compare it outcomes with the conventional totally extraperitoneal (TEP) technique. TEP inguinal hernia repair is a widely accepted alternative to conventional open technique with several perioperative advantages. Transumbilical laparoendoscopic singlesite surgery (LESS) is an emerging approach and has been reported for a number of surgical procedures with superior aesthetic results but other advantages need to be proven. Thirty-eight uncomplicated inguinal hernias were repaired by EESS approach between January 2010 and January 2011. All procedures were performed through a 25 cm infraumbilical incision using the Alexis wound retractor attached to a surgical glove and three trocars. Body mass index, age, operative time, blood loss, complications, conversion rate, analgesia requirement, hospital stay, return to normal activities and patient satisfaction with aesthetic results were analysed and compared with the last 38 matched-pair group of patients who underwent a conventional TEP inguinal hernia repair by the same surgeon. All procedures were performed successfully with no conversion. In both unilateral and bilateral EESS inguinal repairs, the mean operative time was longer than conventional TEP (55± 20 vs. 40± 15 min, P = 0.049 and 70± 15 vs. 55± 10 min, P = 0.014). Aesthetic result was superior in the EESS group (2.88± 0.43 vs. 2.79± 0.51, P = 0.042). There was no difference between the two approaches regarding blood loss, complications, hospital stay, time until returns to normal activities and analgesic requirement. EESS inguinal hernia repair is safe and effective, with superior cosmetic results in the treatment of uncomplicated inguinal hernias. Other advantages of this new technique still need to be proven.

Excitation-energy dependence of the resonant Auger transitions to the 4p4(1D)np (n=5,6) states across the 3d3/2-15p and 3d5/2-16p resonances in Kr

International Nuclear Information System (INIS)

Sankari, A.; Alitalo, S.; Nikkinen, J.; Kivimaeki, A.; Aksela, S.; Aksela, H.; Fritzsche, S.

2007-01-01

The energy dependencies of the intensities and angular distribution parameters β of the resonant Auger final states 4p 4 ( 1 D)np (n=5,6) of Kr were determined experimentally in the excitation-energy region of the overlapping 3d 3/2 -1 5p and 3d 5/2 -1 6p resonances. The experimental results were compared with the outcome of multiconfiguration Dirac-Fock calculations. Combining experimental and calculated results allowed us to study interference effects between the direct and several resonant channels that populate the 4p 4 ( 1 D)np states. The inclusion of the direct channel was crucial in order to reproduce the observed energy behavior of the angular distribution parameters. It was also important to take into account experimentally observed shake transitions

[Non-incarcerated inguinal hernia in children: operation within 7 days not necessary].

Science.gov (United States)

Timmers, L; Hamming, J F; Oostvogel, H J M

2005-01-29

To assess the necessity to operate on non-incarcerated inguinal hernia in children within 7 days of diagnosis. Retrospective. Data on 360 children, 0-10 years old (104 girls and 256 boys) who were operated on for inguinal hernia between 1 January 1993-31 December 2001 at the St. Elisabeth Hospital in Tilburg, the Netherlands, were collected from the medical records. These data included sex, age, interval between diagnosis and repair, recurrence, incarceration, length of hospitalisation and complications. In the group of 113 children 0-1 years old, 137 inguinal hernias were repaired, ofwhich 16 were incarcerated on presentation. The interval between diagnosis and repair was known in 93 of 121 cases: 37 hernias were repaired within 7 days and 56 at a later stage. In the latter group, there was one case of secondary incarceration (1.8%; 95% CI: 0-5.4). The number needed to treat was 56. In the group of 247 children 1-10 years old, 269 inguinal hernias were repaired, of which 8 were primarily incarcerated. The interval between diagnosis and repair was known in 208 of 261 cases: 34 hernias were repaired within 7 days and 174 at a later stage. In the latter group, 3 hernias incarcerated secondarily (1.7%; 95% CI: 0-3.7). The number needed to treat was 58. In the group of non-incarcerated hernias 1 complication occurred, in the group of incarcerated hernias none. The mean length of hospitalisation of children with non-incarcerated hernia was 0.85 days, and of children with incarcerated hernia 2.4 days. In children with a non-incarcerated inguinal hernia who are waiting for an operation, the risk of secondary incarceration and complications is 2% which we do not think is enough reason to carry out an elective hernia-repair procedure within 7 days.

Inguinal hernia repair: totally preperitoneal laparoscopic approach versus Stoppa operation: randomized trial of 100 cases.

Science.gov (United States)

Champault, G G; Rizk, N; Catheline, J M; Turner, R; Boutelier, P

1997-12-01

In a prospective randomized trial comparing the totally preperitoneal (TPP) laparoscopic approach and the Stoppa procedure (open), 100 patients with inguinal hernias (Nyhus IIIA, IIIB, IV) were followed over a 3-year period. Both groups were epidemiologically comparable. In the laparoscopic group, operating time was significantly longer (p = 0.01), but hospital stay (3.2 vs. 7.3 days) and delay in return to work (17 vs. 35 days) were significantly reduced (p = 0.01). Postoperative comfort (less pain) was better (p = 0.001) after laparoscopy. In this group, morbidity was also reduced (4 vs. 20%; p = 0.02). The mean follow-up was 605 days, and 93% of the patients were reviewed at 3 years. There were three (6%) recurrences after TPP, especially at the beginning of the surgeon's learning curve, versus one for the Stoppa procedure (NS). For bilateral hernias, the authors suggest the use of a large prosthesis rather than two small ones to minimize the likelihood of recurrence. In the conditions described, the laparoscopic (TPP) approach to inguinal hernia treatment appears to have the same long-term recurrence rate as the open (Stoppa) procedure but a real advantage in the early postoperative period.

Early-onset inguinal hernia as risk factor for schizophrenia or related psychosis: a nationwide register-based cohort study.

Science.gov (United States)

Melkersson, Kristina; Wernroth, Mona-Lisa

2017-10-01

In an earlier interview study, we found that more men with familial schizophrenia had undergone inguinal hernia operation, than men with sporadic schizophrenia. However, there are no other studies published specifically on inguinal hernia and schizophrenia. Therefore, the aim of this study was to carry out a Swedish register-based cohort study on the association between inguinal hernia and schizophrenia or related psychosis. Data from the Total Population- and Medical Birth-Registers were used to create a cohort of all individuals born in Sweden 1987-1999 (n=1 406 168). The cohort individuals were linked with the In- and Out-patient Registers and followed from birth to 2015 to identify onset of schizophrenia, schizoaffective disorder and inguinal hernia. Cox proportional hazards regression models were used to assess the association between inguinal hernia before age 13 and risk of developing schizophrenia or schizoaffective disorder during a follow-up from age 13. Inguinal hernia before age 13 was identified in 21 095 individuals, and during the follow-up in total 1314 individuals developed schizophrenia or schizoaffective disorder. The risk of schizophrenia or schizoaffective disorder was higher among individuals with inguinal hernia before age 13, than among individuals without such a diagnosis, especially among the men [adjusted hazard ratio (95% confidence interval); all: 1.44 (1.01-2.06), p=0.0452, men: 1.46 (1.01-2.12), p=0.0460, women: 0.56 (0.14-2.27), p=0.4173]. This study shows that early-onset inguinal hernia is associated with increased risk of developing schizophrenia or schizoaffective disorder, especially in men. Such an association may point to a common biological basis for the development of inguinal hernia and schizophrenia or related psychosis.

Laparoscopic approach to incarcerated inguinal hernia in children.

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Kaya, Mete; Hückstedt, Thomas; Schier, Felix

2006-03-01

The purpose of this study was to describe the laparoscopic approach to incarcerated inguinal hernia in children. After unsuccessful manual reduction, 29 patients (aged 3 weeks to 7 years; median, 10 weeks; 44 boys, 15 girls) with incarcerated inguinal hernia underwent immediate laparoscopy. The hernial content was reduced in a combined technique of external manual pressure and internal pulling by forceps. The bowel was inspected, and the hernia was repaired. In all patients, the procedure was successful. No conversion to the open approach was required. Immediate laparoscopic herniorrhaphy in the same session was added. No complications occurred. Laparoscopy allowed for simultaneous reduction under direct visual control, inspection of the incarcerated organ, and definitive repair of the hernia. Technically, it appears easier than the conventional approach because of the internal inguinal ring being widened by intraabdominal carbon dioxide insufflation. The hospital stay is shorter.

External Genital Abnormalities and Inguinal Hernia among Males of Children Nurseries, North West of Iran

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Hossein Haratipour

2016-02-01

Full Text Available Background Abnormalities of external genitalia in male children nurseries and inguinal hernia are the most common congenital disorders in children. We aimed to determine prevalence rate of inguinal hernia and other genital among children nurseries, in Shahrood-Iran. Materials and Methods In this descriptive cross-sectional study, we examined 920 children nurseries boys. Physical examination of children was performed in presence of a parent in a warm room in supine and upright position with and without Valsalva maneuver. A written consent was obtained from parents before examination. Past medical history and history of surgery on inguinal and genital area was taken. Examination was performed 2 interns who were trained about genital system examination.   Results A total of 920 children nurseries boys aged 3 to 6 years were examined which were detected in 88 children and prevalence rate of these abnormalities were 9.6%. The prevalence of abnormalities in the children under study were as follows: Inguinal hernia (5.1%, cryptorchidism (2.1%, Hydrocele (1.5%, hypospadias (0.4%, Varicocele (0.1%, micropenis (0.4%. Conclusion Regarding to relatively high prevalence rate of these abnormalities and low level of people knowledge, seem screening systems for diagnosis and appropriate treatment of these abnormalities to be necessary.

Characterization of a newly isolated highly effective 3,5,6-trichloro-2-pyridinol degrading strain Cupriavidus pauculus P2.

Science.gov (United States)

Cao, Li; Liu, Hongming; Zhang, Hao; Huang, Ke; Gu, Tao; Ni, Haiyan; Hong, Qing; Li, Shunpeng

2012-09-01

A bacterial strain P2 capable of degrading 3,5,6-trichloro-2-pyridinol (TCP) was isolated and characterized. Phylogenetic analysis based on 16S rRNA gene sequence indicated that it belonged to the genus of Cupriavidus, because it showed the highest sequence similarity to Cupriavidus pauculus LMG 3413(T) (99.7 %) and DNA-DNA relatedness value between strain P2 and C. pauculus LMG 3413(T) was 76.8 %. In combination with morphological, physiological and biochemical characters, strain P2 was identified as C. pauculus. It could use TCP as the sole carbon source and energy source for its growth. It showed a high average degradation rate of 10 mg/L h in mineral salt medium amended with TCP (50-800 mg/L). During TCP degradation, chloridion was released into the medium in two obvious discontinuous stages. Along with this, two colorful metabolites were produced. Finally, the molarity of the total released chloridion was three times that of the initial TCP in the medium. This is the first report of TCP-degrading strain from the genus of Cupriavidus and the detection of two colorful metabolites during TCP degradation. Strain P2 might be a promising candidate for its application in the bioremediation of TCP-polluted environments.

Topographic distribution of inguinal lymph nodes metastasis: significance in determination of treatment margin for elective inguinal lymph nodes irradiation of low pelvic tumors

International Nuclear Information System (INIS)

Wang, C.J.; Chin, Y.Y.; Leung, Stephen Wan; Chen, H.C.; Sun, L.M.; Fang, F.M.

1996-01-01

Purpose: To study the distribution of gross inguinal lymph node metastasis and, in particular, its correlation with major pelvic bony structures on a simulation film. Methods and Materials: Thirty-seven cases of low pelvic tumors having gross inguinal lymph node metastasis that were treated with radiation therapy between November 1987 and December 1992 were segregated for study. The patient's nodes were palpated and marked with lead wire before the simulation film was taken. The geometric center of the usually round or elliptical node on the film was assumed to be the origin of the previously uninfested node. A total of 84 such labeled nodes was obtained from these 37 cases. These centers were transferred to and mapped collectively on a new simulation film showing major pelvic bony structures of left hemipelvis and upper femur. Results: Distribution of gross inguinal lymph nodes was found confined to the following area, as related to major pelvic bony structure: laterally, just abutting the tangential line that passes through lateral border of the femoral head; medially: 3 cm away from the body's midline axis; superiorly: 1 cm below the line that joins both upper borders of the femoral head; inferiorly: 2.5 cm below the low borders of ischial tuberosity. According to this rectangular boundary, three nodes were out of field, nine nodes near the border less than 1 cm margin. This area adequately covered 86% (72 of 84) of the studied nodes. Conclusion: Distribution study is important in determining the treatment margin. In general, an additional 1-2 cm beyond the area described above is the recommended treatment margin for elective inguinal lymph nodes irradiation with high confidence level of coverage.

Evaluation of a single-dose of intravenous magnesium sulphate for prevention of postoperative pain after inguinal surgery

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Shashi Kiran

2011-01-01

Full Text Available This study was undertaken to study efficacy of single dose of intravenous magnesium sulphate to reduce post-operative pain in patients undergoing inguinal surgery. One hundred patients undergoing inguinal surgery were divided randomly in two groups of 50 each. The patients of magnesium sulphate group (Group-I received magnesium sulphate 50 mg/kg in 250 ml of isotonic sodium chloride solution IV whereas patients in control group (Group-II received same volume of isotonic sodium chloride over 30 minutes preoperatively. Anaesthesia was induced with propofol (2 mg/kg and pethidine (1 mg/kg. Atracurium besylate (0.5 mg/kg was given to facilitate insertion of LMA. Pain at emergence from anaesthesia and 2, 4, 6, 12 and 24 hours after surgery was evaluated. The timing and dosage of rescue analgesic during first 24 hrs after operation was noted. Pain in postop period was significantly lower in magnesium sulphate group in comparison to control group at emergence from anaesthesia and 2, 4, 6, 12 and 24 hrs postop [1.86 vs. 1.96 (P=0.138, 1.22 vs. 1.82 (P=0.001, 1.32 vs. 1.88 (P=0.000, 2.74 vs. 3.84 (P=0.000, 1.36 vs. 2.00 (P=0.000 and 0.78 vs 1.30 (P=0.000, respectively]. Patients in group-I were more sedated as compared to group-II [sedation score 1.86 vs. 1.40 (P=0.000]. Rescue analgesia requirement postoperatively in first 4, 8 and 16 hrs was significantly lower in patients of group-1 than in group- II [1.9 vs. 3.8 (P<0.05, 25.50 vs. 52.50 (P<0.05 and 0.000 vs. 7.5 (P<0.05]. Preoperative magnesium sulphate infusion decreases postop pain and requirement of rescue analgesia.

Isolation of an insulin-like growth factor II cDNA with a unique 5' untranslated region from human placenta

International Nuclear Information System (INIS)

Shen, Shujane; Daimon, Makoto; Wang, Chunyeh; Ilan, J.; Jansen, M.

1988-01-01

Human insulin-like growth factor II (IGF-II) cDNA from a placental library was isolated and sequenced. The 5' untranslated region (5'-UTR) sequence of this cDNA differs completely from that of adult human liver and has considerable base sequence identity to the same region of an IGF-II cDNA of a rat liver cell line, BRL-3A. Human placental poly(A) + RNA was probed with either the 5'-UTR of the isolated human placental IGF-II cDNA or the 5'-UTR of the IGF-II cDNA obtained from adult human liver. No transcripts were detected by using the 5'-UTR of the adult liver IGF-II as the probe. In contrast, three transcripts of 6.0, 3.2, and 2.2 kilobases were detected by using the 5'-UTR of the placental IGF-II cDNA as the probe or the probe from the coding sequence. A fourth IGF-II transcript of 4.9 kilobases presumably containing a 5'-UTR consisting of a base sequence dissimilar to that of either IGF-II 5'-UTR was apparent. Therefore, IGF-II transcripts detected may be products of alternative splicing as their 5'-UTR sequence is contained within the human IGF-II gene or they may be a consequence of alternative promoter utilization in placenta

Two Ports Laparoscopic Inguinal Hernia Repair in Children

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Medhat M. Ibrahim

2015-01-01

Full Text Available Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7% cases were suffering unilateral hernia and 20 (22.2% patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%. The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus. Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.

The efficacy of the semi-blind approach of transversus abdominis plane block on postoperative analgesia in patients undergoing inguinal hernia repair: a prospective randomized double-blind study

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Salman AE

2013-01-01

Full Text Available A Ebru Salman,1 Fahri Yetisir,2 Banu Yürekli,3 Mustafa Aksoy,1 Murat Yildirim,2 Mehmet Kiliç21Anesthesiology and Reanimation Department, 2General Surgery Department, Atatürk Research and Training Hospital, Ankara, Turkey; 3Endocrinology Department, Bozyaka Research and Training Hospital, Izmir, TurkeyPurpose: In this prospective, randomized, double-blind study, our aim was to compare the analgesic efficacy of the semi-blind approach of transversus abdominis plane (TAP block with a placebo block in patients undergoing unilateral inguinal hernia repair.Methods: After receiving hospital ethical committee approval and informed patient consents, American Society of Anesthesiologists (ASA I–III patients aged 18–80 were enrolled in the study. Standard anesthesia monitoring was applied to all patients. After premedication, spinal anesthesia was administered to all patients with 3.5 mL heavy bupivacaine at the L3-L4 subarachnoid space. Patients were randomly allocated into 2 groups. Group I (n = 32 received a placebo block with 20 mL saline, Group II (n = 32 received semi-blind TAP block with 0.25% bupivacaine in 20 mL with a blunt regional anesthesia needle into the neurofascial plane via the lumbar triangle of Petit near the midaxillary line before fascial closure. At the end of the operation, intravenous (IV dexketoprofen was given to all patients. The verbal analog scale (VAS was recorded at 2, 4, 6, 12, and 24 hours postoperatively. Paracetamol IV was given to patients if their VAS score > 3. A rescue analgesic of 0.05 mg/kg morphine IV was applied if VAS > 3. Total analgesic consumption and morphine requirement in 24 hours were recorded.Results: TAP block reduced VAS scores at all postoperative time points (P < 0.001. Postoperative analgesic and morphine requirement in 24 hours was significantly lower in group II (P < 0.01.Conclusion: Semi-blind TAP block provided effective analgesia, reducing total 24-hour postoperative analgesic

Pain and functional impairment 6 years after inguinal herniorrhaphy

DEFF Research Database (Denmark)

Aasvang, Eske Kvanner; Bay-Nielsen, Morten; Kehlet, Henrik

2006-01-01

2002 and June 2003 (n=1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224...... and subsequent sexual dysfunction represent a clinically significant problem in about 3% of younger male patients with a previous inguinal herniorrhaphy. Intraoperative nerve damage and disposition to other chronic pain conditions are among the most likely pathogenic factors.......To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation...

Genetic variation in the 3’ untranslated region of dengue virus serotype 3 strains isolated from mosquitoes and humans in Brazil

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de Castro Márcia Gonçalves

2013-01-01

Full Text Available Summary Background Dengue, a mosquito-borne viral infection caused by one of the four dengue virus (DENV serotypes (DENV-1 to 4, replicate alternately on the mosquito vector and human host and are responsible for infections throughout tropical and subtropical regions of the world. In Brazil, the disease has become a major public health problem and the introduction of DENV-3 in 2000 in Rio de Janeiro (RJ was associated with severe dengue epidemics. The potential emergence of strains associated with severe disease highlights the need for the surveillance of DENV in human host and vectors. Methods Aiming to contribute for DENV phylogenetic and vector-virus-human host studies, we sequenced the entire genome of one DENV-3 isolated from naturally infected Aedes aegypti from RJ in 2001 and characterized the 3’ UTR from strains isolated from mosquitoes and humans. Mosquitoes were pooled and submitted to virus isolation in Ae. albopictus C6/36 cells and the infecting serotype was identified by immunofluorescence using type-specific monoclonal antibody. Sequence analysis was performed using BioEdit software, the multiple alignments were performed using CLUSTAL W and the phylogenetic analysis by MEGA 5, using the Neighbor-joining method. Secondary structure prediction was performed by using the MFOLD program. Results Exclusive substitutions and a substitution leading to a stop codon on the NS5 gene were observed in the DENV-3 isolated from a naturally infected Ae. aegypti and fully sequenced. As an 8- nucleotides deletion was observed within the 11- nucleotides (nts insertion on the variable region (VR from the 3′UTR in this isolate, we further sequenced other DENV-3 from both mosquitoes and humans. The majority of DENV-3 from RJ analyzed were characterized by the 11-nts insertion in the VR of the 3′UTR, despite the observation of strains carrying the 8-nts deletion. The latter presented similar secondary structures, however not all strains

Repair of inguinal hernia: a comparison between extraperitoneal laparoscopy and Lichtenstein open surgery

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Tavassoli A

2010-06-01

Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The inguinal hernia is a common disorder in general surgery. Different methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia."n"nMethods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared."n"nResults: The operation duration, the rate of complications and frequency of recurrence were similar in two groups; but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the

Application of serum microRNA-9-5p, 21-5p, and 223-3p combined with tumor markers in the diagnosis of non-small-cell lung cancer in Yunnan in southwestern China.

Science.gov (United States)

Yang, Yanlong; Chen, Kai; Zhou, Yongchun; Hu, Zaoxiu; Chen, Shuai; Huang, Yunchao

2018-01-01

Xuanwei City is located in late Permian coal-accumulating areas of the northeastern region of Yunnan Province. In China, morbidity and mortality from lung cancer are highest in Yunnan. Identifying useful circulating markers suitable for the diagnosis of lung cancer in this region is quite meaningful. In this study, we evaluated diagnostic roles of serum miR-9-5p, 21-5p, 223-3p, 135b-5p, 339-5p, and 501-5p in patients with non-small-cell lung cancer (NSCLC) in Yunnan. Moreover, we evaluated the diagnostic performance of several tumor markers, including carcinoembryonic antigen (CEA), cytokeratin 19 fragment 21-1 (CYFRA21-1), and squamous cell carcinoma-related antigen (SCC). Quantitative real-time polymerase chain reaction detected six miRNAs in the serum of 104 NSCLC patients and 50 cancer-free controls. Other markers, including CEA, CYFRA21-1, and SCC, in serum were also measured. The diagnostic ability of miRNAs and tumor markers was evaluated by receiver operating characteristic (ROC) curve analysis. The diagnostic performance of these serum markers was also evaluated in Xuanwei and non-Xuanwei subjects, because the etiological and the epidemiological characteristics of lung cancer in Xuanwei were quite different from those in other regions. Serum miR-9-5p, miR-21-5p, miR-223-3p, CEA, CYFRA21-1, and SCC were upregulated in NSCLC patients, compared with cancer-free controls. No significant difference was found in miR-135b-5p, miR-339-5p, and miR-501-5p expression. The area under ROC curves (AUCs) of miR-9-5p, miR-21-5p, miR-223-3p, CEA, CYFRA21-1, and SCC were 0.706, 0.765, 0.744, 0.749, 0.735, and 0.616, respectively. When combined, miRNAs and tumor markers yielded the highest diagnostic power, with AUC of 0.886, sensitivity of 82.69%, and specificity of 88.00%. In Xuanwei subjects, miR-223-3p and CEA may be suitable biomarkers to distinguish NSCLC from cancer-free states with AUCs of 0.752 and 0.791, respectively. The diagnostic power of the combination of mi

Study on the mechanism of the 3He+p→p+p+d reaction at 3He momentum of 5 GeV/c

International Nuclear Information System (INIS)

Blinov, A.V.; Chuvilo, I.V.; Drobot, V.V.

1985-01-01

The mechanism of the reaction 3 He+p → p+p+d is studied making use of the ITEP 80-cm liquid-hydrogen bubble chamber exposed to the beam of 5 GeV/c 3 He nuclei. The reaction cross sections is equal to 20.6+-0.3 mb. The phase space regions associated with quasi-free scattering (QFS) and final state interaction (FSI) are selected. Angular, mass and momentum distributions of the reaction products are obtained in the entire kinematically allowed range. The experimental data in the QFS region are compared with theoretical calculations based on the simplest pole diagram approximation. The 3 He and deuteron wave functions (WF) correspond to the realistic Reid potential. The D-wave components of these WF are taken into account. The absolute value of the cross section and shape of the distributions are described as a whole reasonably enough in the frame of the considered model in the kinematical region where FSI may be neglected

The role of peripheral afferents in persistent inguinal postherniorrhaphy pain

DEFF Research Database (Denmark)

Wijayasinghe, N; Ringsted, T K; Bischoff, J M

2016-01-01

) in the medial aspect of the inguinal region that triggers pain upon minimal pressure. As TPs may play a role in the pathophysiology of PIPP, the aim of this trial was to investigate the analgesic effects of local anaesthetic TP-blockade. METHODS: A randomized, double-blind, placebo-controlled, crossover trial......-algometry) and quantitative sensory testing (pressure pain thresholds, thermal detection/pain thresholds, supra-threshold heat perception), before and after the TP-blockade. RESULTS: The median (95% CI) reduction in pain was 63% (44.1 to 73.6%) after bupivacaine compared with 36% (11.6 to 49.7%; P=0.003) after placebo....... Significant increases in cool detection (P=0.01) and pressure pain thresholds (P=0.009) with decreases in supra-threshold heat pain perception (P=0.003) were seen after bupivacaine only. In four out of six volunteers, increased thermal and evoked-pain thresholds after bupivacaine compared with placebo...

A 5‑year Review of Darning Technique of Inguinal Hernia Repair

African Journals Online (AJOL)

modes of presentation,[8,9] and in many hospitals where the experience ... will be ideal. This study aims to present our experience with the use of the. Darning technique for repair of inguinal hernia in a Nigerian ... Study Design: A descriptive retrospective study ... site infection was the most common complication occurring in.

Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

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Reza Firoozabadi

2015-09-01

Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

Post test analysis of TEPSS tests -P2-, -P3-, -P5- and -P7- using the system code RELAP5/MOD 3.2

International Nuclear Information System (INIS)

Luebbesmeyer, D.

2000-01-01

For the PANDA-Test-Facility (TEPSS configuration) post-test calculations and analyses have been performed for experiment -P2- (Early Start), -P3- (PCC start up), -P5- (Symmetric case, Two PCCs only) and -P7- (Severe Accident). Post test calculations have been performed with the system code RELAP5/Mod 3.2 using two different nodalization of the PANDA facility namely a basis nodalization and a much reduced one. The general trend of the calculations can be summarised: RELAP5/Mod3.2 calculated the general trends of the experiments sufficiently accurate; Using the reduced nodalization the results seem to be slightly more accurate than for the basic nodalization; On the other hand, calculations based on the reduced nodalization are not significantly faster than those with basic nodalization; The mass error is in the order of 200 to 900 kg. (author)

Paternal uniparental isodisomy of chromosome 11p15.5 within the pancreas causes isolated hyperinsulinaemic hypoglycaemia

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Sarah E Flanagan

2011-11-01

Full Text Available BackgroundLoss of function mutations in the genes encoding the pancreatic β-cell ATP-sensitive potassium (KATP channel are identified in approximately 80% of patients with diazoxide-unresponsive hyperinsulinaemic-hypoglycaemia (HH. For a small number of patients HH can occur as part of a multisystem disease such as Beckwith-Wiedemann syndrome (BWS. In approximately 20% of patients, BWS results from chromosome 11 paternal uniparental disomy (UPD, which causes dysregulation of imprinted growth regulation genes at 11p15.5. There is a considerable range in the clinical features and phenotypic severity associated with BWS which is likely to be due to somatic mosaicism. The cause of HH in these patients is not known.Research Design and methodsWe undertook microsatellite analysis of 12 markers spanning chromosome 11p in two patients with severe HH and diffuse disease requiring a pancreatectomy. In both patients mutations in the KATP channel genes had not been identified. ResultsWe identified segmental paternal UPD in DNA extracted from pancreatic tissue in both patients. UPD was not observed in DNA extracted from the patient’s leukocytes or buccal samples. In both cases the UPD encompassed the differentially methylated region at chromosome 11p15.5. Despite this neither patient had any further features of BWS.ConclusionsPaternal UPD of the chromosome 11p15.5 differentially methylated region limited to the pancreatic tissue may represent a novel cause of isolated diazoxide unresponsive HH. Loss of heterozygosity studies should therefore be considered in all patients with severe HH who have undergone pancreatic surgery when KATP channel mutation(s have not been identified.

Laparoscopic Repair of Inguinal Hernias

OpenAIRE

Carter, Jonathan; Duh, Quan-Yang

2011-01-01

For patients with recurrent inguinal hernia, or bilateral inguinal hernia, or for women, laparoscopic repair offers significant advantages over open techniques with regard to recurrence risk, pain, and recovery. For unilateral first-time hernias, either laparoscopic or open repair with mesh can offer excellent results. The major drawback of laparoscopy is that the technique requires a significant number of cases to master. For surgeons in group practice, it makes sense to have one surgeon in ...

Isolation of a novel protein, P12-from adult Drosophila melanogaster that inhibits deoxyribonucleoside and protein kinase activities and activates 3'-5'-exonuclease activity

DEFF Research Database (Denmark)

Christiansen, Louise Slot; Zanten, Gabriella van; Berenstein, Dvora

2016-01-01

We have previously found that Drosophila melanogaster only has one deoxyribonucleoside kinase, Dm-dNK, however, capable to phosphorylate all four natural deoxyribonucleosides. Dm-dNK was originally isolated from an embryonic cell line. We wanted to study the expression of Dm-dNK during development......-dNK, also inhibited the two protein kinases to the same degree. Furthermore, testing P12 in a DNA polymerase based assay we found that the 3'-5'-exonuclease part of the DNA polymerase (Klenow polymerase) was activated....

Salidroside Inhibits Myogenesis by Modulating p-Smad3-Induced Myf5 Transcription

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Peng Zhang

2018-03-01

Full Text Available Aim: Salidroside is an active compound extracted from Rhodiola rosea which is used to alleviate fatigue and enhance endurance in high altitude regions. Some studies have demonstrated that salidroside can affect precursor cell differentiation in hematopoietic stem cells, erythrocytes, and osteoblasts. The aim of this study was to investigate the effect of salidroside on myoblast differentiation and to explore the underlying molecular mechanisms of this effect.Methods: C2C12 myoblast cells were treated with different concentrations of salidroside in differentiation media. Real-time PCR, Western blotting, and immunofluorescence assay were employed to evaluate the effects of salidroside on C2C12 differentiation. RNA interference was used to reveal the important role of Myf5 in myogenesis inhibited by salidroside. Chromatin Immunoprecipitation and dual-luciferase reporter assay were utilized to explore the underlying mechanisms of salidroside-induced upregulation of Myf5.Results: We found that salidroside inhibits myogenesis by downregulating MyoD and myogenin, preserves undifferentiated reserve cell pools by upregulating Myf5. Knocking down Myf5 expression significantly rescued the myogenesis inhibited by salidroside. The effect of salidroside on myogenesis was associated with increased phosphorylated Smad3 (p-Smad3. Both SIS3 (Specific inhibitor of p-Smad3 and dominant negative Smad3 plasmid (DN-Smad3 attenuated the inhibitory effect of salidroside on C2C12 differentiation. Moreover, the induction of Myf5 transcription by salidroside was dependent on a Smad-binding site in the promoter region of Myf5 gene.Conclusion and Implications: Our findings identify a novel role and mechanism for salidroside in regulating myogenesis through p-Smad3-induced Myf5 transcription, which may have implications for its further application in combating degenerative muscular diseases caused by depletion of muscle stem cells, such as Duchenne muscular dystrophy or

Day case inguinal hernia surgery in Nigerian children: Prospective ...

African Journals Online (AJOL)

required readmission into the hospital. Conclusion: Day case inguinal hernia surgery in children is safe and well accepted by patients and parents alike. Health institutions in which children with inguinal hernias still queue for long periods for space on the operation list need to adopt day case surgery for inguinal hernia in ...

Preparation of a nano- and micro-fibrous decellularized scaffold seeded with autologous mesenchymal stem cells for inguinal hernia repair

Directory of Open Access Journals (Sweden)

Zhang Y

2017-02-01

Full Text Available Yinlong Zhang,1,* Yuanyuan Zhou,1,* Xu Zhou,2,* Bin Zhao,1,* Jie Chai,1 Hongyi Liu,1 Yifei Zheng,1 Jinling Wang,3 Yaozong Wang,4 Yilin Zhao2 1Medical College, Xiamen University, 2Department of Oncology and Vascular Intervention Radiology, 3Department of Emergency, 4Department of Orthopaedics, Zhongshan Hospital, Xiamen University, Xiamen, People’s Republic of China *These authors contributed equally to this work Abstract: Prosthetic meshes used for hernioplasty are usually complicated with chronic pain due to avascular fibrotic scar or mesh shrinkage. In this study, we developed a tissue-engineered mesh (TEM by seeding autologous bone marrow-derived mesenchymal stem cells onto nanosized fibers decellularized aorta (DA. DA was achieved by decellularizing the aorta sample sequentially with physical, mechanical, biological enzymatic digestion, and chemical detergent processes. The tertiary structure of DA was constituted with micro-, submicro-, and nanosized fibers, and the original strength of fresh aorta was retained. Inguinal hernia rabbit models were treated with TEMs or acellular meshes (AMs. After implantation, TEM-treated rabbit models showed no hernia recurrence, whereas AM-treated animals displayed bulges in inguinal area. At harvest, TEMs were thicker, have less adhesion, and have stronger mechanical strength compared to AMs (P<0.05. Moreover, TEM showed better cell infiltration, tissue regeneration, and neovascularization (P<0.05. Therefore, these cell-seeded DAs with nanosized fibers have potential for use in inguinal hernioplasty. Keywords: nanobiomaterial, tissue engineering, inguinal hernia, hernioplasty, decellularized aorta 

Recurrence and complications of pediatric inguinal hernia repair ...

African Journals Online (AJOL)

complications of inguinal hernia repair in pediatric patients ... surgery. Patients and methods This retrospective study was ... Bilateral inguinal hernia was observed ..... single-blind comparison of laparoscopic versus open repair of pediatric.

Postoperative urinary retention after inguinal hernia repair: a single institution experience.

Science.gov (United States)

Blair, A B; Dwarakanath, A; Mehta, A; Liang, H; Hui, X; Wyman, C; Ouanes, J P P; Nguyen, H T

2017-12-01

Inguinal hernia repair is a common general surgery procedure with low morbidity. However, postoperative urinary retention (PUR) occurs in up to 22% of patients, resulting in further extraneous treatments.This single institution series investigates whether patient comorbidities, surgical approaches, and anesthesia methods are associated with developing PUR after inguinal hernia repairs. This is a single institution retrospective review of inguinal hernia from 2012 to 2015. PUR was defined as patients without a postoperative urinary catheter who subsequently required bladder decompression due to an inability to void. Univariate and multivariate logistic regressions were performed to quantify the associations between patient, surgical, and anesthetic factors with PUR. Stratification analysis was conducted at age of 50 years. 445 patients were included (42.9% laparoscopic and 57.1% open). Overall rate of PUR was 11.2% (12% laparoscopic, 10.6% open, and p = 0.64). In univariate analysis, PUR was significantly associated with patient age >50 and history of benign prostatic hyperplasia (BPH). Risk stratification for age >50 revealed in this cohort a 2.49 times increased PUR risk with lack of intraoperative bladder decompression (p = 0.013). At our institution, we found that patient age, history of BPH, and bilateral repair were associated with PUR after inguinal hernia repair. No association was found with PUR and laparoscopic vs open approach. Older males may be at higher risk without intraoperative bladder decompression, and therefore, catheter placement should be considered in this population, regardless of surgical approach.

Differences in gaze behaviour of expert and junior surgeons performing open inguinal hernia repair.

Science.gov (United States)

Tien, Tony; Pucher, Philip H; Sodergren, Mikael H; Sriskandarajah, Kumuthan; Yang, Guang-Zhong; Darzi, Ara

2015-02-01

Various fields have used gaze behaviour to evaluate task proficiency. This may also apply to surgery for the assessment of technical skill, but has not previously been explored in live surgery. The aim was to assess differences in gaze behaviour between expert and junior surgeons during open inguinal hernia repair. Gaze behaviour of expert and junior surgeons (defined by operative experience) performing the operation was recorded using eye-tracking glasses (SMI Eye Tracking Glasses 2.0, SensoMotoric Instruments, Germany). Primary endpoints were fixation frequency (steady eye gaze rate) and dwell time (fixation and saccades duration) and were analysed for designated areas of interest in the subject's visual field. Secondary endpoints were maximum pupil size, pupil rate of change (change frequency in pupil size) and pupil entropy (predictability of pupil change). NASA TLX scale measured perceived workload. Recorded metrics were compared between groups for the entire procedure and for comparable procedural segments. Twenty-five cases were recorded, with 13 operations analysed, from 9 surgeons giving 630 min of data, recorded at 30 Hz. Experts demonstrated higher fixation frequency (median[IQR] 1.86 [0.3] vs 0.96 [0.3]; P = 0.006) and dwell time on the operative site during application of mesh (792 [159] vs 469 [109] s; P = 0.028), closure of the external oblique (1.79 [0.2] vs 1.20 [0.6]; P = 0.003) (625 [154] vs 448 [147] s; P = 0.032) and dwelled more on the sterile field during cutting of mesh (716 [173] vs 268 [297] s; P = 0.019). NASA TLX scores indicated experts found the procedure less mentally demanding than juniors (3 [2] vs 12 [5.2]; P = 0.038). No subjects reported problems with wearing of the device, or obstruction of view. Use of portable eye-tracking technology in open surgery is feasible, without impinging surgical performance. Differences in gaze behaviour during open inguinal hernia repair can be seen between expert and junior surgeons and may have

African Heath Sciences Vol 5 No 3back up.p65

African Journals Online (AJOL)

FOMCS2

developed femoral triangle sepsis at the cannulation site and aneurysm of the external iliac artery. The aneurysm later ruptured ... additional history of leg swelling of 4 months duration was obtained. ... line of femoral artery, incising the inguinal ligament, ex- ploration ... haematoma forms with a central area that remains fluid.

Avoiding cord extraction or mobilization during pediatric inguinal ...

African Journals Online (AJOL)

inguinal hernia repair: a step midway between conventional ... the left side, and 19 were bilateral. The mean ... The conventional open approach through inguinal inci- sion is the ... using laparoscopy has gained popularity and many studies.

Early assessment of bilateral inguinal hernia repair: A comparison between the laparoscopic total extraperitoneal and Stoppa approaches

Directory of Open Access Journals (Sweden)

Edivaldo Massazo Utiyama

2016-01-01

Full Text Available Background: The present clinical trial was designed to compare the results of bilateral inguinal hernia repair between patients who underwent the conventional Stoppa technique and laparoscopic total extraperitoneal repair (LTE with a single mesh and without staple fixation. Patients and Methods: This controlled, randomised clinical trial was conducted at General Surgery and Trauma of the Clinics Hospital, Medical School, the University of São Paulo between September 2010 and February 2011. Totally, 50 male patients, with a bilateral inguinal hernia, older than 25 years were considered eligible for the study. The following parameters were analysed during the early post-operative period: (1 The intensity of surgical trauma, operation time, C-reactive protein (CRP levels, white blood cell count, bleeding and pain intensity; (2 quality of life assessment; and (3 post-operative complications. Results: LTE procedure was longer than the Stoppa procedure (134.6 min ± 38.3 vs. 90.6 min ± 41.3; P 0.05. There was no difference in pain during the 1st and 7th post-operative, physical functioning, physical limitation, the impact of pain on daily activities, and the Carolinas Comfort Scale during the 7th and 15th post-operative (P > 0.05. Complications occurred in 88% of Stoppa group (22 patients and 64% in LTE group (16 patients (P < 0.05. Conclusion: The comparative study between the Stoppa and LTE approaches for the bilateral inguinal hernia repair demonstrated that: (1 The LTE approach showed less surgical trauma despite the longer operation time; (2 Quality of life during the early post-operative period were similar; and (3 Complication rates were higher in the Stoppa group.

Adenocarcinoma arising at a colostomy site with inguinal lymph node metastasis: report of a case.

Science.gov (United States)

Iwamoto, Masayoshi; Kawada, Kenji; Hida, Koya; Hasegawa, Suguru; Sakai, Yoshiharu

2015-02-01

Inguinal lymph node metastasis from adenocarcinoma arising at a colostomy site is extremely rare, and the significance of surgical resection for metastatic inguinal lymph nodes has not been established. An 82-year-old woman who had undergone abdominoperineal resection 27 years earlier was admitted to our hospital complaining of bleeding from a colostomy. Physical examination revealed that a tumor at the colostomy site directly invaded into the peristomal skin, and that a left inguinal lymph node was firm and swollen. Positron emission tomography/computed tomography scan demonstrated accumulation of (18)F-fluorodeoxy glucose into both the colostomy tumor and the left swollen inguinal lymph node, while there was no evidence of metastasis to liver or lungs. She underwent open left hemicolectomy with wide local resection of the colostomy, and dissection of left inguinal lymph nodes. Histological diagnosis was a moderately differentiated adenocarcinoma that directly invaded into the surrounding skin and metastasized to the left inguinal lymph node. The patient has been followed up for >5 years without any sign of recurrence. In general, inguinal lymph node metastasis from colorectal cancers is regarded as a systemic disease with a poor prognosis, and so systemic chemotherapy and radiotherapy, but not surgical lymph node dissection, are recommended. Considering the lymphatic drainage route in the present case, inguinal lymph node metastasis does not represent a systemic disease but rather a sentinel nodal metastasis from adenocarcinoma at a colostomy site. Surgical dissection of metastatic inguinal lymph nodes should be considered to enable a favorable prognosis in the absence of distant metastasis to other organs. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Two-trocar needlescopic approach to incarcerated inguinal hernia in children.

Science.gov (United States)

Shalaby, Rafik; Shams, Abdul Moniem; Mohamed, Soliman; el-Leathy, Mohamed; Ibrahem, Medhat; Alsaed, Gamal

2007-07-01

Many studies described the safety and effectiveness of laparoscopy in the treatment of inguinal hernia in children. Needlescopic techniques have been recently used in repairing inguinal hernias, which made this type of surgery more cosmetic and less invasive. However, few reports have described its role in the treatment of incarcerated inguinal hernia. The aim of this study was to assess the feasibility and outcome of needlescopy in the treatment of incarcerated inguinal hernia in children. A total of 250 children, comprising 190 boys and 60 girls, who presented with incarcerated inguinal hernia were analyzed. Their ages ranged from 6 months to 6 years (mean age, 2 years). In 170 (68%) cases, manual reduction was successful. One hundred of these patients were subjected to definitive surgery in the same day, whereas the remaining 70 patients were subjected to needlescopy 1 to 3 days later. In 80 (32%) cases, external manual reduction was unsuccessful. These children were subjected to urgent needlescopic reduction and herniorrhaphy. The incarcerated herniae were easily reduced and the contents thoroughly inspected under direct vision. Then the hernia was repaired in the same setting. In all patients, there was no need to convert the procedure to an open approach. Immediate needlescopic herniorrhaphy in the same session was added without significant increase in operative time. The mean operative time is 10 minutes. There were no intraoperative complications. The study showed that needlescopic approach to incarcerated inguinal hernia in children is feasible, safe, easy, and preferable to the open surgery. In addition to reduction of incarcerated hernial contents under direct vision, it allows definitive treatment of hernial defect at the same time without significant increase in operative time and hospital stay.

Technology development of p-type microstrip detectors with radiation hard p-spray isolation

International Nuclear Information System (INIS)

Pellegrini, G.; Fleta, C.; Campabadal, F.; Diez, S.; Lozano, M.; Rafi, J.M.; Ullan, M.

2006-01-01

A technology for the fabrication of p-type microstrip silicon radiation detectors using p-spray implant isolation has been developed at CNM-IMB. The p-spray isolation has been optimized in order to withstand a gamma irradiation dose up to 50 Mrad (Si), which represents the ionization radiation dose expected in the middle region of the SCT-Atlas detector of the future Super-LHC during 10 years of operation. The best technological options for the p-spray implant were found by using a simulation software package and dedicated calibration runs. Using the optimized technology, detectors have been fabricated in the Clean Room facility of CNM-IMB, and characterized by reverse current and capacitance measurements before and after irradiation. The average full depletion voltage measured on the non-irradiated detectors was V FD =41±3 V, while the leakage current density for the microstrip devices at V FD +20 V was 400 nA/cm 2

Analgesia pós-operatória em cirurgia ortopédica: estudo comparativo entre o bloqueio do plexo lombar por via perivascular inguinal (3 em 1 com ropivacaína e a analgesia subaracnóidea com morfina Analgesia pós-operatoria en cirugía ortopédica: estudio comparativo entre el bloqueo del plexo lombar por vía perivascular inguinal (3 en 1 con ropivacaína y la analgesia subaracnóidea con morfina Postoperative analgesia following orthopedic surgery: a study comparing perivascular lumbar plexus inguinal block with ropivacaine (3 in 1 and spinal anesthesia with morphine

Directory of Open Access Journals (Sweden)

Neuber Martins Fonseca

2003-04-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo lombar pelo acesso perivascular inguinal, chamado de bloqueio 3 em 1, tem sido utilizado para analgesia pós-operatória. O objetivo deste estudo foi comparar a analgesia pós-operatória do bloqueio 3 em 1 a da morfina subaracnóidea em pacientes submetidos a cirurgias ortopédicas em membro inferior (MI. MÉTODO: Foram estudados 40 pacientes escalados para cirurgia ortopédica de MI, de ambos os sexos, estado físico ASA I e II, com idades entre 15 e 75 anos, distribuídos em 2 grupos (M e BPL. Foi realizada anestesia subaracnóidea em todos os pacientes, em L3-L4 ou L4-L5, com 20 mg de bupivacaína isobárica a 0,5%. No grupo M (n = 20 foi associado 50 µg de morfina ao anestésico local. No grupo BPL (n = 20 foi realizado o bloqueio 3 em 1 ao término da cirurgia, utilizando 200 mg de ropivacaína a 0,5%. Avaliou-se a analgesia e a intensidade da dor às 4, 8, 12, 14, 16, 20 e 24 horas após o término da cirurgia, o nível do bloqueio subaracnóideo, o tempo cirúrgico e as complicações. RESULTADOS: A duração da analgesia no grupo BPL foi de 13,1 ± 2,47, enquanto no grupo M todos os pacientes referiam dor e ausência de bloqueio motor no primeiro instante avaliado (4 horas. Houve falha do bloqueio de um dos 3 nervos em 3 pacientes. A incidência de náusea e prurido foi significativamente maior no grupo M. Quanto à retenção urinária, não houve diferença significante entre os grupos. Não houve depressão respiratória, hipotensão arterial ou bradicardia. A analgesia pós-operatória foi mais efetiva no grupo BPL, comparada ao grupo M às 4, 8, 12,14 e 16 horas. Às 20 e 24 horas não houve diferença significante entre os grupos. CONCLUSÕES: A analgesia pós-operatória proporcionada pelo bloqueio 3 em 1 apresentou efeitos colaterais inferiores à morfina subaracnóidea com tempo de analgesia semelhante.JUSTIFICATIVA Y OBJETIVOS: El bloqueo del plexo lumbar por el acceso

A Longitudinal Supra-Inguinal Fascia Iliaca Compartment Block Reduces Morphine Consumption After Total Hip Arthroplasty.

Science.gov (United States)

Desmet, Matthias; Vermeylen, Kris; Van Herreweghe, Imré; Carlier, Laurence; Soetens, Filiep; Lambrecht, Stijn; Croes, Kathleen; Pottel, Hans; Van de Velde, Marc

The role of a fascia iliaca compartment block (FICB) for postoperative analgesia after total hip arthroplasty (THA) remains questionable. High-dose local anesthetics and a proximal injection site may be essential for successful analgesia. High-dose local anesthetics may pose a risk for local anesthetic systemic toxicity. We hypothesized that a high-dose longitudinal supra-inguinal FICB is safe and decreases postoperative morphine consumption after anterior approach THA. We conducted a prospective, double blind, randomized controlled trial. Patients scheduled for THA were randomized to group FICB (longitudinal supra-inguinal FICB with 40-mL ropivacaine 0.5%) or group C (control, no block). Standard hypothesis tests (t test or Mann-Whitney U test, χ test) were performed to analyze baseline characteristics and outcome parameters. The primary end point of the study was total morphine (mg) consumption at 24 hours postoperatively. Serial total and free ropivacaine serum levels were determined in 10 patients. After obtaining ethical committee approval and written informed consent, 88 patients were included. Mean (SD) morphine consumption at 24 hours postoperatively was reduced in group FICB compared to group C: 10.25 (1.64) mg versus 19.0 (2.4) mg (P = 0.004). Using a mean dose of 2.6-mg/kg ropivacaine (range, 2-3.4 mg/kg), none of the patients had total or free ropivacaine levels above the maximum tolerated serum concentration. We conclude that a high-dose longitudinal supra-inguinal FICB reduces postoperative morphine requirements after anterior approach THA.Clinical Trials Registry: EU Clinical Trials Register. www.clinicaltrialsregister.eu #2014-002122-12.

Trans rectus sheath extra-peritoneal procedure (TREPP) for inguinal hernia: the first 1,000 patients.

Science.gov (United States)

Lange, J F M; Lange, M M; Voropai, D A; van Tilburg, M W A; Pierie, J P E N; Ploeg, R J; Akkersdijk, W L

2014-08-01

After the introduction of mesh in inguinal hernia repair, the focus to improve surgical technique has changed from recurrence to chronic postoperative inguinal pain. At present, the most common surgical techniques are the Lichtenstein hernioplasty and total extraperitoneal procedure. Both techniques have their own specific disadvantages, with regard to potential nerve damage and the necessity of general anesthesia, respectively. The goal of this study was to evaluate the results of a new technique in which the inguinal nerves are not at risk, and in which general anesthesia is not needed: trans rectus sheath extraperitoneal procedure (TREPP). Between 2006 and 2010, a total of 1,000 patients were treated for inguinal hernia with TREPP. A questionnaire concerning pain, sensibility changes, patient satisfaction, and recurrence was sent to all patients. The questionnaire was completed by 932 patients. Almost 90% of patients had not experienced any pain since the surgical procedure; 8% of patients reported experiencing some pain, but less than preoperatively; and 2% of patients reported an increase in pain postoperatively. Recurrence occurred in 1 and 3% were unsure about this. Reduced sensibility of the scar, scrotum, and upper leg was reported by 12.4, 1.4, and 1.5%, respectively. Overall, 97.4% of patients were satisfied with the results of the surgical procedure. The time period in which TREPP was performed was not associated with any of the outcome measures. TREPP has proven to be a feasible new technique for inguinal hernia repair, with excellent results, justifying a randomized controlled trial in which TREPP should be compared with standard techniques.

An internal duplication in the 5' noncoding region of strain H: a bovine viral diarrhoea virus (BVDV) isolated from pigs

NARCIS (Netherlands)

Gennip, van H.G.P.; Widjojoatmodjo, M.N.; Smit, de A.J.; Moormann, R.J.M.

1999-01-01

A pig pestivirus isolate, strain H, was characterized by using reverse transcription-PCR (RT-PCR) and direct sequencing of the amplicons. A duplication of 74 nucleotides was found at the 5' terminus of the 5' noncoding (NC) region, which was also found in RNA isolates from tonsils from two other

Factors Influencing Choice of Inguinal Hernia Repair Technique ...

African Journals Online (AJOL)

Background: Inguinal hernia repair surgery is one of the most frequently performed surgical procedures worldwide. This study sought to highlight factors that may influence decisions concerning inguinal hernia repair techniques. Methods: This descriptive crosssectional study was carried out in September 2014 among ...

Ethnicity-related differences in inguinal canal dimensions between African and Caucasian populations and their potential impact on the mesh size for open and laparoscopic groin hernia repair in low-resource countries in Africa.

Science.gov (United States)

Mitura, Kryspin; Kozieł, Sławomir; Pasierbek, Michał

2018-03-01

Access to surgery in Africa is significantly limited. Treatment outcomes in Africa differ significantly compared to those achieved in Europe or the US. Therefore, to popularise tension-free repair, it is essential to determine the economically justified mesh size for the African population. To conduct anthropometric evaluation of the inguinal canal in African and European patients to determine its potential consequences for the mesh size for open and laparoscopic hernia repair. The measurements were made in 44 adult males in Africa (group I) and were compared to measurements in 45 consecutive Caucasian males (group II). The mean age of patients was respectively 48.3 and 51.2 years. There was no statistically significant difference in the internal ring diameter between groups (2.2 vs. 2.1 cm; p = 0.58). The distance between the pubic tubercle and the inferomedial border of the internal inguinal ring was significantly shorter in group I (3.8 vs. 5.1 cm; p < 0.001). A similar difference was found in the length of transverse arch aponeurosis (2.9 vs. 4.0 cm; p < 0.001). The distance between the pubic tubercle and anterior superior iliac spine in group I was approximately 2 cm shorter on each side (10.0 vs. 11.8 cm; p < 0.001). The anatomical differences in inguinal dimensions between Central African and European populations support the potential need to adjust the standard size of synthetic mesh used for hernia repair to the needs of local populations. The significantly smaller dimensions of the inguinal canal in African males may allow the use of smaller meshes.

Pitfalls in the diagnosis and management of inguinal lymphogranuloma venereum: important lessons from a case series.

Science.gov (United States)

Oud, Emerentiana Veronica; de Vrieze, Nynke Hesselina Neeltje; de Meij, Arjan; de Vries, Henry John C

2014-06-01

Current lymphogranuloma venereum (LGV) guidelines mainly focus on anorectal infections. Inguinal LGV infections have been rare in the current epidemic among men who have sex with men (MSM), but might require a different approach not yet recommended in current guidelines for the treatment and diagnosis of LGV. We describe 4 inguinal LGV cases. Three MSM developed inguinal LGV infection several weeks after a previous consultation, of which two had received azithromycin after being notified for LGV. Three failed the recommended 21 days doxycycline treatment. These inguinal LGV cases highlight 3 pitfalls in the current standard management of LGV: (1) Urethral chlamydia infections in MSM can be caused by LGV biovars that in contrast to non-LGV biovars require prolonged antibiotic therapy. (2) The recommended one gram azithromycin contact treatment seems insufficient to prevent established infections. (3) Inguinal LGV may require prolonged courses of doxycycline, exceeding the currently advised 21 days regimen. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Academic Performance in Adolescence after Inguinal Hernia Repair in Infancy: A Nationwide Cohort Study

DEFF Research Database (Denmark)

Hansen, Tom G; Pedersen, Jacob K; Henneberg, Steen Winther

2011-01-01

for inguinal hernia repair in infancy and subsequent academic performance. METHODS:: Using Danish birth cohorts from 1986-1990, we compared the academic performance of all children who had undergone inguinal hernia repair in infancy to a randomly selected, age-matched 5% population sample. Primary analysis...... compared average test scores at ninth grade adjusting for sex, birth weight, and paternal and maternal age and education. Secondary analysis compared the proportions of children not attaining test scores between the two groups. RESULTS:: From 1986-1990 in Denmark, 2,689 children underwent inguinal hernia...... repair in infancy. A randomly selected, age-matched 5% population sample consists of 14,575 individuals. Although the exposure group performed worse than the control group (average score 0.26 lower; 95% CI, 0.21-0.31), after adjusting for known confounders, no statistically significant difference (-0...

Treatment for incarcerated indirect hernia with "Cross-Internal Ring" inguinal oblique incision in children.

Science.gov (United States)

Yan, Xue-Qiang; Yang, Jun; Zheng, Nan-Nan; Kuang, Hou-Fang; Duan, Xu-Fei; Bian, Hong-Qiang

2017-01-01

This study aims to evaluate the utility of the "Cross-Internal Ring" inguinal oblique incision for the surgical treatment of incarcerated indirect hernia (IIH) complicated with severe abdominal distension. Patients of IIH complicated with severe abdominal distension were reviewed retrospectively. All patients received operation through the "Cross-Internal Ring" inguinal oblique incision. There were totally 13 patients were included, male to female ratio was 9-4. The time for patients to resume oral feeding varying from 2 to 5 days after operation, no complications include delayed intestinal perforation, intra-abdominal abscess, and incision infection happened. Average postoperative hospital stay was 5.2 days. All cases were followed up for 6-18 months. No recurrence or iatrogenic cryptorchidism happened. "Cross-Internal Ring" inguinal oblique incision is a simple, safe, and reliable surgical method to treat pediatric IIH complicated with severe abdominal distension.

Laparoscopic Inguinal Hernia Repair in a Developing Nation: Short ...

African Journals Online (AJOL)

bilateral hernias, and recurrent hernias), there are data demonstrating an ... no reports of laparoscopic inguinal hernia repair from the. Anglophone ... MATERIALS AND METHODS .... inguinal hernia repair has advantages over open repair for.

Comparison of post-operative wound infection after inguinal hernia repair with polypropylene mesh and polyester mesh

International Nuclear Information System (INIS)

Mughal, M.A.; Ahmed, M.; Sajid, M.T.; Mustafa, Q.U.A.; Shukr, I.; Ahsan, J.

2012-01-01

Objective: To compare post operative wound infection frequency after inguinal hernia repair with polypropylene and polyester mesh using standard Lichtenstein hernioplasty technique. Study Design: Randomized controlled trial. Place and Duration: This study was conducted at general surgery department CMH/MH Rawalpindi from 8th April 2007 to 1st Jan 2008 over a period of 09 months. Patients and Materials: Sixty patients received through outpatient department with diagnosis of inguinal hernia satisfying inclusion/exclusion criteria were included. Patients were divided into two groups randomly. Group 1 included those patients in whom polypropylene mesh was used while group II patients were implanted with polyester mesh. Demographic as well as data concerning post operative wound infection was collected and analyzed. Results: Fifty seven patients (95%) were males while remaining (05%) were females. Mean age in group I was 41.17+-9.99 years while in group II was 41.47+-9.79 years (p=0.907). One patient (3.3%) in each group developed wound infection diagnosed by clinical evidence of pain at wound site, redness, induration and purulent discharge. Conclusion: There is no difference in post operative wound infection rate after inguinal Lichtenstein hernioplasty using either polypropylene or polyester mesh. (author)

The system La(PO3)3-Ca(PO3)2-P2O5

International Nuclear Information System (INIS)

Jungowska, W.; Znamierowska, T.

1993-01-01

Ternary system La(PO 3 ) 3 -Ca(PO 3 ) 2 -P 2 O 5 has been studied by means of thermal and roentgenography analysis. The existence of single intermediate compound CaLa(PO 3 ) 5 has been observed. The phase diagrams for the ternary system as well as for two binary systems La(PO 3 ) 3 -Ca(PO 3 ) 2 and CaLa(PO 3 ) 5 -LaP 5 O 11 have been shown. 7 refs, 3 figs

Recurrence and Pain after Mesh Repair of Inguinal Hernias

African Journals Online (AJOL)

Abstract. Background: Surgery for inguinal hernias has ... repair. Methods: The study was conducted on all inguinal hernia patients operated between 1st. October ... bilateral (1.6%). Only 101 .... Open Mesh Versus Laparoscopic Mesh. Repair ...

Imaging findings of angiomyxolipoma of the spermatic cord mimicking inguinal hernia

NARCIS (Netherlands)

Cho, H.S.; Woo, J.Y.; Hong, H.S.; Yang, I.; Lee, Y.; Jung, A.Y.; Yang, D.H.; Kim, J.W.

2013-01-01

We report the case in a 72-year-old man who presented with a right inguinal mass and with a one month history that was initially interpreted as an inguinal hernia. Ultrasonography (US) and computed tomography (CT) demonstrated a right inguinal mass, including myxoid and fat component, extending from

CT and US findings of ovarian torsion within an incarcerated inguinal hernia.

Science.gov (United States)

Hyun, Park Mee; Jung, Ah Young; Lee, Yul; Yang, Ik; Yang, Dae Hyun; Hwang, Ji-Young

2015-02-01

Inguinal hernia is relatively common in children. Although inguinal hernia is not frequently encountered in girls in comparison to boys, there are occasional cases of uterine or ovarian herniation in female indirect inguinal hernia. Incarcerated ovary in hernia sac has the risk of torsion and strangulation. We present an 8-year-old girl with painful mass in her left groin. With computed tomography (CT) and ultrasonography (US), we made the diagnosis of ovarian strangulation within an incarcerated inguinal hernia. Since ultrasound is primarily used for evaluation of groin mass, CT findings of an incarcerated inguinal hernia is rarely reported.

Amyand′s hernia masquerading as a strangulated inguinal hernia: A case report and literature review

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Shahbaz Habib Faridi

2014-01-01

Full Text Available We report a rare case of a 62-year-old male who presented to surgical emergency department with the complaints of sudden onset pain and swelled in the right inguinal region with nausea, vomiting and abdominal distension. There was a history of a reducible swelling in the right inguino-scrotal region for the last 1 year. Based on history, clinical examination and investigations a provisional diagnosis of right-sided strangulated inguinal hernia was made and patient was planned for an emergency surgery. On the exploration, the hernial sac revealed a gangrenous vermiform appendix and the diagnosis of Amyand′s hernia was made. Appendectomy was performed through the same incision, and hernial repair was done using a polypropylene mesh.

Inguinal Hernia Repair Using Self-adhering Sutureless Mesh: Adhesix™: A 3-Year Follow-up with Low Chronic Pain and Recurrence Rate.

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Tabbara, Malek; Genser, Laurent; Bossi, Manuela; Barat, Maxime; Polliand, Claude; Carandina, Sergio; Barrat, Christophe

2016-02-01

To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh "Adhesix™" and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17-84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.

Pre-operative Spermatic Cord Ultrasonography Helps to Reduce the Incidence of Metachronous Inguinal Hernia in Boys

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Shoujiang Huang

2018-06-01

Full Text Available Background/purpose: Thickening of the spermatic cord is a clinical sign of an inguinal hernia. We therefore tested whether pre-operative spermatic cord ultrasonography could reduce the incidence of metachronous inguinal hernia (MIH.Methods: Boys under 2 years old with an initial unilateral inguinal hernia were enrolled in this study. In whom the width of the asymptomatic-sided spermatic cord was ≥0.5 cm, these patients underwent contralateral groin exploration. Age at initial operation, weight, initial operation side, the sonographic width of the spermatic cord, the operative findings and presence of MIH were recorded, and the relationship among them was studied. Boys in the US group underwent an open herniorrhaphy with pre-operative ultrasound examination; the non-US group included boys who did not undergo a pre-operative ultrasound examination. A receiver operator curve (ROC analysis was performed to evaluated predictive value of the sonographic width of the spermatic cord for contralateral hernia.Results: A total of 24 months' follow-up data were obtained from 1,793 boys (US group 1,162, non-US group 631. In the US group, the width of the hernia-sided spermatic cord (0.75 ± 0.18 cm was larger than the normal side (0.37 ± 0.05 cm, P < 0.001. And the width of normal side spermatic cord had no significant difference between the groups regarding other factors such as age and weight. In whom the width of the asymptomatic-sided spermatic cord was ≥0.5 cm, the corresponding incidence of CIH was 86.4% (57/66. The width of the spermatic cord predicted the presence of contralateral hernia with ROC area under the curve = 0.943 (95% CI = 0.919–0.966. The total incidence of MIH was 4.1% (74/1793. The incidence of MIH in the US group was 2.2% (25/1162 much lower than 7.8% (49/631 in the non-US group (P < 0.001. If the width of the asymptomatic-sided spermatic cord was 0.5 cm and 0.54 cm, the corresponding sensitivity was 0.682 and 0

The Danish Inguinal Hernia database.

Science.gov (United States)

Friis-Andersen, Hans; Bisgaard, Thue

2016-01-01

To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. Patients ≥18 years operated for groin hernia. Type and size of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time). All institutions have continuous access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles the medical management of the database. The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015). A total of 49 peer-reviewed national and international publications have been published from the database (June 2015). The Danish Inguinal Hernia Database is fully active monitoring surgical quality and contributes to the national and international surgical society to improve outcome after groin hernia repair.

The initial experience of introducing the Onstep technique for inguinal hernia repair in a general surgical department

DEFF Research Database (Denmark)

Andresen, K; Burcharth, Jakob Hornstrup Frølunde; Rosenberg, J

2015-01-01

BACKGROUND AND AIMS: A new technique for the repair of inguinal hernia, called Onstep, has been described. This technique places the mesh in the preperitoneal space medially and between the internal and external oblique muscles laterally. The Onstep technique has not yet been described outside...... repair. Inguinal Pain Questionnaire results: 95.5% reported no pain or pain that was easily ignored. CONCLUSIONS: It seems from this study that the Onstep technique is a safe method for inguinal hernia repair regarding perioperative and postoperative complications. The postoperative pain seems...

Herniographic appearance of the lateral inguinal fossa

International Nuclear Information System (INIS)

Ekberg, O.; Kesek, P.

1987-01-01

Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do. (orig.)

Pain related sexual dysfunction after inguinal herniorrhaphy

DEFF Research Database (Denmark)

Aasvang, EK; Møhl, Bo; Bay-Nielsen, M

2006-01-01

, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18-40 years undergoing inguinal herniorrhaphy between October......To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation...... 2002 and June 2003 (n=1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224...

In vitro effect of amoxicillin and clarithromycin on the 3’ region of cagA gene in Helicobacter pylori isolates

Science.gov (United States)

Bustamante-Rengifo, Javier Andrés; Matta, Andrés Januer; Pazos, Alvaro; Bravo, Luis Eduardo

2013-01-01

AIM: To evaluate the in vitro effect of amoxicillin and clarithromycin on the cag pathogenicity island (cag PAI). METHODS: One hundred and forty-nine clinical isolates of Helicobacter pylori (H. pylori) cultured from gastric biopsies from 206 Colombian patients with dyspeptic symptoms from a high-risk area for gastric cancer were included as study material. Antimicrobial susceptibility was determined by the agar dilution method. Resistant isolates at baseline and in amoxicillin and clarithromycin serial dilutions were subjected to genotyping (cagA, vacA alleles s and m), Glu-Pro-Ile-Tyr-Ala (EPIYA) polymerase chain reaction and random amplified polymorphic DNA (RAPD). Images of the RAPD amplicons were analyzed by Gel-Pro Analyzer 4.5 program. Cluster analyses was done using SPSS 15.0 statistical package, where each of the fingerprint bands were denoted as variables. Dendrograms were designed by following Ward’s clustering method and the estimation of distances between each pair of H. pylori isolates was calculated with the squared Euclidean distance. RESULTS: Resistance rates were 4% for amoxicillin and 2.7% for clarithromycin with 2% double resistances. Genotyping evidenced a high prevalence of the genotype cagA-positive/vacA s1m1. The 3’ region of cagA gene was successfully amplified in 92.3% (12/13) of the baseline resistant isolates and in 60% (36/60) of the resistant isolates growing in antibiotic dilutions. Upon observing the distribution of the number of EPIYA repetitions in each dilution with respect to baseline isolates, it was found that in 61.5% (8/13) of the baseline isolates, a change in the number of EPIYA repetitions lowered antibiotic pressure. The gain and loss of EPIYA motifs resulted in a diversity of H. pylori subclones after bacterial adjustment to changing conditions product of antibiotic pressure. RAPD PCR evidenced the close clonal relationship between baseline isolates and isolates growing in antibiotic dilutions. CONCLUSION: Antibiotic

Outpatient repair for inguinal hernia in elderly patients: still a challenge?

Science.gov (United States)

Palumbo, Piergaspare; Amatucci, Chiara; Perotti, Bruno; Zullino, Antonio; Dezzi, Claudia; Illuminati, Giulio; Vietri, Francesco

2014-01-01

Elective inguinal hernia repair as a day case is a safe and suitable procedure, with well-recognized feasibility. The increasing number of elderly patients requiring inguinal hernia repair leads clinicians to admit a growing number of outpatients. The aim of the current study was to analyze the outcomes (feasibility and safety) of day case treatment in elderly patients. Eighty patients >80 years of age and 80 patients ≤55 years of age underwent elective inguinal hernia repairs under local anesthesia. There were no mortalities or major complications in the elderly undergoing inguinal herniorraphies as outpatients, and only one unanticipated admission occurred in the younger age group. Elective inguinal hernia repair in the elderly has a good outcome, and age alone should not be a drawback to day case treatment. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

pHresh 3.5: a new low pH liquid skin cleanser.

Science.gov (United States)

Shellow, W V

1981-01-01

pHresh 3.5, a new low pH liquid skin cleanser, was evaluated for safety and efficacy in four clinical studies. In 5- and 21-day predictive patch tests the cleanser was rated mild compared to four other widely used cleansers. As a degreasing agent it was found effective during a 4-week study period, especially in subjects with severe facial oiliness. Daily use of the product for a month in tretinoin-treated acne patients failed to indicate any lack of compatability of the two agents. Resolution of pre-existing skin irritation was not impaired by pHresh 3.5 usage.

Fine genetic structure of the 2D3-2F5 region of the X-chromosome of Drosophila melanogaster

International Nuclear Information System (INIS)

Gvozdev, V.A.; Gostimsky, S.A.; Gerasimova, T.I.; Dubrovskaya, E.S.; Braslavskaya, O.Yu.

1975-01-01

97 lethal and semilethal mutations were induced by ethyl methanesulfonate, nitrosomethyl urea and γ-irradiation in the 2D3-F5 region of the X-chromosome of D. melanogaster. Approximately 1 per cent of the tested X-chromosomes carried a lethal in the 2D3-2F5 region. The mutation frequencies per band of DNA content in this region and the whole X-chromosome are equal. Complementation analysis revealed at least 10 functionally independent essential loci in this region including about 10 bands. The data presented in this study support the one band - one gene hypothesis. The Pgd locus coding for 6-phosphogluconate dehydrogenase (6PGD) is mapped in the 2D3 (or 2D4) band. Isolation of 11 lethal or semilethal point mutations with null or reduced 6PGD acticity shows that the Pgd locus is a vital one. (orig.) [de

Subnitride chemistry: A first-principles study of the NaBa3N, Na5Ba3N, and Na16Ba6N phases

International Nuclear Information System (INIS)

Oliva, Josep M.

2005-01-01

An ab initio study on the electronic structure of the subnitrides NaBa 3 N, Na 5 Ba 3 N, and Na 16 Ba 6 N is performed for the first time. The NaBa 3 N and Na 5 Ba 3 N phases consist of infinite 1 ∞ [NBa 6/2 ] strands composed of face-sharing NBa 6 octahedra surrounded by a 'sea' of sodium atoms. The Na 16 Ba 6 N phase consist of discrete [NBa 6 ] octahedra arranged in a body-cubic fashion, surrounded by a 'sea' of sodium atoms. Our calculations suggest that the title subnitrides are metals. Analysis of the electronic structure shows partial interaction of N(2s) with Ba(5p) electrons in the lower energy region for NaBa 3 N and Na 5 Ba 3 N. However, no dispersion is observed for the N(2s) and Ba(5p) bands in the cubic phase Na 16 Ba 6 N. The metallic band below the Fermi level shows a strong mixing of N(2p), Ba(6s), Ba(5d), Ba(6p), Na(3s) and Na(3p) orbitals. The metallic character in these nitrides stems from delocalized electrons corresponding to hybridized 5d l 6s m 6p n barium orbitals which interact with hybridized 3s n 3p m sodium orbitals. Analysis of the electron density and electronic structure in these nitrides shows two different regions: a metallic matrix corresponding to the sodium atoms and the regions around them and heteropolar bonding between nitrogen and barium within the infinite 1 ∞ [NBa 6/2 ] strands of the NaBa 3 N and Na 5 Ba 3 N phases, and within the isolated [NBa 6 ] octahedra of the Na 16 Ba 6 N phase. The nitrogen atoms inside the strands and octahedra are negatively charged, the anionic character of nitrogens being larger in the isolated octahedra of the cubic phase Na 16 Ba 6 N, due to the lack of electron delocalization along one direction as opposed to the other phases. The sodium and barium atoms appear to be slightly negatively and positively charged, the latter to a larger extent. From the computed Ba-N overlap populations as well as the analysis of the contour maps of differences between total density and superposition of

A case report of fallopian tube into inguinal canal in patient with unicorn uretus

OpenAIRE

Maryam Asgharnia; Ziba Zahiri; Fariba Mirblouk; Fatemeh Hosseinzadeh; seyedeh Fatemeh Dalil Heirati

2014-01-01

Introduction: Presence of the ovary, fallopian tube and uterus within an inguinal canal is a rare condition in women of reproductive age. Case report: In this report we present a 31-year-old female with 5 years primary infertility who was admitted for infertility evaluation. We described a patient with unicornuate uterus without rudimentary horn and the left fallopian tube within the left inguinal canal diagnosed through laparoscopy. Conclusion: The surgeon who works on infertility may encoun...

Laparoendoscopic single-site extraperitoneal inguinal hernia repair: initial experience in 10 patients.

Science.gov (United States)

Do, Minh; Liatsikos, Evangelos; Beatty, John; Haefner, Tim; Dunn, Ian; Kallidonis, Panagiotis; Stolzenburg, Jens-Uwe

2011-06-01

Recent technical advances and a trend toward laparoscopic single incision surgery have led us to explore the feasibility of laparoendoscopic single-site (LESS) hernia repair. We present our technique and initial experience with LESS extraperitoneal inguinal hernia repair in 10 consecutive men with unilateral inguinal hernias. Age range was 43.7 (28-64) years. Mean body mass index was 28 (range 24-30). Six were left inguinal hernias. There were six indirect and four direct hernias. Three patients had undergone previous open appendectomy. Incarcerated or bilateral hernias were excluded from our initial series. All cases were performed by three surgeons who were experienced in conventional totally extraperitoneal laparoscopic hernia repair as well as experienced in LESS. A literature review of current single-port inguinal hernia repair data is also presented. The mean operative time was 53 minutes (range 45-65  min). The average length of skin incision was 2.8  cm (range 2.3-3.2  cm). No drain was necessary in any of the patients, while no recordable bleeding was observed. There were no intraoperative or immediate postoperative complications. Hospitalization period was 2 days for all patients. After a limited follow-up of 1 month, there have been no recurrences and no complaints of testicular pain. The results of the current series compare favorably with those found in a literature review. LESS extraperitoneal inguinal hernia repair is both feasible and safe, although more technically demanding than its conventional laparoscopic counterpart. Although the cosmetic result with the former approach may prove superior, there are standing questions regarding the complications and long-term outcome. Randomized and if possible blinded trials that compare conventional and single-incision laparoscopic hernia repair may help to distinguish the most advantageous technique.

Irreducible Inguinal Hernias in the Paediatric Age Group | Ezomike ...

African Journals Online (AJOL)

BACKGROUND: An inguinal hernia is said to be irreducible when the content fails to return into the peritoneal cavity without surgical intervention. Irreducibility is an ever present risk in untreated inguinal hernias and its management remains an important part of pediatric surgery practice. When a hernia is irreducible ...

Robotic Inguinal Hernia Repair: Technique and Early Experience.

Science.gov (United States)

Arcerito, Massimo; Changchien, Eric; Bernal, Oscar; Konkoly-Thege, Adam; Moon, John

2016-10-01

Laparoscopic inguinal hernia repair has been shown to have multiple advantages compared with open repair such as less postoperative pain and earlier resume of daily activities with a comparable recurrence rate. We speculate robotic inguinal hernia repair may yield equivalent benefits, while providing the surgeon added dexterity. One hundred consecutive robotic inguinal hernia repairs with mesh were performed with a mean age of 56 years (25-96). Fifty-six unilateral hernias and 22 bilateral hernias were repaired amongst 62 males and 16 females. Polypropylene mesh was used for reconstruction. All but, two patients were completed robotically. Mean operative time was 52 minutes per hernia repair (45-67). Five patients were admitted overnight based on their advanced age. Regular diet was resumed immediately. Postoperative pain was minimal and regular activity was achieved after an average of four days. One patient recurred after three months in our earlier experience and he was repaired robotically. Mean follow-up time was 12 months. These data, compared with laparoscopic approach, suggest similar recurrence rates and postoperative pain. We believe comparative studies with laparoscopic approach need to be performed to assess the role robotic surgery has in the treatment of inguinal hernia repair.

[A giant myxoid leiomyoma mimicking an inguinal hernia].

Science.gov (United States)

Huszár, Orsolya; Zaránd, Attila; Szántó, Gyöngyi; Juhász, Viktória; Székely, Eszter; Novák, András; Molnár, Béla Ákos; Harsányi, László

2016-03-06

Leiomyoma is a rare, smooth muscle tumour that can occur everywhere in the human body. The authors present the history of a 60-year-old female, who had a giant, Mullerian type myxoid leiomyoma in the inguinal region mimicking acute abdominal symptoms. After examination the authors removed the soft tissue mass in the right femoral region reaching down in supine position to the middle third of the leg measuring 335 × 495 × 437 mm in greatest diameters in weight 33 kg. Reconstruction of the tissue defect was performed using oncoplastic guidelines. During the follow-up time no tumour recurrence was detected and the quality of life of the patient improved significantly.

Phosphoinositide 5-phosphatase Fig 4p is required for both acute rise and subsequent fall in stress-induced phosphatidylinositol 3,5-bisphosphate levels.

Science.gov (United States)

Duex, Jason E; Nau, Johnathan J; Kauffman, Emily J; Weisman, Lois S

2006-04-01

Phosphoinositide lipids regulate complex events via the recruitment of proteins to a specialized region of the membrane at a specific time. Precise control of both the synthesis and turnover of phosphoinositide lipids is integral to membrane trafficking, signal transduction, and cytoskeletal rearrangements. Little is known about the acute regulation of the levels of these signaling lipids. When Saccharomyces cerevisiae cells are treated with hyperosmotic medium the levels of phosphatidylinositol 3,5-bisphosphate (PI3,5P(2)) increase 20-fold. Here we show that this 20-fold increase is rapid and occurs within 5 min. Surprisingly, these elevated levels are transient. Fifteen minutes following hyperosmotic shock they decrease at a rapid rate, even though the cells remain in hyperosmotic medium. In parallel with the rapid increase in the levels of PI3,5P(2), vacuole volume decreases rapidly. Furthermore, concomitant with a return to basal levels of PI3,5P(2) vacuole volume is restored. We show that Fig 4p, consistent with its proposed role as a PI3,5P(2) 5-phosphatase, is required in vivo for this rapid return to basal levels of PI3,5P(2). Surprisingly, we find that Fig 4p is also required for the hyperosmotic shock-induced increase in PI3,5P(2) levels. These findings demonstrate that following hyperosmotic shock, large, transient changes occur in the levels of PI3,5P(2) and further suggest that Fig 4p is important in regulating both the acute rise and subsequent fall in PI3,5P(2) levels.

Structure-function analysis of STING activation by c[G(2',5')pA(3',5')p] and targeting by antiviral DMXAA.

Science.gov (United States)

Gao, Pu; Ascano, Manuel; Zillinger, Thomas; Wang, Weiyi; Dai, Peihong; Serganov, Artem A; Gaffney, Barbara L; Shuman, Stewart; Jones, Roger A; Deng, Liang; Hartmann, Gunther; Barchet, Winfried; Tuschl, Thomas; Patel, Dinshaw J

2013-08-15

Binding of dsDNA by cyclic GMP-AMP (cGAMP) synthase (cGAS) triggers formation of the metazoan second messenger c[G(2',5')pA(3',5')p], which binds the signaling protein STING with subsequent activation of the interferon (IFN) pathway. We show that human hSTING(H232) adopts a "closed" conformation upon binding c[G(2',5')pA(3',5')p] and its linkage isomer c[G(2',5')pA(2',5')p], as does mouse mSting(R231) on binding c[G(2',5')pA(3',5')p], c[G(3',5')pA(3',5')p] and the antiviral agent DMXAA, leading to similar "closed" conformations. Comparing hSTING to mSting, 2',5'-linkage-containing cGAMP isomers were more specific triggers of the IFN pathway compared to the all-3',5'-linkage isomer. Guided by structural information, we identified a unique point mutation (S162A) placed within the cyclic-dinucleotide-binding site of hSTING that rendered it sensitive to the otherwise mouse-specific drug DMXAA, a conclusion validated by binding studies. Our structural and functional analysis highlights the unexpected versatility of STING in the recognition of natural and synthetic ligands within a small-molecule pocket created by the dimerization of STING. Copyright © 2013 Elsevier Inc. All rights reserved.

Unusual Initial Presentation of Herpes Simplex Virus as Inguinal Lymphadenopathy

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Sarah A. Fleming

2015-01-01

Full Text Available Genital herpes simplex virus (HSV infections are a common cause of inguinal lymphadenopathy. However, surgical excision of enlarged inguinal nodes is almost never performed to initially diagnose genital herpes simplex virus, due to the distinct external presentation of genital herpetic vesicles that usually occur with the first symptoms of infection. Therefore, the histologic and immunophenotypic features of HSV-associated inguinal lymphadenopathy are unfamiliar to most pathologists. The current report describes the lymph node pathology of two immunocompetent patients, whose initial HSV diagnosis was established through surgical excision of enlarged inguinal lymph nodes. Histologic examination showed features consistent with viral lymphadenopathy, including florid follicular hyperplasia, monocytoid B-cell hyperplasia, and paracortical hyperplasia without extensive necrosis. Immunohistochemical stains for HSV antigens, using polyclonal anti-HSV I and II antibodies, demonstrate strong immunoreactivity for HSV in a small number of cells in the subcapsular sinuses, especially in areas with monocytoid B-cell hyperplasia. Rare scattered HSV-positive cells also are identified in paracortical areas and germinal centers. We conclude that an initial diagnosis of genital HSV infection may be established by inguinal lymph node biopsy.

Analgesia and sedation practices for incarcerated inguinal hernias in children.

Science.gov (United States)

Al-Ansari, Khalid; Sulowski, Christopher; Ratnapalan, Savithiri

2008-10-01

In this study, the use of medications for analgesia and/or sedation for incarcerated inguinal hernia reductions in the emergency department was analyzed. A retrospective chart review was conducted for all patients presenting to a pediatric emergency department with incarcerated inguinal hernia from 2002 to 2005. A total of 99 children presented with incarcerated hernias during the study period. The median age was 11 months. Forty-four percent of children received medication for the procedure, of them 75% received parenteral and 25% oral or intranasal medications. Forty-five percent of children who received medication went through at least 1 hernia reduction attempt initially without medications. More than half the children with incarcerated inguinal hernias did not receive any medication for pain and/or sedation prior to hernia reduction. Guidelines for medication use for children with incarcerated inguinal hernias need to be developed.

Association of miR-548c-5p, miR-7-5p, miR-210-3p, miR-128-3p with recurrence in systemically untreated breast cancer

DEFF Research Database (Denmark)

Block, Ines; Burton, Mark; Sørensen, Kristina Pilekær

2018-01-01

. To validate their prognostic potential, we analyzed microRNA expression in an independent cohort (n = 110) using a pairmatched study design minimizing dependence of classical markers. The expression of hsa-miR-548c-5p was significantly associated with abridged disease-free survival (hazard ratio [HR]:1.96, p...... = 0.027). Contradicting published results, high hsa-miR516-3p expression was associated with favorable outcome (HR:0.29, p = 0.0068). The association is probably time-dependent indicating later relapse. Additionally, re-analysis of previously published expression data of two matching cohorts (n = 100......, n = 255) supports an association of hsa-miR-128-3p with shortened diseasefree survival (HR:2.48, p = 0.0033) and an upregulation of miR-7-5p (p = 0.0038; p = 0.039) and miR-210-3p (p = 0.031) in primary tumors of patients who experienced metastases. Further analysis may verify the prognostic...

Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

NARCIS (Netherlands)

Burgmans, J.P.J.

2015-01-01

The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

Patient-Related Risk Factors for Recurrence After Inguinal Hernia Repair

DEFF Research Database (Denmark)

Burcharth, Jakob; Pommergaard, Hans-Christian; Bisgaard, Thue

2015-01-01

patient demographics, hernia characteristics, connective tissue composition and degradation, habits and social relations, and conditions related to inguinal hernia recurrence. Results. From a total of 5061 records screened, we included 40 observational studies enrolling 720 651 inguinal hernia procedures...

Characterization of sequence diversity in Plasmodium falciparum SERA5 from Indian isolates

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Rahul C.N

2015-06-01

Full Text Available Objective: To characterize the sequence diversity of blood-stage Plasmodium falciparum serine repeat antigen-5 (PfSERA5 which is lacking in a malaria-endemic country like India. Methods: In this study, parasitic DNA was obtained from field isolates collected from various geographic regions. Subsequently, PfSERA5 gene sequence was PCR amplified and DNA sequenced. Results: We reported the existence of unique repeat polymorphisms and novel haplotypes for both the octamer repeat (OR and serine repeat (SR regions of the N-terminal fragment of PfSERA5 from Indian isolates. Several isolates from India were identical to low-frequency African haplotypes. Unique finding of our study was an Indian isolate showing deletion in a perfectly conserved 14 mer sequence within octamer repeat. Indian haplotypes reported in this study were found to be distributed into the three earlier classified allelic clusters of FCR3, K1 and Honduras showcasing broad diversity as compared to worldwide haplotypes. Conclusions: This study is the first report on genetic diversity of PfSERA5 antigen from India. Further evaluation of these haplotypes by serotyping would provide useful information for investigating variant-specific immunity and aid in malaria vaccine research.

Treatment for incarcerated indirect hernia with “Cross-Internal Ring” inguinal oblique incision in children

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Xue-Qiang Yan

2017-01-01

Full Text Available Background: This study aims to evaluate the utility of the “Cross-Internal Ring” inguinal oblique incision for the surgical treatment of incarcerated indirect hernia (IIH complicated with severe abdominal distension. Materials and Methods: Patients of IIH complicated with severe abdominal distension were reviewed retrospectively. All patients received operation through the “Cross-Internal Ring” inguinal oblique incision. Results: There were totally 13 patients were included, male to female ratio was 9-4. The time for patients to resume oral feeding varying from 2 to 5 days after operation, no complications include delayed intestinal perforation, intra-abdominal abscess, and incision infection happened. Average postoperative hospital stay was 5.2 days. All cases were followed up for 6–18 months. No recurrence or iatrogenic cryptorchidism happened. Conclusion: “Cross-Internal Ring” inguinal oblique incision is a simple, safe, and reliable surgical method to treat pediatric IIH complicated with severe abdominal distension.

Genome analysis of environmental and clinical P. aeruginosa isolates from sequence type-1146.

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David Sánchez

Full Text Available The genomes of Pseudomonas aeruginosa isolates of the new sequence type ST-1146, three environmental (P37, P47 and P49 and one clinical (SD9 isolates, with differences in their antibiotic susceptibility profiles have been sequenced and analysed. The genomes were mapped against P. aeruginosa PAO1-UW and UCBPP-PA14. The allelic profiles showed that the highest number of differences were in "Related to phage, transposon or plasmid" and "Secreted factors" categories. The clinical isolate showed a number of exclusive alleles greater than that for the environmental isolates. The phage Pf1 region in isolate SD9 accumulated the highest number of nucleotide substitutions. The ORF analysis of the four genomes assembled de novo indicated that the number of isolate-specific genes was higher in isolate SD9 (132 genes than in isolates P37 (24 genes, P47 (16 genes and P49 (21 genes. CRISPR elements were found in all isolates and SD9 showed differences in the spacer region. Genes related to bacteriophages F116 and H66 were found only in isolate SD9. Genome comparisons indicated that the isolates of ST-1146 are close related, and most genes implicated in pathogenicity are highly conserved, suggesting a genetic potential for infectivity in the environmental isolates similar to the clinical one. Phage-related genes are responsible of the main differences among the genomes of ST-1146 isolates. The role of bacteriophages has to be considered in the adaptation processes of isolates to the host and in microevolution studies.

Cyclic [G(2',5')pA(3',5')p] is the metazoan second messenger produced by DNA-activated cyclic GMP-AMP synthase.

Science.gov (United States)

Gao, Pu; Ascano, Manuel; Wu, Yang; Barchet, Winfried; Gaffney, Barbara L; Zillinger, Thomas; Serganov, Artem A; Liu, Yizhou; Jones, Roger A; Hartmann, Gunther; Tuschl, Thomas; Patel, Dinshaw J

2013-05-23

Recent studies identified cyclic GMP-AMP (cGAMP) as a metazoan second messenger triggering an interferon response. cGAMP is generated from GTP and ATP by cytoplasmic dsDNA sensor cGAMP synthase (cGAS). We combined structural, chemical, biochemical, and cellular assays to demonstrate that this second messenger contains G(2',5')pA and A(3',5')pG phosphodiester linkages, designated c[G(2',5')pA(3',5')p]. We show that, upon dsDNA binding, cGAS is activated through conformational transitions, resulting in formation of a catalytically competent and accessible nucleotide-binding pocket for generation of c[G(2',5')pA(3',5')p]. We demonstrate that cyclization occurs in a stepwise manner through initial generation of 5'-pppG(2',5')pA prior to cyclization to c[G(2',5')pA(3',5')p], with the latter positioned precisely in the catalytic pocket. Mutants of cGAS dsDNA-binding or catalytic pocket residues exhibit reduced or abrogated activity. Our studies have identified c[G(2',5')pA(3',5')p] as a founding member of a family of metazoan 2',5'-containing cyclic heterodinucleotide second messengers distinct from bacterial 3',5' cyclic dinucleotides. Copyright © 2013 Elsevier Inc. All rights reserved.

The Danish Inguinal Hernia database

DEFF Research Database (Denmark)

Friis-Andersen, Hans; Bisgaard, Thue

2016-01-01

AIM OF DATABASE: To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. STUDY POPULATION: Patients ≥18 years operated for groin hernia. MAIN VARIABLES: Type and size...... access to their own data stratified on individual surgeons. Registrations are based on a closed, protected Internet system requiring personal codes also identifying the operating institution. A national steering committee consisting of 13 voluntary and dedicated surgeons, 11 of whom are unpaid, handles...... the medical management of the database. RESULTS: The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015). A total of 49 peer-reviewed national and international publications have been published from the database (June 2015). CONCLUSION: The Danish Inguinal Hernia...

Electron-impact excitation cross sections of the higher argon 3p5np (n=5,6,7) levels

International Nuclear Information System (INIS)

Weber, Tobin; Boffard, John B.; Lin, Chun C.

2003-01-01

We have measured the electron-impact excitation cross sections for argon into the ten levels of 3p 5 5p configuration, as well as numerous levels of the 3p 5 6p and 3p 5 7p configurations. Fluorescence from the decay of the excited atoms to the levels of 3p 5 4s configuration was used to determine the optical-emission cross sections. These results were combined with transition probabilities to find apparent cross sections into the 3p 5 5p and 3p 5 6p levels. These new cross sections of the Ar(3p 5 np) levels along with the available Ne(2p 5 3p), Kr(4p 5 5p), and Xe(5p 5 6p) data help provide a global view of the excitation behaviors of the np 5 n ' p levels of the rare-gas series

Isolation of probes specific to human chromosomal region 6p21 from immunoselected irradiation-fusion gene transfer hybrids

International Nuclear Information System (INIS)

Ragoussis, J.; Jones, T.A.; Sheer, D.; Shrimpton, A.E.; Goodfellow, P.N.; Trowsdale, J.; Ziegler, A.

1991-01-01

A hybrid cell line (R21/B1) containing a truncated human chromosome 6 (6pter-6q21) and a human Y chromosome on a hamster background was irradiated and fused to A23 (TK-) or W3GH (HPRT-) hamster cells. Clones containing expressed HLA class I genes (4/40) were selected using monoclonal antibodies. These clones were recloned and analyzed with a panel of probes from the HLA region. One hybrid (4G6) contained the entire HLA complex. Two other hybrids (4J4 and 4H2) contained only the HLA class I region, while the fourth hybrid (5P9) contained HLA class I and III genes in addition to other genes located in the 6p21 chromosomal region. In situ hybridization showed that the hybrid cells contained more than one fragment of human DNA. Alu and LINE PCR products were derived from these cells and compared to each other as well as to products from two somatic cell hybrids having the 6p21 region in common. The PCR fragments were then screened on conventional Southern blots of the somatic cell hybrids to select a panel of novel probes encompassing the 6p21 region. In addition, the origin of the human DNA fragments in hybrid 4J4 was determined by regional mapping of PCR products

Two Ports Laparoscopic Inguinal Hernia Repair in Children

OpenAIRE

Ibrahim, Medhat M.

2015-01-01

Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation...

Association Between Thoracic Aortic Disease and Inguinal Hernia

OpenAIRE

Olsson, Christian; Eriksson, Per; Franco?Cereceda, Anders

2014-01-01

Background The study hypothesis was that thoracic aortic disease (TAD) is associated with a higher?than?expected prevalence of inguinal hernia. Such an association has been reported for abdominal aortic aneurysm (AAA) and hernia. Unlike AAA, TAD is not necessarily detectable with clinical examination or ultrasound, and there are no population?based screening programs for TAD. Therefore, conditions associated with TAD, such as inguinal hernia, are of particular clinical relevance. Methods and ...

Physicomechanical evaluation of polypropylene, polyester, and polytetrafluoroethylene meshes for inguinal hernia repair.

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Deeken, Corey R; Abdo, Michael S; Frisella, Margaret M; Matthews, Brent D

2011-01-01

For meshes to be used effectively for hernia repair, it is imperative that engineers and surgeons standardize the terminology and techniques related to physicomechanical evaluation of these materials. The objectives of this study were to propose standard techniques, perform physicomechanical testing, and classify materials commonly used for inguinal hernia repair. Nine meshes were evaluated: 4 polypropylene, 1 polyester, 1 polytetrafluoroethylene, and 3 partially absorbable. Physical properties were determined through image analysis, laser micrometry, and density measurements. Biomechanical properties were determined through suture retention, tear resistance, uniaxial, and ball burst testing with specimens tested in 2 different orientations. A 1-way ANOVA with Tukey's post-test or a t-test were performed, with p INFINIT (WL Gore & Associates) did not resist tearing as effectively as the others. All meshes exhibited supraphysiologic burst strengths except INFINIT and ULTRAPRO. Significant differences exist between the physicomechanical properties of polypropylene, polyester, polytetrafluoroethylene, and partially absorbable mesh prostheses commonly used for inguinal hernia repair. Orientation of the mesh was also shown to be critical for the success of meshes, particularly those demonstrating anisotropy. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

A case report of fallopian tube into inguinal canal in patient with unicorn uretus

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Maryam Asgharnia

2014-11-01

Full Text Available Introduction: Presence of the ovary, fallopian tube and uterus within an inguinal canal is a rare condition in women of reproductive age. Case report: In this report we present a 31-year-old female with 5 years primary infertility who was admitted for infertility evaluation. We described a patient with unicornuate uterus without rudimentary horn and the left fallopian tube within the left inguinal canal diagnosed through laparoscopy. Conclusion: The surgeon who works on infertility may encounter such unexpected intraoperative findings, and must call attention to these findings.

The 95ΔG mutation in the 5'untranslated region of the norA gene increases efflux activity in Staphylococcus epidermidis isolates.

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García-Gómez, Elizabeth; Jaso-Vera, Marcos E; Juárez-Verdayes, Marco A; Alcántar-Curiel, María D; Zenteno, Juan C; Betanzos-Cabrera, Gabriel; Peralta, Humberto; Rodríguez-Martínez, Sandra; Cancino-Díaz, Mario E; Jan-Roblero, Janet; Cancino-Diaz, Juan C

2017-02-01

In the Staphylococcus aureus ATCC25923 strain, the flqB mutation in the 5'untranslated region (5'UTR) of the norA gene causes increased norA mRNA expression and high efflux activity (HEA). The involvement of the norA gene 5'UTR in HEA has not been explored in S. epidermidis; therefore, we examined the function of this region in S. epidermidis clinical isolates. The selection of isolates with HEA was performed based on ethidium bromide (EtBr) MIC values and efflux efficiency (EF) using the semi-automated fluorometric method. The function of the 5'UTR was studied by quantifying the levels of norA expression (RT-qPCR) and by identifying 5'UTR mutations by sequence analysis. Only 10 isolates from a total of 165 (6.1%) had HEA (EtBr MIC = 300 μg/ml and EF ranged from 48.4 to 97.2%). Eight of 10 isolates with HEA had the 5'UTR 95 Δ G mutation. Isolates carrying the 95 Δ G mutation had higher levels of norA expression compared with those that did not. To corroborate that the 95 Δ G mutation is involved in HEA, a strain adapted to EtBr was obtained in vitro. This strain also presented the 95 Δ G mutation and had a high level of norA expression and EF, indicating that the 95 Δ G mutation is important for the HEA phenotype. The 95 Δ G mutation produces a different structure in the Shine-Dalgarno region, which may promote better translation of norA mRNA. To our knowledge, this is the first report to demonstrate the participation of the 5'UTR 95 Δ G mutation of the norA gene in the HEA phenotype of S. epidermidis isolates. Here, we propose that the efflux of EtBr is caused by an increment in the transcription and/or translation of the norA gene. Copyright © 2016 Elsevier Ltd. All rights reserved.

Study of phase equilibria and glass formation in the CaO-WO3-P2O5 system

International Nuclear Information System (INIS)

Bielis, I.Ya.

1980-01-01

The method of quenching has been used to investigate the liquidus surface of a portion of the CaO-WO 3 -P 2 O 5 system limited by the Ca(PO 3 ) 2 -W 2 O 3 (PO 4 ) 2 and CaWO 4 -Ca 2 P 2 O 7 cross-sections. The primary crystallization fields on the compounds: WO 3 , W 2 O 3 (PO 4 ) 2 , CaWO 4 , Ca 2 P 7 O 7 , Ca(PO 3 ) 2 are separated. The liquidus surface isotherms at 900, 1000, 1100 and 1200 deg C have been plotted on the concentration triangle plane. It has been found that the cross-sections of W 2 O 3 (PO 4 ) 2 -Ca(PO 3 ) 2 , WO 3 -Ca(PO 3 ) 2 , WO 3 -Ca 2 P 2 O 7 and CaWO 4 -Ca 2 P 2 O 7 are eutectic-type quasi-binary systems. The position of the glass transition region in the CaO-WO 3 -P 2 O 5 system has been determined for the treatment temperatures of 1100, 1200 and 1300 deg C and a correlation between the configuration of the glass transition region and the phase diagram of the system has been demonstrated [ru

Combined Partial Penectomy With Bilateral Robotic Inguinal Lymphadenectomy Using Near-infrared Fluorescence Guidance.

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Sávio, Luís Felipe; Panizzutti Barboza, Marcelo; Alameddine, Mahmoud; Ahdoot, Michael; Alonzo, David; Ritch, Chad R

2018-03-01

To describe our novel technique for performing a combined partial penectomy and bilateral robotic inguinal lymphadenectomy using intraoperative near-infrared (NIR) fluorescence guidance with indocyanine green (ICG) and the DaVinci Firefly camera system. A 58-year-old man presented status post recent excisional biopsy of a 2-cm lesion on the left coronal aspect of the glans penis. Pathology revealed "invasive squamous cell carcinoma of the penis with multifocal positive margins." His examination was suspicious for cT2 primary and his inguinal nodes were cN0. He was counseled to undergo partial penectomy with possible combined vs staged bilateral robotic inguinal lymphadenectomy. Preoperative computed tomography scan was negative for pathologic lymphadenopathy. Before incision, 5 mL of ICG was injected subcutaneously beneath the tumor. Bilateral thigh pockets were then developed simultaneously and a right, then left robotic modified inguinal lymphadenectomy was performed using NIR fluorescence guidance via the DaVinci Firefly camera. A partial penectomy was then performed in the standard fashion. The combined procedure was performed successfully without complication. Total operative time was 379 minutes and total robotic console time was 95 minutes for the right and 58 minutes to the left. Estimated blood loss on the right and left were 15 and 25 mL, respectively. A total of 24 lymph nodes were retrieved. This video demonstrates a safe and feasible approach for combined partial penectomy and bilateral inguinal lymphadenectomy with NIR guidance using ICG and the DaVinci Firefly camera system. The combined robotic approach has minimal morbidity and avoids the need for a staged procedure. Furthermore, use of NIR guidance with ICG during robotic inguinal lymphadenectomy is feasible and may help identify sentinel lymph nodes and improve the quality of dissection. Further studies are needed to confirm the utility of NIR guidance for robotic sentinel lymph node

Laparoscopic surgery in the treatment of incarcerated indirect inguinal hernia in children.

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Yin, Yiyu; Zhang, Hongwei; Zhang, Xiang; Sun, Fang; Zou, Huaxin; Cao, Hui; Wen, Cheng

2016-12-01

We aimed to explore the feasibility and the safety of the laparoscopic surgery for incarcerated indirect inguinal hernia (IIH) in children. From January 2012 to December 2014, 64 children were enrolled into this study. All 64 patients received laparoscopic surgery and we reviewed their perioperative and postoperative follow-up studies. In addition, we enrolled 60 cases of children who received traditional surgery of IIH administered through minimally invasive surgery as the control group. Results from the present study showed that the mean operation time for the laparoscopic group was 41.5 min (range, 15-80 min) which was significantly shorter than the control group. Nine cases developed incarcerated intestine necrosis, expanded umbilical incision and parallel resection anastomosis. They received laparoscopic hernia sac high ligation. Only 5 cases developed scrotum edema after the surgery. The postoperative length of the stay ranged from 2 to 7 days (average, 3.2). The postoperative follow-up was from 6 months to 1 year and no relapse or secondary testicular atrophy was observed in the laparoscopic group. The operation time, incidence of postoperative complications and length of stay in the laparoscopic group were decreased compared to the control group, and differences were statistically significant (Pincarcerated inguinal hernia is safe and feasible and produced better results compared with the alternative.

Technical success of the ultrasound-guided supra-inguinal fascia iliaca compartment block in older children and adolescents for hip arthroscopy.

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Eastburn, Elizabeth; Hernandez, Maria A; Boretsky, Karen

2017-11-01

Hip arthroscopic surgery is performed on older pediatric patients. Fascia iliaca compartment block has proven efficacy in providing analgesia following hip surgery and can be performed with target location of local anesthetic below or above the inguinal ligament. The reported success of ultrasound-guided infra-inguinal fascia iliaca compartment block is lower when compared to traditional landmark technique, while the reliability of supra-inguinal fascia iliaca compartment block is unreported. The primary aim was to report the results in obtaining sensory changes in the distribution of the femoral and lateral femoral cutaneous nerves following supra-inguinal fascia iliaca compartment block in patients undergoing arthroscopic hip surgery. Secondary outcomes are the ability to find echogenic landmarks and to report pain scores and opioid consumption. We reviewed the electronic medical record and regional anesthesia database of patients receiving ultrasound-guided fascia iliaca compartment block for arthroscopic hip surgery. Sensory changes to the femoral and lateral femoral cutaneous nerves were determined. Identification of echogenic landmarks was quantified. Pain scores and opioid consumption were determined. Seventeen patients of mean age 15.4 years old (SD 1.3; range 13-17 years) were included. Sensory changes to both the femoral and lateral femoral cutaneous nerves occurred in 94% of patients (95% CI: 82%-100%). The average volume of ropivacaine 0.2% was 0.53 mL/Kg (SD 0.11 mL/Kg). Echogenic landmarks were identified in all patients. Pain scores and opioid consumption were generally low. A supra-inguinal location for the deposition of local anesthetic when performing fascia iliaca nerve block for hip surgery is reliable in anesthetizing the femoral and lateral femoral cutaneous nerves and should encourage investigation into the clinical efficacy. © 2017 John Wiley & Sons Ltd.

Analgesia pós-operatória para procedimentos cirúrgicos ortopédicos de quadril e fêmur: comparação entre bloqueio do compartimento do psoas e bloqueio perivascular inguinal Analgesia postoperatoria para procedimientos quirúrgicos ortopédicos de cadera y fémur: comparación entre bloqueo del compartimiento del psoas y bloqueo perivascular inguinal Postoperative analgesia for orthopedic surgeries of the hip and femur: a comparison between psoas compartment and inguinal paravascular blocks

Directory of Open Access Journals (Sweden)

Luiz Eduardo Imbelloni

2006-12-01

Full Text Available JUSTIFICATIVA E OBJETIVOS: Este estudo avaliou a eficácia da injeção única de bupivacaína a 0,25% no compartimento do psoas ou perivascular inguinal por meio do estimulador de nervos periféricos para analgesia pós-operatória em pacientes submetidos a intervenções cirúrgicas ortopédicas. MÉTODO: Cem pacientes receberam bloqueio do plexo lombar através do compartimento do psoas e foram comparados com 100 pacientes que receberam bloqueio do plexo lombar via perivascular inguinal, identificados pelo estimulador de nervos periféricos com a injeção de 40 mL bupivacaína a 0,25% sem epinefrina. A analgesia nos nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foi avaliada 4, 8, 12, 16, 20 e 24 horas após o final da intervenção cirúrgica. A intensidade da dor foi também avaliada no mesmo período. A quantidade de opióides administrada no pós-operatório foi anotada. Em cinco pacientes de cada grupo, estudo radiográfico com contraste não-iônico foi realizado para avaliar a dispersão da solução anestésica. RESULTADOS: Os nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foram bloqueados em 92% dos pacientes no compartimento do psoas versus 62% no bloqueio perivascular inguinal. O bloqueio do plexo lombar reduziu a necessidade de opióides e 42% dos pacientes submetidos ao bloqueio do compartimento do psoas e 36% dos pacientes no bloqueio inguinal não necessitaram de analgésico adicional no pós-operatório. A duração da analgesia foi em torno de 21 horas com bloqueio do compartimento do psoas e 15 horas com bloqueio perivascular inguinal. CONCLUSÕES: O bloqueio do compartimento do psoas e perivascular inguinal é uma excelente técnica para analgesia pós-operatória em intervenções cirúrgicas ortopédicas reduzindo a necessidade de opióides. Este estudo mostrou que a injeção no compartimento do psoas foi mais fácil e mais efetiva no bloqueio

Isolation and Genetic Characterization of Avian Influenza Viruses Isolated from Wild Birds in the Azov-Black Sea Region of Ukraine (2001-2012).

Science.gov (United States)

Muzyka, Denys; Pantin-Jackwood, Mary; Spackman, Erica; Smith, Diane; Rula, Oleksandr; Muzyka, Nataliia; Stegniy, Borys

2016-05-01

Wild bird surveillance for avian influenza virus (AIV) was conducted from 2001 to 2012 in the Azov - Black Sea region of the Ukraine, considered part of the transcontinental wild bird migration routes from northern Asia and Europe to the Mediterranean, Africa, and southwest Asia. A total of 6281 samples were collected from wild birds representing 27 families and eight orders for virus isolation. From these samples, 69 AIVs belonging to 15 of the 16 known hemagglutinin (HA) subtypes and seven of nine known neuraminidase (NA) subtypes were isolated. No H14, N5, or N9 subtypes were identified. In total, nine H6, eight H1, nine H5, seven H7, six H11, six H4, five H3, five H10, four H8, three H2, three H9, one H12, one H13, one H15, and one H16 HA subtypes were isolated. As for the NA subtypes, twelve N2, nine N6, eight N8, seven N7, six N3, four N4, and one undetermined were isolated. There were 27 HA and NA antigen combinations. All isolates were low pathogenic AIV except for eight highly pathogenic (HP) AIVs that were isolated during the H5N1 HPAI outbreaks of 2006-08. Sequencing and phylogenetic analysis of the HA genes revealed epidemiological connections between the Azov-Black Sea regions and Europe, Russia, Mongolia, and Southeast Asia. H1, H2, H3, H7, H8, H6, H9, and H13 AIV subtypes were closely related to European, Russian, Mongolian, and Georgian AIV isolates. H10, H11, and H12 AIV subtypes were epidemiologically linked to viruses from Europe and Southeast Asia. Serology conducted on serum and egg yolk samples also demonstrated previous exposure of many wild bird species to different AIVs. Our results demonstrate the great genetic diversity of AIVs in wild birds in the Azov-Black Sea region as well as the importance of this region for monitoring and studying the ecology of influenza viruses. This information furthers our understanding of the ecology of avian influenza viruses in wild bird species.

Isolated Echinococcosis of cervical region

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Pratima Khare

2014-01-01

Full Text Available Echinococcosis, commonly called as hydatid disease, is a parasitic infestation caused by the larva of the genus Echinococcus in human. Isolated occurrence of Echinococcosis without any evidence of visceral disease is very rare. A thorough search of the literature revealed only 11 cases of isolated cervical Echinococcosis. We report here a very rare case of isolated hydatid cyst in a 45-year-old female patient, who presented with swelling in right cervical region about 5 cm below the angle of mandible with no evidence of the disease elsewhere in the body. The case was diagnosed on fine needle aspiration cytology. The diagnosis was further supported by histopathology. We propose that the treating physician should also consider the differential diagnosis of Echinococcosis in the presence of an asymptomatic soft tissue mass, especially when the patient lives in an endemic area.

Convalescence after inguinal herniorrhaphy

DEFF Research Database (Denmark)

Bay-Nielsen, M.; Thomsen, H.; Andersen, H.F.

2004-01-01

leisure activity was 14 days. After 30 days, 6.8 per cent of patients had not resumed employment and 17.0 per cent had not yet resumed strenuous leisure activity. Important reasons for not resuming work and leisure activity were pain (approximately 60 per cent of patients) and wound problems...... incurring a risk of higher reoperation rates. Pain and wound problems remain the most important factors for not resuming work or leisure activity as recommended.......BACKGROUND: Convalescence after inguinal herniorrhaphy is usually 3-4 weeks and is an important outcome parameter of hernia surgery. The aim of this study was to describe in detail the consequences of recommending a short convalescence, including the risk of recurrence. METHODS...

Presence of Inguinal Hernia in Soccer Players with Osteitis Pubis

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Ali Eraslan

2017-11-01

Conclusion: The study revealed that soccer players with osteitis pubis may have concomitant inguinal hernia, and that osteitis pubis may develop in soccer players who have undergone hernia repair. In addition, more severe osteitis pubis findings on the same side with hernia indicate that the two pathologies occur with common mechanisms. It should not be forgotten that inguinal hernia be considered in the differential diagnosis of osteitis pubis, which it may accompany. Conservative methods are mostly used in the treatment of osteitis pubis, whereas the treatment of inguinal hernia is surgery. If only one entity is diagnosed when both are present, the success of treatment will decrease.

Neuroendocrine tumor of the inguinal node: A very rare presentation

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Niharika Bisht

2017-12-01

Full Text Available Neuroendocrine tumors are a broad family of tumors arising most commonly in the gastrointestinal tract and the bronchus pulmonary tree. The other common sounds are the parathyroid, pituitary and adrenal gland. Inguinal node as a primary presentation of a neuroendocrine tumor is an extremely rare presentation. We present the case of a 43-year-old-male who presented with the complaints of an inguinal node swelling without any other symptoms and on further evaluation was diagnosed to have a non-metastatic neuroendocrine tumor of the inguinal node. He was treated with a combination of chemotherapy and surgery and is presently awaiting completion chemotherapy.

Embryologic and anatomic basis of inguinal herniorrhaphy.

Science.gov (United States)

Skandalakis, J E; Colborn, G L; Androulakis, J A; Skandalakis, L J; Pemberton, L B

1993-08-01

The embryology and surgical anatomy of the inguinal area is presented with emphasis on embryologic and anatomic entities related to surgery. We have presented the factors, such as patent processus vaginalis and defective posterior wall of the inguinal canal, that may be responsible for the genesis of congenital inguinofemoral herniation. These, together with impaired collagen synthesis and trauma, are responsible for the formation of the acquired inguinofemoral hernia. Still, we do not have all the answers for an ideal repair. Despite the latest successes in repair, we, to paraphrase Ritsos, are awaiting the triumphant return of Theseus.

Pain during sexual activity before and after laparoscopic inguinal hernia repair

DEFF Research Database (Denmark)

Tolver, Mette A; Rosenberg, Jacob

2015-01-01

during sexual activity was a risk factor for postoperative pain during sexual activity. METHODS: A prospective questionnaire study before and 6 months after hernia repair was conducted. Men (age 18-85 years) undergoing laparoscopic inguinal hernia repair were included. RESULTS: In total, 160 men were......BACKGROUND: Sexual life may be impaired by pain during sexual activity in patients with inguinal hernia. On the other hand, inguinal hernia repair has also been reported to cause sexual dysfunction in terms of pain during sexual activity and ejaculation. The primary aim of this study...... was to estimate the prevalence of pain during sexual activity before and after laparoscopic inguinal hernia repair, and the secondary, to describe pain location, frequency of pain during sexual activity, and to which degree sexual life was affected by the pain. Furthermore, to examine whether preoperative pain...

The primary structures of two yeast enolase genes. Homology between the 5' noncoding flanking regions of yeast enolase and glyceraldehyde-3-phosphate dehydrogenase genes.

Science.gov (United States)

Holland, M J; Holland, J P; Thill, G P; Jackson, K A

1981-02-10

Segments of yeast genomic DNA containing two enolase structural genes have been isolated by subculture cloning procedures using a cDNA hybridization probe synthesized from purified yeast enolase mRNA. Based on restriction endonuclease and transcriptional maps of these two segments of yeast DNA, each hybrid plasmid contains a region of extensive nucleotide sequence homology which forms hybrids with the cDNA probe. The DNA sequences which flank this homologous region in the two hybrid plasmids are nonhomologous indicating that these sequences are nontandemly repeated in the yeast genome. The complete nucleotide sequence of the coding as well as the flanking noncoding regions of these genes has been determined. The amino acid sequence predicted from one reading frame of both structural genes is extremely similar to that determined for yeast enolase (Chin, C. C. Q., Brewer, J. M., Eckard, E., and Wold, F. (1981) J. Biol. Chem. 256, 1370-1376), confirming that these isolated structural genes encode yeast enolase. The nucleotide sequences of the coding regions of the genes are approximately 95% homologous, and neither gene contains an intervening sequence. Codon utilization in the enolase genes follows the same biased pattern previously described for two yeast glyceraldehyde-3-phosphate dehydrogenase structural genes (Holland, J. P., and Holland, M. J. (1980) J. Biol. Chem. 255, 2596-2605). DNA blotting analysis confirmed that the isolated segments of yeast DNA are colinear with yeast genomic DNA and that there are two nontandemly repeated enolase genes per haploid yeast genome. The noncoding portions of the two enolase genes adjacent to the initiation and termination codons are approximately 70% homologous and contain sequences thought to be involved in the synthesis and processing messenger RNA. Finally there are regions of extensive homology between the two enolase structural genes and two yeast glyceraldehyde-3-phosphate dehydrogenase structural genes within the 5

The role of surgical expertise with regard to chronic postoperative inguinal pain (CPIP) after Lichtenstein correction of inguinal hernia: a systematic review.

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Lange, J F M; Meyer, V M; Voropai, D A; Keus, E; Wijsmuller, A R; Ploeg, R J; Pierie, J P E N

2016-06-01

The aim of this study was to evaluate whether a relation exists between surgical expertise and incidence of chronic postoperative inguinal pain (CPIP) after inguinal hernia repair using the Lichtenstein procedure . CPIP after inguinal hernia repair remains a major clinical problem despite many efforts to address this problem. Recently, case volume and specialisation have been found correlated to significant improvement of outcomes in other fields of surgery; to date these important factors have not been reviewed extensively enough in the context of inguinal hernia surgery. A systematic literature review was performed to identify randomised controlled trials reporting on the incidence of CPIP after the Lichtenstein procedure and including the expertise of the surgeon. Surgical expertise was subdivided into expert and non-expert. In a total of 16 studies 3086 Lichtenstein procedures were included. In the expert group the incidence of CPIP varied between 6.9 and 11.7 % versus an incidence of 18.1 and 39.4 % in the non-expert group. Due to the heterogeneity between groups no statistical significance could be demonstrated. The results of this evaluation suggest that an association between surgical expertise and CPIP is highly likely warranting further analysis in a prospectively designed study.

[The quality of patient care under the German DRG system using as example the inguinal hernia repair].

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Rudroff, C; Schweins, M; Heiss, M M

2008-02-01

The DRG system in Germany was introduced to improve and at the same time simplify the reimbursement of costs in German hospitals. Cost effectiveness and economic efficiency were the declared goals. Structural changes and increased competition among different hospitals were the consequences. The effect on the qualitiy of patient care has been discussed with some concern. Furthermore, doubts have been expressed about the correct representation of the various diagnoses and treatments in the coding system and the financial revenue. Inguinal hernia repair serves as an example to illustrate some common problems with the reimbursement in the DRG system. Virtual patients were grouped using a "Web Grouper" and analysed using the cost accounting from the G-DRG-Browser of the InEK. Additionally, the reimbursement for ambulant hernia repair was estimated. The DRG coding did not differentiate the various operative procedures for inguinal hernia repair. They all generated the same revenues. For example, the increased costs for bilateral inguinal hernia repair are not represented in the payment. Furthermore, no difference is made between primary and recurrent inguinal hernia. In the case of a short-term hospital stay, part of the revenue is retained. In the case of ambulatory treatment of inguinal hernia, the reimbursement is by far not a real compensation for the actual costs. The ideal patient in the DRG system suffers from a primary inguinal hernia, undergoes an open hernia repair without mesh, and remains for 2-3 days in hospital. Minimally invasive procedures, repair of bilateral inguinal hernia and ambulant operation are by far less profitable--if at all. The current revenues for inguinal hernia repair require improvement and adjustment to reality in order to accomplish the goals which the DRG system in Germany aims at.

Direct and Recurrent Inguinal Hernias are Associated with Ventral Hernia Repair

DEFF Research Database (Denmark)

Henriksen, Nadia A; Sorensen, Lars T; Bay-Nielsen, Morten

2013-01-01

A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim...

Analysis of the 3d9ns (n = 5, 6), 3d95p, 3d94f and 3d84s4p configurations of five times ionized arsenic (As VI)

International Nuclear Information System (INIS)

Ryabtsev, A.N.; Gayasov, R.R.; Joshi, Y.N.; Van het Hof, G.J.

1993-01-01

The spectrum of arsenic was photographed in the 100-1250 A region on grazing and normal incidence spectrographs. The spectrum of As VI was extended. Seven out of eight levels of the 3d 9 5s and 6s configurations, 12 out of 12 levels of the 3d 9 5p configuration, 13 out of 20 levels of the 3d 9 4f configuration and 35 levels belonging to the 3d 9 4s4p configuration have been established. Least-Square-Fitted parametric calculations involving configuration interactions both in even and odd parity systems were carried out to adequately interpret the spectrum. One hundred and thirty-two additional lines were classified in the As VI spectrum. A new value of the ionization limit was obtained. Thus, the 3d 9 2 D 5/2 ground level in As VII lies 977500 cm -1 (121.17 eV) above the As VI ground state. (orig.)

High resolution emission Fourier transform infrared spectra of the 4p-5s and 5p-6s bands of ArH.

Science.gov (United States)

Baskakov, O I; Civis, S; Kawaguchi, K

2005-03-15

In the 2500-8500 cm(-1) region several strong emission bands of (40)ArH were observed by Fourier transform spectroscopy through a dc glow discharge in a mixture of argon and hydrogen. Rotational-electronic transitions of the two previously unstudied 4p-5s and 5p-6s,v = 0-0, bands of (40)ArH were measured and assigned in the 6060 and 3770 cm(-1) regions, respectively. A simultaneous fit of the emission transitions of the 4p-5s and 5p-6s bands and an extended set of transitions of the 6s-4p band observed by Dabrowski, Tokaryk, and Watson [J. Mol. Spectrosc. 189, 95 (1998)] and remeasured in the present work yielded consistent values of the spectroscopic parameters of the electronic states under investigation. In the branch of the 4p-5s band with transitions of type (Q)Q(f(3)e) we observed a narrowing in the linewidths with increasing rotational quantum number N. The rotational dependence of the linewidth is caused by predissociation of the 5s state by the repulsive ground 4s state through homogeneous coupling and changes in overlap integrals of the vibrational wave functions with the rotational level. Analysis was based on the Fermi's golden rule approximation model. In the 4p-5s band region a vibrational sequence ofv(')-v(")=1-1, 2-2, and 3-3 were recorded and a number of transitions belonging to the strongest (Q)Q(f(3)e) form branch of the 1-1 band were analyzed.

P - aminobenzoic - 3,5 - T acid

International Nuclear Information System (INIS)

Mihaila, V.; Corol, Delia

1999-01-01

The p-aminobenzoic acid (PABA) is used in the treatment of rheumatoid arthritis and dermatological diseases. The tritium labelling of PABA leads to the elucidation of essential biomedical aspects concerning the collagen behavior. The process of tritium introduction into the PABA molecule consists of two steps: 1. Bromination of PABA with elemental bromine in 3 and 5 positions; 2. Replacement of bromine with tritium by a substitution catalytic reaction.. PABA - 3,5 - T is purified by thin layer preparative chromatography and is characterized radiochemically by radioactivity measurements carried out by liquid scintillators. The chemical concentration is determined by UV spectrophotometry. The quenching is estimated using a calibration curve of the pure product. The specific activities (about 50-60 Ci/mM) allow very sensitive biomedical studies to be performed. (authors)

Vaginocutaneous fistula and inguinal abcess presented 6 years after tension-free vaginal tape sling

Directory of Open Access Journals (Sweden)

Ali Feyzullah Sahin

2013-06-01

Full Text Available Surgical treatment of female stress urinary incontinence (SUI has become very pop- ular after respectable success with minimal invasive surgeries. This is the first report of long term vaginocutaneous fistula (VCF plus inguinal abcess after tension-free vaginal tape (TVT. A 67 year-old woman with vaginal discharge lasting more than 3 years complained with a painful swelling in the left inguinal area for the last three months. She had a medical history of TVT sling procedure for SUI six years ago. She had no history of pelvic surgery, cancer treatment or pelvic irradiation before or after TVT sling. No urethrovaginal or vesicovaginal fistula was found in physical examination and cystocopy. MRI showed a vaginocutenaous fistula and inguinal abcess. This case highlights the need for a high index of suspicion for VCF after TVT.

Generalized oscillator strengths for 5s, 5s', and 5p excitations of krypton

International Nuclear Information System (INIS)

Li Wenbin; Zhu Linfan; Yuan Zhensheng; Sun Jianmin; Cheng Huadong; Xu Kezun; Zhong Zhiping; Liu Xiaojing

2003-01-01

The absolute generalized oscillator strengths (GOSs) for 5s, 5s ' , 5p [5/2] 3,2 , 5p [3/2] 1,2 , and 5p [1/2] 0 transitions of krypton have been determined in a large K 2 region at a high electron-impact energy of 2500 eV. The positions of the minima and maxima of these GOSs have been determined. The present results show that the angular resolution and pressure effect have great influence on the position and the amplitude of the minimum for the GOS of 5s+5s ' transitions. When these effects are considered, the measured minimum position for the GOS of 5s+5s ' transitions is in excellent agreement with the calculation of Chen and Msezane [J. Phys. B 33, 5397 (2000)

The Role of Biotransformation and Oxidative Stress in 3,5-Dichloroaniline (3,5-DCA) Induced Nephrotoxicity in Isolated Renal Cortical Cells from Male Fischer 344 Rats

Science.gov (United States)

Racine, Christopher R.; Ferguson, Travis; Preston, Debbie; Ward, Dakota; Ball, John; Anestis, Dianne; Valentovic, Monica; Rankin, Gary O.

2016-01-01

Among the mono- and dichloroanilines, 3,5-Dichloroaniline (3,5-DCA) is the most potent nephrotoxicant in vivo and in vitro. However, the role of renal biotransformation in 3,5-DCA induced nephrotoxicity is unknown. The current study was designed to determine the in vitro nephrotoxic potential of 3,5-DCA in isolated renal cortical cells (IRCC) obtained from male Fischer 344 rats, and the role of renal bioactivation and oxidative stress in 3,5-DCA nephrotoxicity. IRCC (~4 million cells/ml) from male rats were exposed to 3,5-DCA (0-1.0 mM) for up to 120 min. In IRCC, 3,5-DCA was cytotoxic at 1.0 mM by 60 min as evidenced by the increased release of lactate dehydrogenase (LDH), but 120 min was required for 3,5-DCA 0.5 mM to increase LDH release. In subsequent studies, IRCC were exposed to a pretreatment (antioxidant or enzyme inhibitor) prior to exposure to 3,5-DCA (1.0 mM) for 90 min. Cytotoxicity induced by 3,5-DCA was attenuated by pretreatment with inhibitors of flavin-containing monooxygenase (FMO; methimazole, N-octylamine), cytochrome P450 (CYP; piperonyl butoxide, metyrapone), or peroxidase (indomethacin, mercaptosuccinate) enzymes. Use of more selective CYP inhibitors suggested that the CYP 2C family contributed to 3,5-DCA bioactivation. Antioxidants (glutathione, N-acetyl-L-cysteine, α-tocopherol, ascorbate, pyruvate) also attenuated 3,5-DCA nephrotoxicity, but oxidized glutathione levels and the oxidized/reduced glutathione ratios were not increased. These results indicate that 3,5-DCA may be activated via several renal enzyme systems to toxic metabolites, and that free radicals, but not oxidative stress, contribute to 3,5-DCA induced nephrotoxicity in vitro. PMID:26808022

A Low-Cost Teaching Model of Inguinal Canal: A Useful Method to Teach Surgical Concepts in Hernia Repair

Science.gov (United States)

Ansaloni, Luca; Catena, Fausto; Coccolini, Frederico; Ceresoli, Marco; Pinna, Antonio Daniele

2014-01-01

Objectives: Inguinal canal anatomy and hernia repair is difficult for medical students and surgical residents to comprehend. Methods: Using low-cost material, a 3-dimensional inexpensive model of the inguinal canal was created to allow students to learn anatomical details and landmarks and to perform their own simulated hernia repair. In order to…

Hospital Costs Associated With Laparoscopic and Open Inguinal Herniorrhaphy

OpenAIRE

Spencer Netto, Fernando; Quereshy, Fayez; Camilotti, Bruna G.; Pitzul, Kristen; Kwong, Josephine; Jackson, Timothy; Penner, Todd; Okrainec, Allan

2014-01-01

Purpose: The purpose of this study was to compare the total hospital costs associated with elective laparoscopic and open inguinal herniorrhaphy. Methods: A prospectively maintained database was used to identify patients who underwent elective inguinal herniorrhaphy from April 2009 to March 2011. A retrospective review of electronic patient records was performed along with a standardized case-costing analysis using data from the Ontario Case Costing Initiative. The main outcomes were operatin...

Herniorrafia inguinal: Técnica por sobrecapas de Fascia Transversalis

Directory of Open Access Journals (Sweden)

José Miguel Goderich Lalán

1997-08-01

Full Text Available Se realizó un estudio descriptivo, prospectivo, observacional y longitudinal para evaluar los resultados obtenidos con la aplicación de una técnica de reparación herniaria inguinal (original del autor por sobrecapas de fascia transversalis, en la que se afronta una primera capa de ésta en sutura continua, desde la proyección del tubérculo púbico hasta obliterar el anillo inguinal profundo, después de lo cual se crea una segunda capa al afrontar el arco aponeurótico del transverso a la cintilla iliopubiana. Luego de un seguimiento superior a los 10 años, se comprobó que de 1 475 pacientes sólo hubo recidivas en 1,2 %; éstas fueron más frecuentes en los hombres, en las hernias del tipo indirecto y en los pacientes con más de 45 años. El mayor número de recidivas ocurrió entre el primer y tercer año de operado. Se recomienda introducir esta nueva técnica en la práctica quirúrgica, y cumplir las indicaciones y el proceder señalado por el autorA descriptive, prospective, observational, and longitudinal study was performed to evaluate the results obtained with the application of a technique for the repair of inguinal hernia (the author's original technique by overlayers of fascia transversalis, in which the first layer is copped with the use of continuos suture from the projection of the pubic tubercle until the obliteration of the deep inguinal rign, creating a second layer when copping the aponeurotic arch of the transverse to the iliopubic eminence. After a follow-up longer than 10 years, it was proved that out of 1 475 patients, only 1,2 % presented with recurrences. Relapses were more frequent in males, in indirect hernias and in patients over 45 years of age. The greatest number of recurrences occurred between the first and the third year after the operation. It is recommended to introduce this new technique within the surgical practice and to comply with the indications for the procedure made by the author

Vacuum ultraviolet excited luminescence properties of sol–gel derived GdP5O14:Eu3+ powders

International Nuclear Information System (INIS)

Mbarek, Aïcha; Chadeyron, Geneviève; Boyer, Damien; Avignant, Daniel; Fourati, Mohieddine; Zambon, Daniel

2014-01-01

Sol–gel route has successfully been used to synthesize pure and Eu 3+ doped polycrystalline samples of the GdP 5 O 14 pentaphosphates. The as-prepared samples have structurally been characterized using X-ray diffraction. Optical properties in the vacuum ultraviolet (VUV) of Eu 3+ activated GdP 5 O 14 samples prepared either by sol–gel process or solid-state reaction were investigated at room temperature for comparison. In this GdP 5 O 14 host matrix the P 5 O 14 ultraphosphate groups were proved to exhibit an efficient absorption in the VUV range. The excitation spectra recorded in the VUV-UV spectral region from 120 nm to 350 nm have revealed the presence of Gd 3+ 4f–5d interconfiguration transitions, Gd 3+ –O 2− and Eu 3+ –O 2− charge transfer states(CTS)in addition to intraconfiguration transitions of Gd 3+ ions.Furthermore the Gd 3+ →Eu 3+ energy transfer process was investigated and discussed in the framework of the multiphonon relaxation process. Besides, the GdP 5 O 14 :Eu 3+ phosphor led to a strong red emission under 147/172 nm excitation, so that it can be considered as a promising red phosphor for mercury-free lamps and plasma display panels applications. -- Highlights: • Lanthanide pentaphosphates were synthesized by the sol–gel process. • A broad absorption was evidenced in the VUV range for GdP 5 O 14 :Eu 3+ . • An efficient energy transfer was proved from pentaphosphate lattice to Eu 3+ ions

One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia

DEFF Research Database (Denmark)

Callesen, T; Bech, K; Kehlet, H

2001-01-01

To evaluate the feasibility and safety of unmonitored local anesthesia (ULA) for elective open inguinal hernia repair, we made a prospective, consecutive data collection from 1000 operations on primary and recurrent hernias. Follow-up consisted of a questionnaire 1 mo after surgery and retrieval...... from the electronic patient data management system. In 921 ASA Group I and II and 79 ASA Group III and IV patients, the median age was 60 yr (range, 18-95 yr). ULA was converted to general anesthesia in 5 of 1000 cases, and 961 patients were discharged on the day of surgery after 95 min (median...... anesthesia, day-case setup, or both, primarily because of intraoperative pain (n = 74; 7.8%). We conclude that open inguinal hernia repair can be conducted under ULA, regardless of comorbidity, with a small rate of deviation from day-case setup and minimal morbidity. It provides a safe alternative to other...

Route to neo-inguinal canal: Our experience

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J Jacob Swaroop Anand

2011-01-01

Full Text Available Aim: The objective of this study was to stress the importance and value of this route to neo-inguinal canal creation for undescended testis management laparoscopically. Materials and Methods: Data from the Department of Paediatric Surgery, Coimbatore Medical College, was taken. Retrospective study was undertaken for the period 2004 to 2008. Here the surgical technique and outcome of the treatment are recorded for children aged 1 year to 12 years. Results: A total of 126 children underwent laparoscopic stage II surgery by this route (medial to the medial umbilical ligament. Right-sided undescended testis (UDT was present in 76 (60% patients. Left-sided UDT was present in 45 (35% patients. Bilateral UDT was present in 5 (5% patients. There were 90 (71% patients aged less than 2 years and 36 (29% patients aged more than 2 years. The eldest patient was 12 years of age. The overall hospital stay was 1 day. There were no complications seen in the follow-up. In all cases, the testis could not be brought down in a single stage. Conclusion: Creation of neo-inguinal canal medial to the medial umbilical ligament and just lateral to the bladder has the advantage of gaining more length on the vessels and vas to bring the testis to scrotum. The laparoscopic management of undescended testis in stage II by this innovative new route is simple, less complicated and well tolerated.

INFLUENCE OF TOBACCO, ALCOHOL AND DIABETES ON THE COLLAGEN OF CREMASTER MUSCLE IN PATIENTS WITH INGUINAL HERNIAS.

Science.gov (United States)

Módena, Sérgio Ferreira; Caldeira, Eduardo José; Peres, Marco Antonio O; Andreollo, Nelson Adami

2016-01-01

New findings point out that the mechanism of formation of the hernias can be related to the collagenous tissues, under activity of aggressive agents such as the tobacco, alcohol and diabetes. To analyze the collagen present in the cremaster muscle in patients with inguinal hernias, focusing the effect of tobacco, alcohol, and diabetes. Fifteen patients with inguinal hernia divided in three groups were studied: group I (n=5) was control; group II (n=5) were smokers and/or drinkers; and group III (n=5) had diabetes mellitus. All subjects were underwent to surgical repair of the inguinal hernias obeying the same pre, intra and postoperative conditions. During surgery, samples of the cremaster muscle were collected for analysis in polarized light microscopy, collagen morphometry and protein. The area occupied by the connective tissue was higher in groups II and III (ptabaco, o álcool e o diabete. Avaliar o colágeno presente no músculo cremaster em pacientes com hérnias inguinais enfocando o efeito do tabaco, álcool e diabete. Foram estudados 15 pacientes com hérnias inguinais divididos em: grupo I (n=5) controles; grupo II (n=5) indivíduos fumantes e/ou etilistas; e grupo III (n=5) indivíduos que apresentavam diabete melito. Todos foram submetidos à correção cirúrgica das hérnias inguinais obedecendo às mesmas condições pré, intra e pós-operatórias. Durante o procedimento cirúrgico, amostras do músculo cremaster foram coletadas para análises em microscopia de luz polarizada, morfometria do colágeno e de proteínas. A área ocupada por tecido conjuntivo foi maior nos grupos II e III (ptabaco, o álcool e o diabete ocasionam remodelação no músculo cremaster, levando à perda de suporte ou alteração estrutural nesta região, podendo intensificar as ocorrências e os danos relacionados às hérnias inguinais.

3D seismic isolation for advanced N.P.P application. Hydraulic 3-Dimensional base-isolation system

International Nuclear Information System (INIS)

Shimada, Takahiro; Kashiwazaki, Akihiro; Fujiwaka, Tatsuya; Moro, Satoshi

2003-01-01

In Japan, a number of three-dimensional base isolation systems have been studied for application to new nuclear plant concepts such as the FBR, but these effects have not so far yielded practically applicable results. The impeding factor has been the difficulty of obtaining an adequate capacity on the vertical isolator for supporting the mass of an actual structure and for suppressing rocking motion. In this paper, we propose a new three-dimensional base isolation system that should solve the foregoing problem. The system is constituted of a set of hydraulic load-carrying cylinders connected to accumulator units containing a compressed gas, another set of rocking-suppression cylinders connected in series, and a laminated rubber bearing laid under each load-carrying cylinder. The present paper covers a basic examination for applying the proposed system to a commercialized FBR now under development in Japan, together with static and dynamic loading tests performed on a scale model to verify expected system performance. Response and analysis reflecting the test results has indicated the proposed system to be well applicable to the envisaged commercialized FBR. The study was undertaken as part of an R and D project sponsored by the government for realizing a three-dimensional seismic isolation system applicable to future FRB's. (author)

Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

Directory of Open Access Journals (Sweden)

Cihad Tatar

2016-08-01

Full Text Available Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of noncomplicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3, and the other consisting of patients not undergoing bowel resection (Group 4. Results: In Group 1, it was observed that eight (7.14% of the patients had wound infections, while two (1.78% had hematomas, four (3.57% had seromas, and one (0.89% had relapse. In Group 2, one (2.56% of the patients had a wound infection, while three (7.69% had hematomas, one (2.56% had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection

Convalescence after laparoscopic inguinal hernia repair

DEFF Research Database (Denmark)

Tolver, Mette Astrup; Rosenberg, Jacob; Bisgaard, Thue

2016-01-01

. Furthermore, snowball search was performed in reference lists of identified articles. Randomized controlled trials and prospective comparative or non-comparative trials of high quality were included. Trials with ≥100 patients, >18 years of age and manuscripts in English were included. Scoring systems were...... used for assessment of quality. RESULTS: The literature search identified 1039 papers. Thirty-four trials were included in the final review including 14,273 patients. There was overall a large variation in duration of convalescence. Trials using non-restrictive recommendations of 1-2 days or "as soon...... factors for prolonged convalescence extending more than a few days after laparoscopic inguinal hernia repair. CONCLUSIONS: Patients should be recommended a duration of 1-2 days of convalescence after laparoscopic inguinal hernia repair. Short and non-restrictive recommendations may reduce duration...

Visual Display of 5p-arm and 3p-arm miRNA Expression with a Mobile Application.

Science.gov (United States)

Pan, Chao-Yu; Kuo, Wei-Ting; Chiu, Chien-Yuan; Lin, Wen-Chang

2017-01-01

MicroRNAs (miRNAs) play important roles in human cancers. In previous studies, we have demonstrated that both 5p-arm and 3p-arm of mature miRNAs could be expressed from the same precursor and we further interrogated the 5p-arm and 3p-arm miRNA expression with a comprehensive arm feature annotation list. To assist biologists to visualize the differential 5p-arm and 3p-arm miRNA expression patterns, we utilized a user-friendly mobile App to display. The Cancer Genome Atlas (TCGA) miRNA-Seq expression information. We have collected over 4,500 miRNA-Seq datasets from 15 TCGA cancer types and further processed them with the 5p-arm and 3p-arm annotation analysis pipeline. In order to be displayed with the RNA-Seq Viewer App, annotated 5p-arm and 3p-arm miRNA expression information and miRNA gene loci information were converted into SQLite tables. In this distinct application, for any given miRNA gene, 5p-arm miRNA is illustrated on the top of chromosome ideogram and 3p-arm miRNA is illustrated on the bottom of chromosome ideogram. Users can then easily interrogate the differentially 5p-arm/3p-arm expressed miRNAs with their mobile devices. This study demonstrates the feasibility and utility of RNA-Seq Viewer App in addition to mRNA-Seq data visualization.

Visual Display of 5p-arm and 3p-arm miRNA Expression with a Mobile Application

Directory of Open Access Journals (Sweden)

Chao-Yu Pan

2017-01-01

Full Text Available MicroRNAs (miRNAs play important roles in human cancers. In previous studies, we have demonstrated that both 5p-arm and 3p-arm of mature miRNAs could be expressed from the same precursor and we further interrogated the 5p-arm and 3p-arm miRNA expression with a comprehensive arm feature annotation list. To assist biologists to visualize the differential 5p-arm and 3p-arm miRNA expression patterns, we utilized a user-friendly mobile App to display. The Cancer Genome Atlas (TCGA miRNA-Seq expression information. We have collected over 4,500 miRNA-Seq datasets from 15 TCGA cancer types and further processed them with the 5p-arm and 3p-arm annotation analysis pipeline. In order to be displayed with the RNA-Seq Viewer App, annotated 5p-arm and 3p-arm miRNA expression information and miRNA gene loci information were converted into SQLite tables. In this distinct application, for any given miRNA gene, 5p-arm miRNA is illustrated on the top of chromosome ideogram and 3p-arm miRNA is illustrated on the bottom of chromosome ideogram. Users can then easily interrogate the differentially 5p-arm/3p-arm expressed miRNAs with their mobile devices. This study demonstrates the feasibility and utility of RNA-Seq Viewer App in addition to mRNA-Seq data visualization.

First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient.

Science.gov (United States)

Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

2016-03-01

Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt diagnosis

Attosecond sublevel beating and nonlinear dressing on the 3d-to-5p and 3p-to-5s core-transitions at 91.3 eV and 210.4 eV in krypton.

Science.gov (United States)

Seres, Enikoe; Seres, Jozsef; Namba, Shinichi; Afa, John; Serrat, Carles

2017-12-11

Applying extreme ultraviolet (XUV) transient absorption spectroscopy, the dynamics of the two laser dressed transitions 3d 5/2 -to-5p 3/2 and 3p 3/2 -to-5s 1/2 at photon energies of 91.3 eV and 210.4 eV were examined with attosecond temporal resolution. The dressing process was modeled with density matrix equations which are found to describe very accurately both the experimentally observed transmission dynamics and the linear and nonlinear dressing oscillations at 0.75 PHz and 1.5 PHz frequencies. Furthermore, using Fourier transform XUV spectroscopy, quantum beats from the 3d 5/2 -3d 3/2 and 3p 3/2 -3p 1/2 sublevels at 0.3 PHz and 2.0 PHz were experimentally identified and resolved.

Secondary typing of Mycobacterium tuberculosis isolates with matching IS6110 fingerprints from different geographic regions of the United States.

Science.gov (United States)

Yang, Z H; Bates, J H; Eisenach, K D; Cave, M D

2001-05-01

Fifty-nine isolates of Mycobacterium tuberculosis obtained from different states in the United States and representing 25 interstate clusters were investigated. These clusters were identified by computer-assisted analysis of DNA fingerprints submitted during 1996 and 1997 by different laboratories participating in the CDC National Genotyping and Surveillance Network. Isolates were fingerprinted with the IS6110 right-hand probe (IS6110-3'), the IS6110 left-hand probe (IS6110-5'), and the probe pTBN12, containing the polymorphic GC-rich sequence (PGRS). Spoligotyping based on the polymorphism in the 36-bp direct-repeat locus was also performed. As a control, 43 M. tuberculosis isolates in 17 clusters obtained from patients in Arkansas during the study period were analyzed. Of the 25 interstate clusters, 19 were confirmed as correctly clustered when all the isolates were analyzed on the same gel using the IS6110-3' probe. Of the 19 true IS6110-3' clusters, 10 (53%) were subdivided by one or more secondary typing methods. Clustering of the control group was virtually identical by all methods. Of the three different secondary typing methods, spoligotyping was the least discriminating. IS6110-5' fingerprinting was as discriminating as PGRS fingerprinting. The data indicate that the IS6110-5' probe not only is a useful secondary typing method but also probably would prove to be a more useful primary typing method for a genotyping network which involves isolates from different geographic regions.

Laparoscopic inguinal hernia repair: review of 6 years experience.

Science.gov (United States)

Vanclooster, P; Smet, B; de Gheldere, C; Segers, K

2001-01-01

Since 6 years, the totally extraperitoneal laparoscopic hernia repair has become our procedure of choice to manage inguinal hernia in adult patients, especially for bilateral hernias and recurrences after classical anterior repair. Between March 1993 and March 1999, 976 patients underwent 1259 hernia repairs by an endoscopic total extraperitoneal approach. A large polypropylene prosthesis (15 x 15 cm) is placed and covers all potential defects. Follow-up on patients ranged from 6 to 79 months (mean, 39 months). Per- and postoperative morbidity and complications were acceptable (8.4%) and included conversion to open surgery (0.4%), bleedings (0.3%), urinary retention (4.2%), seromas (2.7%), neuralgias (0.2%), vague persistent groin discomfort (0.4%), orchitis (0.08%) and sigmoido-cutaneous fistula (0.08%). Recurrence rate so far is 0.1%. This retrospective study shows that the totally extraperitoneal repair for inguinal hernia should have a promising future because of low morbidity and low recurrence rate.

MYOMA OF THE ROUND LIGAMENT MIMICKING THE CLINICAL APPEARANCE OF THE INGUINAL HERNIA – A CASE REPORT

Directory of Open Access Journals (Sweden)

Aleš Pišek

2004-12-01

Full Text Available Background. Myomas are the most frequent gynecological tumors. They first occur during puberty; however, they are most frequent among aged between 35 and 50. In this age group their incidence is 15–20%. They are rare after menopause. The majority of myomas arise in the uterus, but they may arise from other extrauterine sites such as the fallopian tubes, ovaries, round ligament, ligamentum latum, sacrouterine ligament, vagina and even the urethra. Most authors agree that there are numerous causes for the occurrence of myomas; however, they have not yet been clearly proven. They however agree that the myomas appear most frequently in the reproductive age, when the ovarian hormone levels are high and they diminish after menopause. They equally agree that the risk factors for the clinically significant myomas are nulliparity, obesity, a positive family history of myomas and African racial origin.Patients and methods. A 43-year-old patient was referred to our institution for operative treatment by her personal gynaecologist who clinically and sonografically verified a solid tumor situated to the right side of the uterus. The size of the tumor was that of a newborn’s head. The patient, however, had been observing a reponible inguinal hernia the size of a female fist for a period of four years. A solid tumor (22×6×7 cm arising from the right round ligament, was remowed during surgery. Half of its size was situated in the inguinal canal thus mimicking the clinical appearance of the inguinal hernia. After the tumor was removed the inner door of the inguinal canal closed by itself, no surgical repair was necessary. On histological examination the tumor was classified as a leiomyoma.Conclusions. Although the leiomyoma of the round ligament is the most frequent tumor of that region it is a rare gynecological tumor. The described case is especially interesting due to the unusual position of the tumor. It was situated partly intraabdominally and partly

Glue versus suture for mesh fixation in inguinal hernia repair.

Science.gov (United States)

Chandrasekar, Shruthi; Jeyakumar, S; Ganapathy, Tharun

2018-03-22

glue were used to fix the mesh instead of sutures. The tissue glue used in this study was N Butyl- 2 - Cyanoacrylate. All patients in the study underwent surgery only by one group of surgeons to maintain homogeneity and were observed in the hospital for 72 h. A note of the pain on VAS scale was made at 12, 24, 48, 72 h, 1 week, 1 month, 3 months and 6 months. Operative time and any complications were also recorded. Results developed using SPSS software show that there is a significant difference in the time taken by both the methods, with glue taking a significantly lower time than sutures. Significance is also seen in the difference in the immediate and chronic post-operative pain between both the groups. However the complication rates in both the groups were found to be the same. It can thus be concluded from this study that tissue glue mesh fixation is superior to suture mesh fixation in open inguinal repair in terms of operative time, immediate and chronic post-operative time. Copyright © 2018. Published by Elsevier Ltd.

Self-adhesive mesh for Lichtenstein inguinal hernia repair. Experience of a single center.

Science.gov (United States)

Tarchi, P; Cosola, D; Germani, P; Troian, M; De Manzini, N

2014-06-01

Lichtenstein tension-free mesh repair is the most frequently performed procedure for inguinal hernioplasty. In the past surgery aimed to control recurrences. Nowadays it is important to avoid postoperative chronic pain and thus several studies have examined the potential role of meshes in causing postoperative pain. The purpose of this study was to retrospectively assess the early and long-term results after Lichtenstein tension-free repair using a self-adhesive mesh (Parietex ProgripTM - Covidien, Germany) in a single center. The study enrolled 211 patients, 199 males (94.3%) and 12 females (5.7%), mean age 62 years (28-90 years), between January 2008 and December 2011. Of these, 206 had primary inguinal hernias while 5 were recurrences following previous tension repair. Ten different general surgeons, including residents, performed Lichtenstein hernia repair using a 12 x 8-cm Parietex ProgripTM mesh. In 88.1% of patients no additional fixation was used, while in 11.9% a single 2-0 polypropylene stitch was placed on the pubic bone. A 1-10 visual analog scale (VAS) was used to assess postoperative pain, evaluating it at 1 week, 1 month and 12, 24 and 36 months. Local paresthesia was assessed at same intervals. Any pain sensation lasting longer than 3 months postoperatively, or requiring injection of analgesics was defined as chronic pain. Mean operating time was 64.1 minutes (SD ± 21.14). There were no intraoperative complications. Early postoperative complications included hematoma-seroma (5.7% cases), superficial wound infection (1%), urinary retention (0.5%), and scrotal swelling (1%). The main follow-up period was 3 years, although patients operated between 2009 and 2011 underwent a shorter follow-up. At one-year follow-up, 17 patients reported groin discomfort, but did not require analgesics. Three patients reported moderate pain, requiring occasional use of oral analgesics, and 2 of these described a discontinuous pain mainly during movement. One patient

Current practices of laparoscopic inguinal hernia repair: a population-based analysis.

Science.gov (United States)

Trevisonno, M; Kaneva, P; Watanabe, Y; Fried, G M; Feldman, L S; Andalib, A; Vassiliou, M C

2015-10-01

The selection of a laparoscopic approach for inguinal hernias varies among surgeons. It is unclear what is being done in actual practice. The purpose of this study was to report practice patterns for treatment of inguinal hernias among Quebec surgeons, and to identify factors that may be associated with the choice of operative approach. We studied a population-based cohort of patients who underwent an inguinal hernia repair between 2007 and 2011 in Quebec, Canada. A generalized linear model was used to identify predictors associated with the selection of a laparoscopic approach. 49,657 inguinal hernias were repaired by 478 surgeons. Laparoscopic inguinal hernia repair (LIHR) was used in 8 % of all cases. LIHR was used to repair 28 % of bilateral hernias, 10 % of recurrent hernias, 6 % of unilateral hernias, and 4 % of incarcerated hernias. 268 (56 %) surgeons did not perform any laparoscopic repairs, and 11 (2 %) surgeons performed more than 100 repairs. These 11 surgeons performed 61 % of all laparoscopic cases. Patient factors significantly associated with having LIHR included younger age, fewer comorbidities, bilateral hernias, and recurrent hernias. An open approach is favored for all clinical scenarios, even for situations where published guidelines recommend a laparoscopic approach. Surgeons remain divided on the best technique for inguinal hernia repair: while more than half never perform LIHR, the small proportion who perform many use the technique for a large proportion of their cases. There appears to be a gap between the best practices put forth in guidelines and what surgeons are doing in actual practice. Identification of barriers to the broader uptake of LIHR may help inform the design of educational programs to train those who have the desire to offer this technique for certain cases, and have the volume to overcome the learning curve.

First Detection of GES-5 Carbapenemase-Producing Acinetobacter baumannii Isolate.

Science.gov (United States)

Al-Agamy, Mohamed H; Jeannot, Katy; El-Mahdy, Taghrid S; Shibl, Atef M; Kattan, Wael; Plésiat, Patrick; Courvalin, Patrice

2017-07-01

This study was conducted to investigate the molecular epidemiology of resistance in Acinetobacter baumannii isolates collected at a hospital in Riyadh, Saudi Arabia, from January through December 2010. Twenty-seven A. baumannii were highly resistant (MIC 90 > 256 μg/ml) to ceftazidime, cefepime, and aztreonam. Imipenem resistance was seen in 24 isolates, of which 18 had an minimum inhibitory concentration (MIC) >32 μg/mL. Ciprofloxacin, gentamicin, and amikacin resistance was found in 93%, 52%, and 37% of all the isolates, respectively. Moreover, 8 (30%) isolates showed colistin resistance, and 15 (56%) were found to have MICs ≥4 μg/mL for tigecycline. The frequency of ADC, GES-1, GES-11, and GES-5 were 96.3% (n = 26), 18.5% (n = 5), 11% (n = 3), and 3.7% (n = 1), respectively. OXA-23 was found in 63% (n = 17) of the isolates; ISAba1 was found upstream of OXA-23 in 16. OXA-24/40 was detected in only one strain. Multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) analysis revealed that the 27 strains were distributed in 8 sequence types (STs) and 16 clonal pulsotypes (A-P). Five singleton STs were identified, including ST15 and ST113-ST116. The emergence of multidrug-resistant A. baumannii is becoming a major concern in Saudi Arabia. Metallo-β-lactamases have no role in carbapenem resistance in this collection. The spread of OXA-23 in our strains occurred across different STs and pulsotypes, unlike what has been observed in many other countries. PFGE typing was more discriminatory than MLST. The high frequency of colistin and tigecycline resistance found in the isolates calls for continuous monitoring. This study describes the first identification of GES-5 conferring carbapenem resistance in A. baumannii.

Synthesis of diadenosine 5', 5'''-P1, P4-tetraphosphate (AP4A) in sea urchin embryos

International Nuclear Information System (INIS)

Morioka, Mizue; Shimada, Hiraku

1984-01-01

Sea urchin embryos were labeled with ( 3 H)adenosine at two developmental stages (morula and prism) and the labeled acid-soluble nucleotides were fractionated successively by column chromatography with DEAE-Sephadex and DEAE-cellulose, and by thin-layer chromatography on a PEI-cellulose plate. Significant radioactivity was detected on the PEI-cellulose plate at the region of diadenosine 5', 5'''-P 1 , P 4 -tetraphosphate (AP 4 A). After treatment of this fraction with phosphodiesterase, the radioactivity was all recovered in the AMP region, while alkaline phosphatase had no effect on the AP 4 A fraction. The present result suggests that AP 4 A is actively synthesized in the sea urchin embryos. (author)

Relaxant mechanisms of 3, 5, 7, 30, 40-pentamethoxyflavone on isolated human cavernosum

DEFF Research Database (Denmark)

Jansakul, Chaweewan; Tachanaparuksa, Kuldej; Mulvany, Michael J.

2012-01-01

We have investigated effects and mechanisms responsible for the activity of 3, 5, 7, 30, 40-pentamethoxyflavone (PMF) on isolated human cavernosum. PMF is the major flavone isolated from Kaempferia parviflora claimed to act as an aphrodisiac. PMF caused relaxation of phenylephrine precontracted...... Krebs solution with nifedipine (blocker of L-type Ca2þ channels), or in Ca2þ-free Krebs solution, PMF caused a further inhibition of human cavernosum contracted with phenylephrine. In human cavernosum treated with thapsigargin (inhibitor of sarcoplasmic reticulum Ca2þ-ATPase) in Ca2þ-free medium, PMF...

Differences in Entamoeba histolytica Cysteine Proteinase 5 Gene Isolated From Bandar Abbas and Tabriz, Iran

Directory of Open Access Journals (Sweden)

Sima Rostami

2017-05-01

Full Text Available Background: Amebiasis with up to 100 000 human deaths each year is the third cause of human deadly parasitic disease. With regard to the fact that cysteine protease 5 is known to be one of the most important pathogenicity factors of the Entamoeba histolytica and also, CP5 gene has been observed only in E. histolytica, hence we discriminated E. histolytica from E. dispar on CP5 gene by polymerase chain reaction (PCR and characterized CP5 gene variation in E. histolytica isolated from patients in both cold regions and tropical regions of Iran at molecular level. Materials and Methods: In the present study, a total of 2332 stool samples (1550 from Tabriz and 782 from Bandar Abbas were studied microscopically. DNA extraction and PCR method were performed on the positive specimens, infected with E. histolytica/E. dispar. Finally we characterized CP5 gene in E. histolytica isolates from 10 positive samples in the cold regions (Tabriz and 10 positive samples in the tropical regions (Bandar Abbas by sequencing and studied the polymorphism of the gene. Results: Of 1550 subjects studied from Tabriz and 782 from Bandar Abaas, 83/1550 (8.3% and 65/782 (5.35% persons were infected with E. histolytica/E. dispar, respectively. The molecular results on 20 E. histolytica PCR positive isolates from both regions revealed that nucleotides substitution and polymorphism on CP5 gene was more in samples from Bandar Abbas than those from Tabriz. Conclusion: Prevalence of amebiasis was high in the tropical region (Bandar Abbas compared with the cold region (Tabriz. In this study, CP5 gene variation in the pathogenicity and virulence of this parasite in the tropical region was higher than that in the cold region.

Posttranslational modification of hepatic cytochrome P-450. Phosphorylation of phenobarbital-inducible P-450 forms PB-4 (IIB1) and PB-5 (IIB2) in isolated rat hepatocytes and in vivo

International Nuclear Information System (INIS)

Koch, J.A.; Waxman, D.J.

1989-01-01

Phosphorylation of hepatic cytochrome P-450 was studied in isolated hepatocytes incubated in the presence of agents known to stimulate protein kinase activity. Incubation of hepatocytes isolated from phenobarbital-induced adult male rats with [ 32 P]orthophosphate in the presence of N 6 , O 2' -dibutyryl-cAMP (diBtcAMP) or glucagon resulted in the phosphorylation of microsomal proteins that are immunoprecipitable by polyclonal antibodies raised to the phenobarbital-induced P-450 form PB-4 (P-450 gene IIB1). Two-dimensional gel electrophoresis revealed that these 32 P-labeled microsomal proteins consist of a mixture of P-450 PB-4 and the closely related P-450 PB-5 (gene IIB2), both of which exhibited heterogeneity in the isoelectric focusing dimension. Phosphorylation of both P-450 forms was markedly enhanced by diBtcAMP at concentrations as low as 5 μM. Phosphoamino acid analysis of the 32 P-labeled P-450 PB-4 + PB-5 immunoprecipitate revealed that these P-450s are phosphorylated on serine in the isolated hepatocytes. Peptide mapping indicated that the site of phosphorylation in hepatocytes is indistinguishable from the site utilized by cAMP-dependent protein kinase in vitro, which was previously identified as serine-128 for the related rabbit protein P-450 LM2. In vitro analyses revealed that phosphorylation of P-450 PB-4 leads to a loss of monooxygenase activity, suggesting that the posttranslational modification of this P-450 enzyme by cAMP-dependent protein kinase may play a role in the modulation of P-450-dependent monooxygenase activity in vivo

Cono extendido, nueva variante técnica en la cirugía de la hernia inguinal Extended cone a new technical variant in the inguinal hernia surgery

Directory of Open Access Journals (Sweden)

Hiram Rodríguez Blanco

2011-06-01

in classification the modified Gilbert was used. RESULTS. There was predominance of male sex. The more frequent location was the right inguinal region and those patients classified as III degree according to the Gilbert's classification. There were six minor complications and up to present time there were not relapses. CONCLUSIONS. The extended cone technique is another option for treatment of patients presenting with III and IV degrees inguinal hernias according to Gilbert's classification.

Imputation and subset-based association analysis across different cancer types identifies multiple independent risk loci in the TERT-CLPTM1L region on chromosome 5p15.33

Science.gov (United States)

Wang, Zhaoming; Zhu, Bin; Zhang, Mingfeng; Parikh, Hemang; Jia, Jinping; Chung, Charles C.; Sampson, Joshua N.; Hoskins, Jason W.; Hutchinson, Amy; Burdette, Laurie; Ibrahim, Abdisamad; Hautman, Christopher; Raj, Preethi S.; Abnet, Christian C.; Adjei, Andrew A.; Ahlbom, Anders; Albanes, Demetrius; Allen, Naomi E.; Ambrosone, Christine B.; Aldrich, Melinda; Amiano, Pilar; Amos, Christopher; Andersson, Ulrika; Andriole, Gerald; Andrulis, Irene L.; Arici, Cecilia; Arslan, Alan A.; Austin, Melissa A.; Baris, Dalsu; Barkauskas, Donald A.; Bassig, Bryan A.; Beane Freeman, Laura E.; Berg, Christine D.; Berndt, Sonja I.; Bertazzi, Pier Alberto; Biritwum, Richard B.; Black, Amanda; Blot, William; Boeing, Heiner; Boffetta, Paolo; Bolton, Kelly; Boutron-Ruault, Marie-Christine; Bracci, Paige M.; Brennan, Paul; Brinton, Louise A.; Brotzman, Michelle; Bueno-de-Mesquita, H. Bas; Buring, Julie E.; Butler, Mary Ann; Cai, Qiuyin; Cancel-Tassin, Geraldine; Canzian, Federico; Cao, Guangwen; Caporaso, Neil E.; Carrato, Alfredo; Carreon, Tania; Carta, Angela; Chang, Gee-Chen; Chang, I-Shou; Chang-Claude, Jenny; Che, Xu; Chen, Chien-Jen; Chen, Chih-Yi; Chen, Chung-Hsing; Chen, Constance; Chen, Kuan-Yu; Chen, Yuh-Min; Chokkalingam, Anand P.; Chu, Lisa W.; Clavel-Chapelon, Francoise; Colditz, Graham A.; Colt, Joanne S.; Conti, David; Cook, Michael B.; Cortessis, Victoria K.; Crawford, E. David; Cussenot, Olivier; Davis, Faith G.; De Vivo, Immaculata; Deng, Xiang; Ding, Ti; Dinney, Colin P.; Di Stefano, Anna Luisa; Diver, W. Ryan; Duell, Eric J.; Elena, Joanne W.; Fan, Jin-Hu; Feigelson, Heather Spencer; Feychting, Maria; Figueroa, Jonine D.; Flanagan, Adrienne M.; Fraumeni, Joseph F.; Freedman, Neal D.; Fridley, Brooke L.; Fuchs, Charles S.; Gago-Dominguez, Manuela; Gallinger, Steven; Gao, Yu-Tang; Gapstur, Susan M.; Garcia-Closas, Montserrat; Garcia-Closas, Reina; Gastier-Foster, Julie M.; Gaziano, J. Michael; Gerhard, Daniela S.; Giffen, Carol A.; Giles, Graham G.; Gillanders, Elizabeth M.; Giovannucci, Edward L.; Goggins, Michael; Gokgoz, Nalan; Goldstein, Alisa M.; Gonzalez, Carlos; Gorlick, Richard; Greene, Mark H.; Gross, Myron; Grossman, H. Barton; Grubb, Robert; Gu, Jian; Guan, Peng; Haiman, Christopher A.; Hallmans, Goran; Hankinson, Susan E.; Harris, Curtis C.; Hartge, Patricia; Hattinger, Claudia; Hayes, Richard B.; He, Qincheng; Helman, Lee; Henderson, Brian E.; Henriksson, Roger; Hoffman-Bolton, Judith; Hohensee, Chancellor; Holly, Elizabeth A.; Hong, Yun-Chul; Hoover, Robert N.; Hosgood, H. Dean; Hsiao, Chin-Fu; Hsing, Ann W.; Hsiung, Chao Agnes; Hu, Nan; Hu, Wei; Hu, Zhibin; Huang, Ming-Shyan; Hunter, David J.; Inskip, Peter D.; Ito, Hidemi; Jacobs, Eric J.; Jacobs, Kevin B.; Jenab, Mazda; Ji, Bu-Tian; Johansen, Christoffer; Johansson, Mattias; Johnson, Alison; Kaaks, Rudolf; Kamat, Ashish M.; Kamineni, Aruna; Karagas, Margaret; Khanna, Chand; Khaw, Kay-Tee; Kim, Christopher; Kim, In-Sam; Kim, Jin Hee; Kim, Yeul Hong; Kim, Young-Chul; Kim, Young Tae; Kang, Chang Hyun; Jung, Yoo Jin; Kitahara, Cari M.; Klein, Alison P.; Klein, Robert; Kogevinas, Manolis; Koh, Woon-Puay; Kohno, Takashi; Kolonel, Laurence N.; Kooperberg, Charles; Kratz, Christian P.; Krogh, Vittorio; Kunitoh, Hideo; Kurtz, Robert C.; Kurucu, Nilgun; Lan, Qing; Lathrop, Mark; Lau, Ching C.; Lecanda, Fernando; Lee, Kyoung-Mu; Lee, Maxwell P.; Le Marchand, Loic; Lerner, Seth P.; Li, Donghui; Liao, Linda M.; Lim, Wei-Yen; Lin, Dongxin; Lin, Jie; Lindstrom, Sara; Linet, Martha S.; Lissowska, Jolanta; Liu, Jianjun; Ljungberg, Börje; Lloreta, Josep; Lu, Daru; Ma, Jing; Malats, Nuria; Mannisto, Satu; Marina, Neyssa; Mastrangelo, Giuseppe; Matsuo, Keitaro; McGlynn, Katherine A.; McKean-Cowdin, Roberta; McNeill, Lorna H.; McWilliams, Robert R.; Melin, Beatrice S.; Meltzer, Paul S.; Mensah, James E.; Miao, Xiaoping; Michaud, Dominique S.; Mondul, Alison M.; Moore, Lee E.; Muir, Kenneth; Niwa, Shelley; Olson, Sara H.; Orr, Nick; Panico, Salvatore; Park, Jae Yong; Patel, Alpa V.; Patino-Garcia, Ana; Pavanello, Sofia; Peeters, Petra H. M.; Peplonska, Beata; Peters, Ulrike; Petersen, Gloria M.; Picci, Piero; Pike, Malcolm C.; Porru, Stefano; Prescott, Jennifer; Pu, Xia; Purdue, Mark P.; Qiao, You-Lin; Rajaraman, Preetha; Riboli, Elio; Risch, Harvey A.; Rodabough, Rebecca J.; Rothman, Nathaniel; Ruder, Avima M.; Ryu, Jeong-Seon; Sanson, Marc; Schned, Alan; Schumacher, Fredrick R.; Schwartz, Ann G.; Schwartz, Kendra L.; Schwenn, Molly; Scotlandi, Katia; Seow, Adeline; Serra, Consol; Serra, Massimo; Sesso, Howard D.; Severi, Gianluca; Shen, Hongbing; Shen, Min; Shete, Sanjay; Shiraishi, Kouya; Shu, Xiao-Ou; Siddiq, Afshan; Sierrasesumaga, Luis; Sierri, Sabina; Loon Sihoe, Alan Dart; Silverman, Debra T.; Simon, Matthias; Southey, Melissa C.; Spector, Logan; Spitz, Margaret; Stampfer, Meir; Stattin, Par; Stern, Mariana C.; Stevens, Victoria L.; Stolzenberg-Solomon, Rachael Z.; Stram, Daniel O.; Strom, Sara S.; Su, Wu-Chou; Sund, Malin; Sung, Sook Whan; Swerdlow, Anthony; Tan, Wen; Tanaka, Hideo; Tang, Wei; Tang, Ze-Zhang; Tardon, Adonina; Tay, Evelyn; Taylor, Philip R.; Tettey, Yao; Thomas, David M.; Tirabosco, Roberto; Tjonneland, Anne; Tobias, Geoffrey S.; Toro, Jorge R.; Travis, Ruth C.; Trichopoulos, Dimitrios; Troisi, Rebecca; Truelove, Ann; Tsai, Ying-Huang; Tucker, Margaret A.; Tumino, Rosario; Van Den Berg, David; Van Den Eeden, Stephen K.; Vermeulen, Roel; Vineis, Paolo; Visvanathan, Kala; Vogel, Ulla; Wang, Chaoyu; Wang, Chengfeng; Wang, Junwen; Wang, Sophia S.; Weiderpass, Elisabete; Weinstein, Stephanie J.; Wentzensen, Nicolas; Wheeler, William; White, Emily; Wiencke, John K.; Wolk, Alicja; Wolpin, Brian M.; Wong, Maria Pik; Wrensch, Margaret; Wu, Chen; Wu, Tangchun; Wu, Xifeng; Wu, Yi-Long; Wunder, Jay S.; Xiang, Yong-Bing; Xu, Jun; Yang, Hannah P.; Yang, Pan-Chyr; Yatabe, Yasushi; Ye, Yuanqing; Yeboah, Edward D.; Yin, Zhihua; Ying, Chen; Yu, Chong-Jen; Yu, Kai; Yuan, Jian-Min; Zanetti, Krista A.; Zeleniuch-Jacquotte, Anne; Zheng, Wei; Zhou, Baosen; Mirabello, Lisa; Savage, Sharon A.; Kraft, Peter; Chanock, Stephen J.; Yeager, Meredith; Landi, Maria Terese; Shi, Jianxin; Chatterjee, Nilanjan; Amundadottir, Laufey T.

2014-01-01

Genome-wide association studies (GWAS) have mapped risk alleles for at least 10 distinct cancers to a small region of 63 000 bp on chromosome 5p15.33. This region harbors the TERT and CLPTM1L genes; the former encodes the catalytic subunit of telomerase reverse transcriptase and the latter may play a role in apoptosis. To investigate further the genetic architecture of common susceptibility alleles in this region, we conducted an agnostic subset-based meta-analysis (association analysis based on subsets) across six distinct cancers in 34 248 cases and 45 036 controls. Based on sequential conditional analysis, we identified as many as six independent risk loci marked by common single-nucleotide polymorphisms: five in the TERT gene (Region 1: rs7726159, P = 2.10 × 10−39; Region 3: rs2853677, P = 3.30 × 10−36 and PConditional = 2.36 × 10−8; Region 4: rs2736098, P = 3.87 × 10−12 and PConditional = 5.19 × 10−6, Region 5: rs13172201, P = 0.041 and PConditional = 2.04 × 10−6; and Region 6: rs10069690, P = 7.49 × 10−15 and PConditional = 5.35 × 10−7) and one in the neighboring CLPTM1L gene (Region 2: rs451360; P = 1.90 × 10−18 and PConditional = 7.06 × 10−16). Between three and five cancers mapped to each independent locus with both risk-enhancing and protective effects. Allele-specific effects on DNA methylation were seen for a subset of risk loci, indicating that methylation and subsequent effects on gene expression may contribute to the biology of risk variants on 5p15.33. Our results provide strong support for extensive pleiotropy across this region of 5p15.33, to an extent not previously observed in other cancer susceptibility loci. PMID:25027329

Under siege: Isolated tributaries are threatened by regionally impaired metacommunities

International Nuclear Information System (INIS)

Merriam, Eric R.; Petty, J. Todd

2016-01-01

Pristine streams are often targeted as conservation priorities because of their ability to preserve regional biodiversity. However, isolation within heavily degraded regions likely alters important metapopulation and metacommunity processes (e.g., rescue and mass effects), affecting the ability of in-tact communities to boost regional conditions. To test this hypothesis, we sampled invertebrate communities and physicochemical conditions from 168 streams within the mountaintop removal-valley fill mining region of West Virginia. We used redundancy analysis to first test for significant effects of local (observed physicochemical conditions) and neighborhood (streams within a 5 km buffer) degradation on assemblage structure across all taxa and stress tolerance (low, moderate, high) and dispersal (low, high) categories. We then used generalized linear and hurdle models to characterize changes in community metrics and individual taxa, respectively. Local condition consistently explained the majority of variation (partial R"2 up to 5 × those of neighborhood condition) in community structure and was the only factor affecting sensitive taxa. Neighborhood condition explained significant variation in moderately tolerant taxa with low dispersal capacity and highly tolerant taxa, regardless of dispersal. Decreased occurrence (Baetis) and abundance (Maccaffertium) of key taxa and corresponding metrics (%E, %EPT) suggest decreased dispersal and associated mass and rescue effects within degraded neighborhoods. Decreased neighborhood conditions also resulted in the proliferation of tolerant taxa (Chironomidae, Chimarra, Hemerodromia). Our results suggest communities within even the most pristine streams are at risk when isolated within heavily impacted regions. Consequently, protection of regional species' pools in heavily impacted regions will require more than simply conserving un-impacted streams. - Graphical abstract: In heavily degraded regions, even the most pristine

Under siege: Isolated tributaries are threatened by regionally impaired metacommunities

Energy Technology Data Exchange (ETDEWEB)

Merriam, Eric R., E-mail: emerriam@mix.wvu.edu; Petty, J. Todd

2016-08-01

Pristine streams are often targeted as conservation priorities because of their ability to preserve regional biodiversity. However, isolation within heavily degraded regions likely alters important metapopulation and metacommunity processes (e.g., rescue and mass effects), affecting the ability of in-tact communities to boost regional conditions. To test this hypothesis, we sampled invertebrate communities and physicochemical conditions from 168 streams within the mountaintop removal-valley fill mining region of West Virginia. We used redundancy analysis to first test for significant effects of local (observed physicochemical conditions) and neighborhood (streams within a 5 km buffer) degradation on assemblage structure across all taxa and stress tolerance (low, moderate, high) and dispersal (low, high) categories. We then used generalized linear and hurdle models to characterize changes in community metrics and individual taxa, respectively. Local condition consistently explained the majority of variation (partial R{sup 2} up to 5 × those of neighborhood condition) in community structure and was the only factor affecting sensitive taxa. Neighborhood condition explained significant variation in moderately tolerant taxa with low dispersal capacity and highly tolerant taxa, regardless of dispersal. Decreased occurrence (Baetis) and abundance (Maccaffertium) of key taxa and corresponding metrics (%E, %EPT) suggest decreased dispersal and associated mass and rescue effects within degraded neighborhoods. Decreased neighborhood conditions also resulted in the proliferation of tolerant taxa (Chironomidae, Chimarra, Hemerodromia). Our results suggest communities within even the most pristine streams are at risk when isolated within heavily impacted regions. Consequently, protection of regional species' pools in heavily impacted regions will require more than simply conserving un-impacted streams. - Graphical abstract: In heavily degraded regions, even the most

Academic Performance in Adolescence after Inguinal Hernia Repair in Infancy: A Nationwide Cohort Study

DEFF Research Database (Denmark)

Hansen, Tom G; Pedersen, Jacob K; Henneberg, Steen W

2011-01-01

for inguinal hernia repair in infancy and subsequent academic performance. METHODS:: Using Danish birth cohorts from 1986-1990, we compared the academic performance of all children who had undergone inguinal hernia repair in infancy to a randomly selected, age-matched 5% population sample. Primary analysis...... found no evidence that a single, relatively brief anesthetic exposure in connection with hernia repair in infancy reduced academic performance at age 15 or 16 yr after adjusting for known confounding factors. However, the higher test score nonattainment rate among the hernia group could suggest...... repair in infancy. A randomly selected, age-matched 5% population sample consists of 14,575 individuals. Although the exposure group performed worse than the control group (average score 0.26 lower; 95% CI, 0.21-0.31), after adjusting for known confounders, no statistically significant difference (-0...

Quasimolecular emission near the Xe(5p 56s 1,3 P 1 - 5p 6 1 S 0) and Kr (4p 55s 1,3 P 1 - 4p 6 1 S 0) resonance lines induced by collisions with He atoms

Science.gov (United States)

Alekseeva, O. S.; Devdariani, A. Z.; Grigorian, G. M.; Lednev, M. G.; Zagrebin, A. L.

2017-02-01

This study is devoted to the theoretical investigation of the quasimolecular emission of Xe*-He and Kr*-He collision pairs near the Xe (5p 56s 1,3 P 1 - 5p 6 1 S 0) and Kr (4p 55s 1,3 P 1 - 4p 6 1 S 0) resonance atomic lines. The potential curves of the quasimolecules Xe(5p 56s) + He and Kr(4p 55s) + He have been obtained with the use of the effective Hamiltonian and pseudopotential methods. Based on these potential curves the processes of quasimolecular emission of Xe*+He and Kr*+He mixtures have been considered and the spectral distributions I(ħΔω) of photons emitted have been obtained in the framework of quasistatic approximation.

An animal model to train Lichtenstein inguinal hernia repair

DEFF Research Database (Denmark)

Rosenberg, J; Presch, I; Pommergaard, H C

2013-01-01

, thus complicating the procedure if operation should be done in the inguinal canal. The chain of lymph nodes resembles the human spermatic cord and can be used to perform Lichtenstein's hernia repair. RESULTS: This experimental surgical model has been tested on two adult male pigs and three adult female...... pigs, and a total of 55 surgeons have been educated to perform Lichtenstein's hernia repair in these animals. CONCLUSIONS: This new experimental surgical model for training Lichtenstein's hernia repair mimics the human inguinal anatomy enough to make it suitable as a training model. The operation...

The interaction of diadenosine polyphosphates with P2X-receptors in the guinea-pig isolated vas deferens

OpenAIRE

Westfall, T D; McIntyre, C A; Obeid, S; Bowes, J; Kennedy, C; Sneddon, P

1997-01-01

The site(s) at which diadenosine 5′,5′′′-P1,P4-tetraphosphate (AP4A) and diadenosine 5′, 5′′′-P1,P5-pentaphosphate (AP5A) act to evoke contraction of the guinea-pig isolated vas deferens was studied by use of a series of P2-receptor antagonists and the ecto-ATPase inhibitor 6-N,N-diethyl-D-β,γ-dibromomethyleneATP (ARL 67156).Pyridoxalphosphate-6-azophenyl-2′,4′-disulphonic acid (PPADS) (300 nM–30 μM), suramin (3–100 μM) and pyridoxal-5′-phosphate (P-5-P) (3–1000 μM) inhibited contractions evo...

3-D crustal P-wave velocity tomography of the Italian region using local and regional seismicity data

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F. M. Mele

1995-06-01

Full Text Available A tomographic experiment was performed in the Italian region using local and regional arrivaI times of p and S seismological phases selected from the Italian National Bulletin in the time interval 1984-1991. We deter- mined a 3-D crustal P-wave velocity model using a simultaneous inversion method that iteratively re1ocates the hypocenters and computes the unknown model parameters. A fast two-point ray tracing algorithm was adopted to compute the ray paths and travel times of P", S", P g' Sg phases with good accuracy. Synthetic tests were performed using the "true" hypocenter and station distribution to rough1y evaluate the extension of the areas most densely spanned by the ray paths; the agreement between synthetic and computed models is more satisfactory at Moho depths than in the upper crust. The qua1ity of the model resulting from inversion of real data is examined by the ca1culation of the Spread Function (Toomey and Foulger, 1989. The 3-D crustal P-wave velocity mode1 of the Italian region shows remarkab1e trends at Moho depths: the areas east of the Apennines call for positive adjustments of the initial velocity va1ue, while the west region shows negative ad- justments. The correspondence among the main features of the velocity field, the map of Moho isobaths and the map of the gravity anoma1ies is also outlined.

PtdIns(3,4,5)P3 is a regulator of myosin-X localization and filopodia formation

DEFF Research Database (Denmark)

Plantard, Laure; Arjonen, Antti; Lock, John G

2010-01-01

Phosphatidylinositol (3,4,5)-trisphosphate [PtdIns(3,4,5)P3] is a key regulator of cell signaling that acts by recruiting proteins to the cell membrane, such as at the leading edge during cell migration. Here, we show that PtdIns (3,4,5)P3 plays a central role in filopodia formation via the bindi...... endosomal vesicles. Given that the localization of Myo10 was dynamically restored to filopodia upon reinstatement of PtdIns(3,4,5)P3-binding, our results indicate that PtdIns(3,4,5)P3 binding to the Myo10-PH2 domain is involved in Myo10 trafficking and regulation of filopodia dynamics....

Influence of pH on the /sup 14/C-labelling pattern after photosynthesis of suspended leaf slices and isolated mesophyll cells from chenopodium album in NaH/sup 14/CO/sub 3/

Energy Technology Data Exchange (ETDEWEB)

Baumann, G; Guenther, G [Paedagogische Hochschule Karl Liebknecht, Potsdam (German Democratic Republic). Sektion Chemie/Biologie

1983-01-01

Photosynthetic fixation of /sup 14/C from solutions of NaH/sup 14/CO/sub 3/ (at constant concentrations of free CO/sub 2/) by suspended leaf slices or isolated mesophyll cells from Chenopodium album is increased with increasing pH. Above all, the incorporation of radioactivity into amino acids and malate is stimulated. A direct uptake of HCO/sub 3/ ions and its fixation by PEP carboxylase is suggested. Isolated mesophyll cells showed at pH 7.3 a higher rate of photosynthesis than at pH 5.0.

Biotransformation of hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) by a prospective consortium and its most effective isolate Serratia marcescens

Energy Technology Data Exchange (ETDEWEB)

Young, D.M.; Ogden, K.L. [Univ. of Arizona, Tucson, AZ (United States). Dept. of Chemical and Environmental Engineering; Unkefer, P.J. [Los Alamos National Lab., NM (United States). Chemical Science and Technology Div.

1997-03-05

The biotransformation of hexahydro-1,3,5-trinitro-1,3,5 triazine (RDX) has been observed in liquid culture by a consortium of bacteria found in horse manure. Five types of bacteria were found to predominate in the consortium and were isolated. The most effective of these isolates at transforming RDX was Serratia marcescens. The biotransformation of RDX by all of these bacteria was found to occur only in the anoxic stationary phase. The process of bacterial growth and RDX biotransformation was quantified for the purpose of developing a predictive type model. Cell growth was assumed to follow Monod kinetics. All of the aerobic and anoxid growth parameters were determined: {mu}{sub max}, K{sub s}, and Y{sub x/s}. RDX was found to competitively inhibit cell growth in both atmospheres. Degradation of RDX by Serratia marcescens was found to proceed through the stepwise reduction of the three nitro groups to nitroso groups. Each of these reductions was found to be first order in both component and cell concentrations. The degradation rate constant for the first step in this reduction process by the consortium was 0.022 L/g cells {center_dot} h compared to 0.033 L/g cells {center_dot} h for the most efficient isolate.

An inguinal hernia sac tumor of extrahepatic cholangiocarcinoma origin

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Yamazaki Hidehiro

2006-03-01

Full Text Available Abstract Background Metastatic hernia sac tumor from biliary malignancy is extremely rare with only one such case previously reported. We herein report an additional case of extrahepatic cholangiocarcinoma presenting as a hernia sac tumor. Case presentation A 78-year-old man presented with an irreducible right inguinal hernia associated with a firm tumor, 2.0 cm in diameter. A computed tomography scan demonstrated a soft tissue density mass with heterogeneous enhancement within the right inguinal canal. The patient underwent a hernia repair and the hernia sac tumor was resected. Histological examination of the tumor revealed a metastatic adenocarcinoma suggesting the tumor was of pancreato-biliary origin. Further investigation using imaging studies disclosed a primary tumor in the upper bile duct. The patient died of the disease nine months after the resection. Conclusion Hernia sac tumors should be considered when an irreducible, growing mass appears within an inguinal hernia. Computed tomography may be useful for the early detection of hernia sac tumors from undiagnosed intra-abdominal malignancies.

Ultrasound-guided transversus abdominis plane block in patients undergoing open inguinal hernia repair: 0.125% bupivacaine provides similar analgesic effect compared to 0.25% bupivacaine.

Science.gov (United States)

Erdoğan Arı, Dilek; Yıldırım Ar, Arzu; Karadoğan, Firdevs; Özcabı, Yetkin; Koçoğlu, Ayşegül; Kılıç, Fatih; Akgün, Fatma Nur

2016-02-01

To evaluate the effectiveness of 0.125% bupivacaine compared to 0.25% bupivacaine for ultrasound-guided transversus abdominis plane (TAP) block in patients undergoing open inguinal hernia repair. Randomized, double-blind study. Educational and research hospital. Forty adult patients of American Society of Anesthesiologists physical status I-III undergoing elective primary unilateral open inguinal hernia repair under spinal anesthesia. Patients in group I received 20 mL of 0.25% bupivacaine, whereas patients in group II received 20 mL of 0.125% bupivacaine for TAP block at the end of the surgery. Pain intensity was assessed at rest and during coughing using 10-cm visual analog scale score at 5, 15, 30, and 45 minutes and 1, 2, 4, 6, 12, and 24 hours after TAP block. Morphine consumption and time to first morphine requirement were recorded. Visual analog scale scores at rest and during coughing were not significantly different between groups at all time points measured. Twenty-four hours of morphine consumption (7.72±7.33 mg in group I and 6.06±5.20 mg in group II; P=.437) and time to first morphine requirement (182.35±125.16 minutes in group I and 143.21±87.28 minutes in group II; P=.332) were not different between groups. 0.125% Bupivacaine provides similar analgesic effect compared to 0.25% bupivacaine for ultrasound-guided TAP block in patients undergoing open inguinal hernia repair. Copyright © 2016 Elsevier Inc. All rights reserved.

Combustion synthesis and characterization of MV0.5P0.5O4: Sm3+, Tm3+ (M = Gd, La, Y)

Science.gov (United States)

Motloung, Selepe J.; Lephoto, Mantwa A.; Tshabalala, Kamohelo G.; Ntwaeaborwa, Odireleng M.

2018-04-01

In this paper, GdV0.5P0.5O4: Sm3+, Tm3+, LaV0.5P0.5O4: Sm3+, Tm3+ and YV0.5P0.5O4: Sm3+, Tm3+ phosphor powders were prepared by solution combustion method using urea as a fuel. The phase purity, surface morphology, optical and photoluminescence properties were investigated by X-ray diffraction (XRD), scanning electron microscopy (SEM), UV-vis spectroscopy and photoluminescence spectroscopy. The XRD results indicated that the prepared powders are of a single phase and crystallized in tetragonal structure for Gd and Y systems while monoclinic phase was observed for La system. SEM showed that the samples consisted of mixed structures. The estimated band gaps were 2.2, 2.4 and 2.3 eV for Y, Gd and La systems respectively. The photoluminescence results showed four emission peaks. One peak is assigned to 1G4 - 3H6 transition of Tm3+, and three other emission peaks are attributed to 6G5/2 - 6H5/2, 6G5/2 - 6H7/2 and 6G5/2 - 6H9/2 transitions of Sm3+. The photoluminescent intensity was the highest in the gadolinium system.

Evidence of Recombinant Citrus tristeza virus Isolate Occurring in Acid Lime cv. Pant Lemon Orchard in Uttarakhand Terai Region of Northern Himalaya in India.

Science.gov (United States)

Singh, Jaywant Kumar; Tarafdar, Avijit; Sharma, Susheel Kumar; Biswas, Kajal Kumar

2013-06-01

The present study for the first time describes biological and molecular characterization of Citrus tristeza virus (CTV) occurring in the Terai area of Uttarakhand State in Northern Himalaya region of India. Direct antigen coated-ELISA and reverse transcriptase-polymerase chain reaction (RT-PCR) detected the CTV infection in Acid lime cv. Pant lemon (Citrus aurantifolia) orchards of Pantnagar with an estimated disease incidence of 16.6-20.5 %. To know the biological and genetic properties, an isolate, CTV Pant 4 was characterized. Isolate Pant 4 could be graft transmitted to Kinnow, Nagpur and Darjeeling mandarins, Mosambi sweet orange, Kagzi lime, Sweet lime, Sour orange but not to Rough lemon. The sequence analyses of the 5'ORF1a (3038 nucleotides) of LPro domain and 3'end (2058 nt) covering ORF7-ORF10 regions of the CTV genome revealed that Pant 4 was closely related to the previously reported Indian CTV isolate, Kpg3 from Northeastern Himalaya region with 97 and 98 % sequence identity, respectively. Whereas, it differed from the previously reported CTV isolate B165 from Southern India with 79 and 92 % identity, respectively for 5'ORF1a and 3' end regions. Recombination and SplitsTree decomposition analyses indicated that CTV isolate Pant 4 was a recombinant isolate originating from Kpg3 as a major and B165 as a minor donor.

Hypogonadism and man’s infertility at patients with indirect inguinal hernia after hernioplasty

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I. S. Sobennikov

2014-11-01

Full Text Available The article estimates hydrologic status and fertility prognosis of 35 year-old reproductive age men with unilateral inguinal hernioplasty in past history from the system syndrome-based approach perspective to the etiology and pathogenesis of indirect inguinal hernia and hypogonadism.

Hypogonadism and man’s infertility at patients with indirect inguinal hernia after hernioplasty

Directory of Open Access Journals (Sweden)

I. S. Sobennikov

2012-01-01

Full Text Available The article estimates hydrologic status and fertility prognosis of 35 year-old reproductive age men with unilateral inguinal hernioplasty in past history from the system syndrome-based approach perspective to the etiology and pathogenesis of indirect inguinal hernia and hypogonadism.

The 4p3(2P) ns, nd configurations of Se I

International Nuclear Information System (INIS)

Mazzoni, M.

1989-01-01

The photoabsorption spectrum of Se I has been photographed in the 1100-900 A wavelength region, using a flash-pyrolisys system: About twenty lines were observed, most of them for the first time. With the support of Hartree-Fock calculations they have been identified and assigned to the 4p 4 →4p 3 ns 3 P(n=7-14) and 4p 4 →4p 3 nd 3 D (n=5-17) series, both converging on the limit 4p 3 ( 2 P 3/2 ). (orig.)

Inguinal hernia vs. arthritis of the hip in sporting adolescents--case report and review of the literature.

Science.gov (United States)

Holzheimer, R G; Gresser, U

2007-07-26

Chronic pain in the hip, groin or thigh can be caused by a wide spectrum of diseases posing extended diagnostic problems. We describe the case of a 10-years old child with chronic pain in the groin with gait restriction for more than six months without successful classification and treatment. The girl suffered from heavy pain in the groin after a sporting contest which forced her to walk with walking sticks and to avoid climbing stairs. Within six months she was examined by pediatric, orthopedic, pediatric surgery, pediatric orthopedic, radiology, pediatric rheumatology specialists. Working diagnoses were transient synovitis (coxitis fugax), arthritis, streptococcal arthritis, Morbus Perthes, rheumatic fever, rheumatoid arthritis. She was treated with antibiotics and ibuprofen in high dosage. Repeated laboratory tests and imaging studies (ultrasound, x-rays, magnetic resonance imaging) of the hip and pelvis did not support any of these diagnoses. Six months after beginning of the complaints the girl was presented by her mother to our institution. The physical examination showed a sharp localized pain in the groin, just in the region of the inguinal ligament with otherwise free hip movement. There was no visible inguinal hernia. The family history for hernia was positive. After infiltration of the ilioinguinal nerve the girl had a complete long-lasting disappearance of pain and gait disturbance. This led to the diagnosis of inguinal hernia with nerve entrapment. After hernia repair and neurolysis/neurectomy there was a continuous state of disappearance of pain and gait disturbances. To avoid such a diagnostic dilemma one should always discuss all possible causes. Non-visible inguinal hernia may be more common in females than previously thought. Nerve entrapment as a cause of groin pain has been well described. The relationship of the start of complaints with sporting activity, a positive family history for inguinal hernia, a lack of signs of inflammation and bone

The efficacy of laparoscopic examination of the internal inguinal ring in children.

Science.gov (United States)

Grossmann, P A; Wolf, S A; Hopkins, J W; Paradise, N F

1995-02-01

The ability of physicians to identify a patent processus vaginalis by laparoscopic examination of the internal ring is now well established, but the efficacy on patient outcome is not. The authors reviewed their experience to determine the effect of diagnostic laparoscopy of the internal ring on the management of children with inguinal hernias. The records of 150 children who underwent inguinal surgery were reviewed--75 before (group 1) and 75 after (group 2) pediatric laparoscopy was introduced into the authors' practice. The children in group 1 were selected for unilateral or bilateral surgery based on history, age, sex, side of presentation, and parental preference. For group 2, laparoscopy was an additional option offered to appropriate patients. Laparoscopy was performed in 43 group 2 patients, using an infraumbilical site. The minimum follow-up period was 2 years for group 1 and 1 year for group 2. The mean ages for groups 1 and 2 were 41.2 and 39.7 months, respectively. There were 61 boys and 14 girls in each group. The percentages of right (R), left (L), and bilateral (B) findings, based on clinical observation, were 56.0 (R), 29.3 (L), and 14.7 (B) for group 1, and 58.7 (R), 26.6 (L), and 14.7 (B) for group 2. The incidence of bilateral surgical exploration was similar for the two groups (group 1, 58.6%; group 2, 61.3%). The addition of laparoscopy significantly lowered the incidence of negative explorations (group 1, 16.0%; group 2, 2.6%; P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Resterilized Polypropylene Mesh for Inguinal Hernia Repair

African Journals Online (AJOL)

2018-04-19

Apr 19, 2018 ... Conclusion: The use of sterilized polypropylene mesh for the repair of inguinal ... and nonabsorbable materials to reduce the tissue–mesh. INTRODUCTION ... which we have been practicing in our center since we introduced ...

Diagnostic Laparoscopy as Decision Tool for Re-recurrent Inguinal Hernia Treatment Following Open Anterior and Laparo-Endoscopic Posterior Repair

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Ferdinand Köckerling

2017-05-01

Full Text Available IntroductionThe guidelines of the international hernia societies recommend posterior repair in laparo-endoscopic technique for recurrent inguinal hernia after open anterior mesh repair and, conversely, open anterior repair for recurrence after laparo-endoscopic primary repair. Even when these guidelines are followed, already 1 year after repair a re-recurrence rate of 1–2% must be expected, with that rate rising further in the subsequent years. Accordingly, increasingly more patients with re-recurrence after anterior and posterior mesh implantation must be treated, which constitutes a problem that to date has been investigated in only very few studies. Hence, there are no well-founded recommendations. This paper now presents a number of case reports aimed at identifying the role of explorative laparoscopy as decision tool for re-recurrent inguinal hernia treatment.Patients and methodsBased on three case reports the role of explorative laparoscopy as decision tool for re-recurrent inguinal hernia treatment is presented below.ResultsIn all the three cases described explorative laparoscopy played a key role as decision tool when deciding how best to treat re-recurrence after anterior and posterior inguinal hernia repair. In one case severe adhesions after robotic prostatectomy and in another case correct placement of the mesh in the posterior plane, adhesions from the cecum to the groin region and no definitive finding of a re-recurrence resulted in an open repair. In the third case, an insufficient laparoscopic posterior mesh placement made the re-recurrent TAPP procedure relatively easy.ConclusionExplorative laparoscopy is an important decision tool for re-recurrent inguinal hernia treatment to minimize the risks of the procedure for the patients.

Patient-reported opioid analgesic requirements after elective inguinal hernia repair: A call for procedure-specific opioid-administration strategies.

Science.gov (United States)

Mylonas, Konstantinos S; Reinhorn, Michael; Ott, Lauren R; Westfal, Maggie L; Masiakos, Peter T

2017-11-01

A better understanding of the analgesia needs of patients who undergo common operative procedures is necessary as we address the growing opioid public health crisis in the United States. The aim of this study was to evaluate patient experience with our opioid prescribing practice after elective inguinal hernia repairs. A prospective, observational study was conducted between October 1, 2015, and September 30, 2016, in a single-surgeon, high-volume, practice of inguinal hernia operation. Adult patients undergoing elective inguinal herniorrhaphy under local anesthesia with intravenous sedation were invited to participate. All patients were prescribed 10 opioid analgesic tablets postoperatively and were counseled to reserve opioids for pain not controlled by nonopioid analgesics. Their experience was captured by completing a questionnaire 2 to 3 weeks postoperatively during their postoperative visit. A total of 185 patients were surveyed. The majority of the participants were males (177, 95.7%) and ≥60 years old (96, 51.9%). Of the 185 patients, 159 (85.9%) reported using ≤4 opioid tablets; 110 patients (59.5%) reported that they used no opioid analgesics postoperatively. None of the patients was taking opioids within 7 days of their postoperative appointment. Of the 147 patients who were employed, 111 (75.5%) reported missing ≤3 work days, 57 of whom (51.4%) missed no work at all. Patients who were employed were more likely to take opioid analgesics postoperatively (P = .049). Patients who took no opioid analgesics experienced less maximum (P require any opioid analgesics, and nearly all of those who thought that they did need opioids used reserved.

Human immune responsiveness to Lolium perenne pollen allergen Lol p III (rye III) is associated with HLA-DR3 and DR5.

Science.gov (United States)

Ansari, A A; Freidhoff, L R; Meyers, D A; Bias, W B; Marsh, D G

1989-05-01

A well-characterized allergen of Lolium perenne (perennial rye grass) pollen, Lol p III, has been used as a model antigen to study the genetic control of the human immune response. Associations between HLA type and IgE or IgG antibody (Ab) responsiveness to Lol p III were studied in two groups of skin-test-positive Caucasoid adults (N = 135 and 67). We found by nonparametric and parametric analyses that immune responsiveness to Lol p III was significantly associated with HLA-DR3 and DR5. No association was found between any DQ type and immune responsiveness to Lol p III. Geometric mean IgE or IgG Ab levels to Lol p III were not different between B8+, DR3+ subjects and B8-, DR3+ subjects, showing that HLA-B8 had no influence on the association. Lol p III IgG Ab data obtained on subjects after grass antigen immunotherapy showed that 100% of DR3 subjects and 100% of DR5 subjects were Ab+. A comparison of all the available protein sequences of DRB gene products showed that the first hypervariable region of DR3 and DR5 (and DRw6), and no other region, contains the sequence Glu9-Tyr-Ser-Thr-Ser13. Our observations are consistent with the possibility that immune responsiveness to the allergen Lol p III is associated with this amino acid sequence in the first hypervariable region of the DR beta 1 polypeptide chain.

IDENTIFICATION OF SALMONELLA SEROVARS ISOLATED DURING 2009-2016 IN TERNOPIL REGION, UKRAINE

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Pokryshko O.V.

2017-06-01

Full Text Available Introduction. Salmonellosis is registered in all regions of the world. Relevance of salmonellosis is due its global distribution, increasing incidence, even in developed countries, frequent outbreaks. The most reports in different countries demonstrated that one of the common Salmonella serotypes isolated from food and environmental samples had been serovars Salmonella Enterica, Typhimurium. In Ukraine 7.3% of all acute diarrheal infections have been cases of salmonellosis. Although large Salmonella outbreaks usually attract media attention, 60–80% of all salmonellosis cases are not recognized as part of a known outbreak and are classified as sporadic cases, or are not diagnosed as such at all. Material & methods. The samples from cultured stool, bile samples, food and environment were inoculated in the Tryptic Soya Broth (TSB for the enrichment and detection of the bacteria. After 24 hours incubation, microorganisms were cultured on the MacConkey agar plates. Then biochemical and serological tests were performed to identify the serovars of the isolated Salmonella in Ternopil regional laboratory center, Ukraine.Results & discussion. Over the past 8 years the incidence of salmonellosis has varied between 8.41 3.3 cases per 100 thousand of population (35 - 90 cases. During this period, the lowest rate recorded in 2015 (3.3 cases per 100 thousand of population, the highest – in 2014. Analysis of morbidity has been shown that elevated levels of infection were due to outbreaks registrated in 2011 (the number of infected people was 23, in 2013 (53 infected people, in 2014 (67 infected people and in 2016 (16 infected people. In Ternopil region the dominant serovar of Salmonella spp. isolated from patients are S. enteritidis (56.8 - 93.5% of all cases of diseases and S. typhimurium (7.8 - 43.8% in last 8 years. Among the carriers circulate S.enteritidis, S. typhimurium – mainly (64,8% and 35.2% respectively. Not typical for Ternopil region

Overexpression of c-myc and loss of heterozigosity on 2p, 3p, 5q, 17p and 18q in sporadic colorectal carcinoma Sobreexpresión de c-myc y pérdida de heterozigosidad en 2p, 3p, 5q, 17p y 18q en carcinoma colorrectal esporádico

Directory of Open Access Journals (Sweden)

A. Sánchez-Pernaute

2005-03-01

Full Text Available Aim: the aim of the present study is to evaluate the prognostic influence of loss of heterozygosity on 2p, 3p, 5q, 17p and 18q, and c-myc overexpression on surgically treated sporadic colorectal carcinoma. Methods: tumor and non-tumor tissue samples from 153 patients were analyzed. Fifty-one percent of patients were male, and mean age in the series was 67 years. Tumors were located in the proximal colon in 37 cases, in the distal bowel in 37, and in the rectum in 79 patients. c-myc overexpression was studied by means of Northern blot analysis, and loss of heterozigosity through microsatellite analysis. Results: c-myc overexpression was detected in 25% of cases, and loss of heterozygosity in at least one of the studied regions in 48%. There was no association between clinical and pathologic features, and genetic alterations. The disease-free interval was significantly shorter for patients with both genetic alterations; the presence of both events was an independent prognostic factor for poor outcome in the multivariate analysis (RR: 4.34, p Objetivo: el objetivo del presente trabajo es evaluar la importancia pronóstica de la pérdida de heterozigosidad en las regiones 2p, 3p, 5q, 17p y 18q y de la sobreexpresión del gen c-myc en el carcinoma colorrectal esporádico, mediante el estudio de la supervivencia libre de enfermedad tras cirugía potencialmente curativa. Métodos: se han analizado muestras tumorales y no tumorales de mucosa colónica de 153 pacientes. El 51% de los pacientes eran varones y la edad media de la serie fue 67 años. Los tumores fueron proximales en 37 casos, distales en 37 y localizados en recto en 79. Se analizó la sobreexpresión del RNA de c-myc por Northern blot, y la presencia de pérdida de heterozigosidad en las diferentes regiones consideradas por análisis de microsatélites. Resultados: se detectó sobreexpresión de c-myc en el 25% de los casos, y pérdida de heterozigosidad en alguna de las regiones estudiadas

Single incision laparoscopic surgery (SILS) inguinal hernia repair - recent clinical experiences of this novel technique.

Science.gov (United States)

Yussra, Y; Sutton, P A; Kosai, N R; Razman, J; Mishra, R K; Harunarashid, H; Das, S

2013-01-01

Inguinal hernia remains the most commonly encountered surgical problem. Various methods of repair have been described, and the most suitable one debated. Single port access (SPA) surgery is a rapidly evolving field, and has the advantage of affording 'scarless' surgery. Single incision laparoscopic surgery (SILS) for inguinal hernia repair is seen to be feasible in both total extraperitoneal (TEP) and transabdominal pre-peritoneal (TAPP) approaches. Data and peri-operative information on both of these however are limited. We aimed to review the clinical experience, feasibility and short term complications related to laparoscopic inguinal hernia repair via single port access. A literature search was performed using Google Scholar, Springerlink Library, Highwire Press, Surgical Endoscopy Journal, World Journal of Surgery and Medscape. The following search terms were used: laparoscopic hernia repair, TAPP, TEP, single incision laparoscopic surgery (SILS). Fourteen articles in English language related to SILS inguinal hernia repair were identified. Nine articles were related to TEP repair and the remaining 5 to TAPP. A total of 340 patients were reported within these studies: 294 patients having a TEP repair and 46 a TAPP. Only two cases of recurrence were reported. Various ports have been utilized, including the SILS port, Tri-Port and a custom- made port using conventional laparoscopic instruments. The duration of surgery was 40-100 minutes and the average length of hospital stay was one day. Early outcomes of this novel technique show it to be feasible, safe and with potentially better cosmetic outcome.

Inguinal hernia repair with tension-free hernioplasty under local anesthesia

International Nuclear Information System (INIS)

Gao, Jia-Sen; Wang, Zhen-Jun; Zhao, Bo; Ma Song Zhang; Pang, Guo-Yi; Na, Dong-Ming; Zhang Yu-Dong

2009-01-01

To evaluate the use of local anesthesia in tension-free hernioplasty in a local hospital. The study took place at Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China during the period from January 2007 to May 2008. All 110 patients who had undergone inguinal hernia repair with mesh under local anesthesia were included in the study. To increase the homogeneity of the sample, we excluded umbilical hernia repairs, parastomal hernia repairs, non-elective procedures, procedures not involving mesh, and repairs performed concurrently with another surgical procedure. We performed a retrospective review of all 110 patients' data. The average operating time was 45 minutes (30-70 minutes), and the average hospital stay was 3-4 days. There was no postoperative mortality in this study. No surgical site infection occurred. Two patients (18%) that suffered from a moderate scrotal hematoma had recovered after extract injection therapy was applied. The duration of incisional pain was 2-3 days, and no patient required post-operative analgesia. During the follow-up, no recurrence occurred. The use of local anesthesia in inguinal hernia repair with tension-free hernioplasty is a safe and effective alternative for inpatient treatment. (aothor)

Analysis of single nucleotide polymorphisms in the 3' region of the estrogen receptor 1 gene in normal and cryptorchid Miniature Dachshunds and Chihuahuas.

Science.gov (United States)

Pathirana, Indunil Nishantha; Tanaka, Kakeru; Kawate, Noritoshi; Tsuji, Makoto; Kida, Kayoko; Hatoya, Shingo; Inaba, Toshio; Tamada, Hiromichi

2010-08-01

This study was performed to examine the distribution of single nucleotide polymorphisms (SNPs) and estimated haplotypes in the canine estrogen receptor (ER) alpha gene (ESR1) and the association of them with different phenotypes of cryptorchidism (CO) in Miniature Dachshunds and Chihuahuas. Forty CO and 68 normal dogs were used, and CO was classified into unilateral (UCO; n=33) and bilateral CO (BCO; n=5) or into abdominal (ACO; n=16) and inguinal CO (ICO; n=22). Thirteen DNA fragments located in the 70-kb region at the 3' end of ESR1 were amplified by PCR and sequenced to examine 13 SNPs (#1-#13) reported in a canine SNP database. Ten SNPs (#1-#4, #7, #8, #10-#13) were not polymorphic, and 5 new SNPs (#14-#18) were discovered. A common haplotype block in normal, CO and CO phenotypes was identified for an approximately 20-kb region encompassing 4 SNPs (#14-#17). Allele, genotype and haplotype frequencies in CO without classification by phenotype and also in UCO, ACO and ICO phenotypes were not statistically different from the normal group. Significant differences in genotype frequencies and homozygosity for the estimated GTTG haplotype within the block were observed in BCO compared with the normal group, although the number of BCO animals was small. Our results demonstrate that the examined SNPs and haplotypes in the 3' end of canine ESR1 are not associated with unilateral, abdominal and inguinal CO phenotypes and CO per se in Miniature Dachshunds and Chihuahuas. Further studies are necessary to suggest a clear association between the ESR1 SNPs and bilateral CO in dogs.

Comparative Study of Inguinal Hernia Repair Rates After Radical Prostatectomy or External Beam Radiotherapy

International Nuclear Information System (INIS)

Lughezzani, Giovanni; Sun, Maxine; Perrotte, Paul; Alasker, Ahmed; Jeldres, Claudio; Isbarn, Hendrik; Budaeus, Lars; Lattouf, Jean-Baptiste; Valiquette, Luc; Benard, Francois; Saad, Fred; Graefen, Markus; Montorsi, Francesco; Karakiewicz, Pierre I.

2010-01-01

Purpose: We tested the hypothesis that patients treated for localized prostate cancer with radical prostatectomy (RP) have a higher risk of requiring an inguinal hernia (IH) repair than their counterparts treated with external beam radiotherapy (EBRT). Methods and Materials: Within the Quebec Health Plan database, we identified 6,422 men treated with RP and 4,685 men treated with EBRT for localized prostate cancer between 1990 and 2000, in addition to 6,933 control patients who underwent a prostate biopsy. From among that population, we identified patients who underwent a unilateral or bilateral hernia repair after either RP or EBRT. Kaplan-Meier plots showed IH repair-free survival rates. Univariable and multivariable Cox regression models tested the predictors of IH repair after RP or EBRT. Covariates consisted of age, year of surgery, and Charlson Comorbidity Index. Results: IH repair-free survival rates at 1, 2, 5, and 10 years were 96.8, 94.3, 90.5, and 86.2% vs. 98.9, 98.0, 95.4, and 92.2%, respectively, in RP vs. EBRT patients (log-rank test, p < 0.001). IH repair-free survival rates in the biopsy population were 98.3, 97.1, 94.9, and 90.2% at the same four time points. In multivariable Cox regression models, RP predisposed to a 2.3-fold higher risk of IH repair than EBRT (p < 0.001). Besides therapy type, patient age (p < 0.001) represented the only other independent predictor of IH repair. Conclusions: RP predisposes to a higher rate of IH repair relative to EBRT. This observation should be considered at informed consent.

Cyclic [G(2′,5′)pA(3′,5′)p] Is the Metazoan Second Messenger Produced by DNA-Activated Cyclic GMP-AMP Synthase

Science.gov (United States)

Gao, Pu; Ascano, Manuel; Wu, Yang; Barchet, Winfried; Gaffney, Barbara L.; Zillinger, Thomas; Serganov, Artem A.; Liu, Yizhou; Jones, Roger A.; Hartmann, Gunther; Tuschl, Thomas; Patel, Dinshaw J.

2015-01-01

SUMMARY Recent studies identified cyclic GMP-AMP (cGAMP) as a metazoan second messenger triggering an interferon response. cGAMP is generated from GTP and ATP by cytoplasmic dsDNA sensor cGAMP synthase (cGAS). We combined structural, chemical, biochemical, and cellular assays to demonstrate that this second messenger contains G(2′,5′)pA and A(3′,5′)pG phosphodiester linkages, designated c[G(2′,5′) pA(3′,5′)p]. We show that, upon dsDNA binding, cGAS is activated through conformational transitions, resulting in formation of a catalytically competent and accessible nucleotide-binding pocket for generation of c[G(2′,5′)pA(3′,5′)p]. We demonstrate that cyclization occurs in a stepwise manner through initial generation of 5′-pppG(2′,5′)pA prior to cyclization to c[G(2′,5′)pA(3′,5′)p], with the latter positioned precisely in the catalytic pocket. Mutants of cGAS dsDNA-binding or catalytic pocket residues exhibit reduced or abrogated activity. Our studies have identified c[G(2′,5′)pA(3′,5′)p] as a founding member of a family of metazoan 2′,5′-containing cyclic heterodinucleotide second messengers distinct from bacterial 3′,5′ cyclic dinucleotides. PMID:23647843

ANESTESIA REGIONAL PARA HERNIORRAFIA INGUINAL EM PACIENTE PORTADOR DE CARDIOMIOPATIA HIPERTROFICA ASSIMETRICA: RELATO DE CASO.

OpenAIRE

Immich, Liége Caroline; Specht, Fabiana; Magro, Priscila Sartoretto Dal; Miranda Jr, Vasco

2017-01-01

Resumen Introdução: A cardiomiopatia hipertrófica assimétrica é uma doençade hipertrofia de ventrículo esquerdo e do septo interventricular. Há aumento da obstrução de saída do ventrículo esquerdo, da força contrátil; diminuição do volume diastólico final do ventrículo esquerdo e da resistência vascular periférica aumentando o consumo de oxigênio com risco de isquemia subendocárdica e arritmias. Relato de paciente portador de cardiomiopatia assimétrica submetido à herniorrafia inguinal aber...

Different types of mesh fixation for laparoscopic repair of inguinal hernia: A protocol for systematic review and network meta-analysis with randomized controlled trials.

Science.gov (United States)

Wei, Kongyuan; Lu, Cuncun; Ge, Long; Pan, Bei; Yang, Huan; Tian, Jinhui; Cao, Nong

2018-04-01

Laparoscopic inguinal hernia repair has become a valid option for repair of an inguinal hernia. Due to there are several types of mesh fixation for laparoscopic repair of inguinal hernia. The study aims to assess and compare the efficacy of different types of mesh fixation for laparoscopic repair of inguinal hernia using network meta-analysis. We will systematically search PubMed, EMBASE the Cochrane library, and Chinese Biomedical Literature Database from their inception to March 2018. Randomized controlled trials (RCTs) that compared the effect of different types of mesh fixation for laparoscopic inguinal hernia repair will be included. The primary outcomes are chronic groin pain, incidence risk of hernia recurrence, and complications. Risk of bias assessment of the included RCTs will be conducted using to Cochrane risk of bias tool. A network meta-analysis will be performed using WinBUGS 1.4.3 software and the result figures will be generated using R x64 3.1.2 software and STATA V.12.0 software. Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to assess the quality of evidence. The results of this study will be published in a peer-reviewed journal. Our study will generate evidence of laparoscopic repair of mesh fixation for adult patients with inguinal hernia and provide suggestions for clinical practice or guideline.

Variable developmental delays and characteristic facial features-A novel 7p22.3p22.2 microdeletion syndrome?

Science.gov (United States)

Yu, Andrea C; Zambrano, Regina M; Cristian, Ingrid; Price, Sue; Bernhard, Birgitta; Zucker, Marc; Venkateswaran, Sunita; McGowan-Jordan, Jean; Armour, Christine M

2017-06-01

Isolated 7p22.3p22.2 deletions are rarely described with only two reports in the literature. Most other reported cases either involve a much larger region of the 7p arm or have an additional copy number variation. Here, we report five patients with overlapping microdeletions at 7p22.3p22.2. The patients presented with variable developmental delays, exhibiting relative weaknesses in expressive language skills and relative strengths in gross, and fine motor skills. The most consistent facial features seen in these patients included a broad nasal root, a prominent forehead a prominent glabella and arched eyebrows. Additional variable features amongst the patients included microcephaly, metopic ridging or craniosynostosis, cleft palate, cardiac defects, and mild hypotonia. Although the patients' deletions varied in size, there was a 0.47 Mb region of overlap which contained 7 OMIM genes: EIP3B, CHST12, LFNG, BRAT1, TTYH3, AMZ1, and GNA12. We propose that monosomy of this region represents a novel microdeletion syndrome. We recommend that individuals with 7p22.3p22.2 deletions should receive a developmental assessment and a thorough cardiac exam, with consideration of an echocardiogram, as part of their initial evaluation. © 2017 Wiley Periodicals, Inc.

Herniorrafía inguinal: Técnica por sobrecapas de Fascia Transversalis

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José Miguel Goderich Lalán

1998-04-01

Full Text Available Se realizó un estudio descriptivo, prospectivo, observacional y longitudinal para evaluar los resultados obtenidos con la aplicación de una técnica de reparación herniaria inguinal (original del autor por sobrecapas de fascia transversalis, en la que se afronta una primera capa de ésta en sutura continua, desde la proyección del tubérculo púbico hasta obliterar el anillo inguinal profundo, después de lo cual se crea una segunda capa al afrontar el arco aponeurótico del transverso a la cintilla iliopubiana. Luego de un seguimiento superior a los 10 años, se comprobó que de 1 475 pacientes sólo hubo recidivas en 1,2 %; éstas fueron más frecuentes en los hombres, en las hernias del tipo indirecto y en los pacientes con más de 45 años. El mayor número de recidivas ocurrió entre el primer y tercer año de operado. Se recomienda introducir esta nueva técnica en la práctica quirúrgica, y cumplir las indicaciones y el proceder señalado por el autorA descriptive, prospective, observational, and longitudinal study was performed to evaluate the results obtained with the application of a technique for the repair of inguinal hernia (the author's original technique by overlayers of fascia transversalis, in which the first layer is copped with the use of continuos suture from the projection of the pubic tubercle until the obliteration of the deep inguinal rign, creating a second layer when copping the aponeurotic arch of the transverse to the iliopubic eminence. After a follow-up longer than 10 years, it was proved that out of 1 475 patients, only 1,2 % presented with recurrences. Relapses were more frequent in males, in indirect hernias and in patients over 45 years of age. The greatest number of recurrences occurred between the first and the third year after the operation. It is recommended to introduce this new technique within the surgical practice and to comply with the indications for the procedure made by the author

Isolated thoracic perfusion with chemofiltration for progressive malignant pleural mesothelioma

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Aigner KR

2017-06-01

Full Text Available Karl Reinhard Aigner, Emir Selak, Sabine Gailhofer Department of Surgical Oncology, Medias Klinikum, Burghausen, Germany Introduction: Therapy of malignant pleural mesothelioma and especially the adequate role of surgery in this context remain the subject of controversial discussions. Radical surgery in particular, which is associated with substantial morbidity, failed to translate into a definite survival advantage. We report on interim results of an ongoing Phase II study of regional chemotherapy in terms of isolated thoracic perfusion with chemofiltration (ITP-F.Patients and methods: Twenty-eight patients (25 male, 3 female, mean age 63.4 years with advanced pleural mesothelioma were included in this study. Isolation of the chest was achieved by insertion of a venous and arterial stop-flow balloon catheter via a femoral access. The aorta and inferior vena cava were blocked at the level of the diaphragm and the upper arms were blocked by pneumatic cuffs. Chemotherapy, consisting of 60 mg/m² cisplatin and 15 mg/m² mitoxantrone, was administered directly into the aorta. The isolated circuit was maintained for 15 minutes followed by ~45 minutes of chemofiltration with a hemoprocessor until 5 L of filtrate were reached. The endpoints of the study were overall survival and quality of life (QoL.Results: Out of 28 patients enrolled in the study, 5 had prior surgeries, 10 patients had systemic chemotherapy, and 5 patients additional irradiation. In all patients in restaging, clinical progress was noted. In all, 162 cycles were administered. Due to chemofiltration, toxicity was within tolerable limits, revealing World Health Organization grade I leucopenia and thrombocytopenia in 9 patients and mucositis grade I in 6 patients. The major surgical complication was inguinal lymphatic fistula in 40% of the cases. Gastrointestinal toxicity and/or neurotoxicity were never observed. One-year survival was 49%, 2-year and 3-year survival was 31%, and 5

The calculation of oscillator strengths for the 5s21S0→5s5p1,3P1 transitions in Cd-like ions

International Nuclear Information System (INIS)

Li Guangyuan

1998-01-01

The screened hydrogenic model is employed to calculate the oscillator strength of the 5s 2 1 S 0 -5s5p 1 P 1 resonance transition in Cd-like ions (Z = 48 -74). The expression for the oscillator strength of the 5s 2 1 S 0 -5s5p 3 P1 is given, with the introduction of the correctional coefficient K and the mixing angle in jj-coupling. The results are compared with that of other authors, and some discussions are also given

Cirugía de la hernia inguinal en la tercera edad: ambulatoria y con hospitalización corta Inguinal hernia surgery in third age patients: ambulatory and with a short hospitalization

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Pablo Gonzalo Pol Herrera

2011-03-01

has increase but in fact its prevalence is unknown. The objective of present study was to assess the result of surgical treatment of the inguinofemoral region hernia in third-age patients seen in the "Dr. Enrique Cabrera" Teaching General Hospital. METHODS. A study was conducted in 1 093 third-age patients operated on of inguinofemoral hernia from January, 1999 to December, 2008 in the above mentioned hospital. In all cases patients had the alternative to be operated on in ambulatory way or with a short hospital stay. Also, were included the patients operated on as an urgency. From the patients operated on in an elective way were excluded those suffering of associated, cardiopulmonary or thromboembolic ASA-III type diseases (classification of the American Society of Anesthesiology. RESULTS. The great incidence of the inguinal hernia was found in ages from 60-69 years (59,3%. The indirect right inguinal hernia was the more frequent. The Desarda's anatomical surgical technique was the more applied one in the inguinal hernia and the Lichtenstein's prosthetic technique with the 32% was the following in frequency. There were 20 relapses (1.8%. Local anesthesia was applied in the 75,4% of patients, in ambulatory way in the 76,4%. The total of complications was of 78 (7,1%. CONCLUSIONS. The surgical treatment of inguinofemoral hernias, ambulatory or with a short hospital stay is a suitable procedure in third-age patients since to increase the comfort of patients, to decrease the hospital infection risk, to reduce the waiting lists and the hospital costs.

A study of the Ne 2s2p{sup 5}({sup 3}P)3s and 3p correlation satellites up to 75 eV above threshold

Energy Technology Data Exchange (ETDEWEB)

Yarzhemsky, V G [RAS Kurnakov Institute of General and Inorganic Chemistry, Moscow (Russian Federation); Amusia, M Ya [Racah Institute of Physics, The Hebrew University, Jerusalem 91904 (Israel); Bolognesi, P; Avaldi, L, E-mail: lorenzo.avaldi@imip.cnr.i [CNR-Istituto di Metodologie Inorganiche e dei Plasmi, Area della Ricerca di Roma 1, CP 10, 00016 Monterotondo Scalo (Italy)

2010-09-28

The 2s2p{sup 5}({sup 3}P)3s {sup 2}P, 3p {sup 2}D and {sup 2}S satellite states of neon have been studied at several energies from 5 to 75 eV above their respective thresholds. The relative intensities of the satellite states with respect to their main lines shed light on the nature of the many-electron correlations leading to the formation of these satellites. The experimental results are compared with a calculation which makes use of a random phase approximation with exchange (RPAE) cross sections, and takes into account the shake-up and direct knock-out channels as well as their interference.

Measurement of the hyperfine structure of the 4d2D3/2,5/2 levels and isotope shifts of the 4p2P3/2->4d2D3/2 and 4p2P3/2->4d2D5/2 transitions in gallium 69 and 71

International Nuclear Information System (INIS)

Rehse, Steven J.; Fairbank, William M.; Lee, Siu Au

2001-01-01

The hyperfine structure of the 4d 2 D 3/2,5/2 levels of 69,71 Ga is determined. The 4p 2 P 3/2 ->4d 2 D 3/2 (294.50-nm) and 4p 2 P 3/2 ->4d 2 D 5/2 (294.45-nm) transitions are studied by laser-induced fluorescence in an atomic Ga beam. The hyperfine A constant measured for the 4d 2 D 5/2 level is 77.3±0.9 MHz for 69 Ga and 97.9± 0.7 MHz for 71 Ga (3σ errors). The A constant measured for the 4d 2 D 3/2 level is -36.3±2.2 MHz for 69 Ga and -46.2±3.8 MHz for 71 Ga. These measurements correct sign errors in the previous determination of these constants. For 69 Ga the hyperfine B constants measured for the 4d 2 D 5/2 and the 4d 2 D 3/2 levels are 5.3±4.1 MHz and 4.6±4.2 MHz, respectively. The isotope shift is determined to be 114±8 MHz for the 4p 2 P 3/2 ->4d 2 D 3/2 transition and 115±7 MHz for the 4p 2 P 3/2 ->4d 2 D 5/2 transition. The lines of 71 Ga are shifted to the blue. This is in agreement with previous measurement. [copyright] 2001 Optical Society of America

Multidisciplinary approach to non-surgical management of inguinal disruption in a professional hockey player treated with platelet-rich plasma, manual therapy and exercise: a case report.

Science.gov (United States)

St-Onge, Eric; MacIntyre, Ian G; Galea, Anthony M

2015-12-01

To present the clinical management of inguinal disruption in a professional hockey player and highlight the importance of a multidisciplinary approach to diagnosis and management. A professional hockey player with recurrent groin pain presented to the clinic after an acute exacerbation of pain while playing hockey. The patient received a clinical diagnosis of inguinal disruption. Imaging revealed a tear in the rectus abdominis. Management included two platelet-rich plasma (PRP) injections to the injured tissue, and subsequent manual therapy and exercise. The patient returned to his prior level of performance in 3.5 weeks. This case demonstrated the importance of a multidisciplinary team and the need for advanced imaging in athletes with groin pain. Research quality concerning the non-surgical management of inguinal disruption remains low. This case adds evidence that PRP, with the addition of manual therapy and exercise may serve as a relatively quick and effective non-surgical management strategy.

Preperitoneal Surgery Using a Self-Adhesive Mesh for Inguinal Hernia Repair

OpenAIRE

Mangram, Alicia; Oguntodu, Olakunle F.; Rodriguez, Francisco; Rassadi, Roozbeh; Haley, Michael; Shively, Cynthia J.; Dzandu, James K.

2014-01-01

Background and Objectives: Laparoscopic preperitoneal hernia repair with mesh has been reported to result in improved patient outcomes. However, there are few published data on the use of a totally extraperitoneal (TEP) approach. The purpose of this study was to present our experience and evaluate early outcomes of TEP inguinal hernia repair with self-adhesive mesh. Methods: This cohort study was a retrospective review of patients who underwent laparoscopic TEP inguinal hernial repair from Ap...

Dedifferentiated retroperitoneal liposarcoma presenting as right inguinal hernia: A case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Jung Myung; Lee, Su Lim; Ku, Young Mi [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of); Choi, Moon Hyung [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

2016-01-15

Retroperitoneal liposarcomas usually present as painless, slow-growing abdominal masses. When masses grow large enough to compress surrounding structures, symptoms may occur. Retroperitoneal liposarcoma clinically manifesting as inguinal hernia is a very rare entity; only 11 cases have been reported. Herein, we present radiographic features of a 37-year-old male with a painless palpable mass in the right groin that was identified as dedifferentiated retroperitoneal liposarcoma herniated through the right inguinal canal.

Dual R3R5 tropism characterizes cerebrospinal fluid HIV-1 isolates from individuals with high cerebrospinal fluid viral load.

Science.gov (United States)

Karlsson, Ulf; Antonsson, Liselotte; Ljungberg, Bengt; Medstrand, Patrik; Esbjörnsson, Joakim; Jansson, Marianne; Gisslen, Magnus

2012-09-10

To study the use of major and alternative coreceptors by HIV-1 isolates obtained from paired plasma and cerebrospinal fluid (CSF) samples. Paired plasma and CSF isolates from HIV-1-infected individuals with varying clinical, virologic, and immunologic parameters were assessed for the ability to infect indicator cells expressing a panel of coreceptors with documented expression in the central nervous system (CNS). HIV-1 isolates obtained from plasma and CSF in 28 individuals with varying viral load, CD4 T-cell counts, and with or without AIDS-defining disease were analyzed for the ability to infect NP2.CD4 cells stably expressing a panel of HIV coreceptors (CCR5, CXCR4, CCR3, CXCR6, GPR1, APJ, ChemR23, RDC-1 or BLT1). All isolates from both plasma and CSF utilized CCR5 and/or CXCR4. However, the ability to use both CCR3 and CCR5 (R3R5) was more pronounced in CSF isolates and correlated with high CSF viral load and low CD4 T-cell count. Notably, four out of five CSF isolates of subtype C origin exhibited CXCR6 use, which coincided with high CSF viral load despite preserved CD4 T-cell counts. The use of other alternative coreceptors was less pronounced. Dual-tropic R3R5 HIV-1 isolates in CSF coincide with high CSF viral load and low CD4 T-cell counts. Frequent CXCR6 use by CSF-derived subtype C isolates indicates that subtype-specific differences in coreceptor use may exist that will not be acknowledged when assessing plasma virus isolates. The findings may also bare relevance for HIV-1 replication within the CNS, and consequently, for the neuropathogenesis of AIDS.

An Incarcerated Colon Inguinal Hernia That Perforated into the Scrotum and Exhibited an Air-Fluid Level

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Seisuke Ota

2015-01-01

Full Text Available There are few reports of a transverse colon inguinal hernia; furthermore, an inguinal hernia perforating the scrotum is rare. Here we report the case of a 79-year-old man who died after developing an incarcerated colon inguinal hernia that perforated the scrotum and exhibited an air-fluid level. The patient was referred to our hospital in November 2011 with a complaint of inability to move. Physical examination revealed an abnormally enlarged left scrotum and cold extremities. He reported a history of gastric cancer that was surgically treated more than 30 years ago. His white blood cell count and C-reactive protein level were elevated. Abdominal and inguinal computed tomography revealed that his transverse colon was incarcerated in the left inguinal canal. Free air and air-fluid level were observed around the transverse colon, suggestive of a perforation. The patient and his family refused any surgical intervention; therefore, he was treated with sultamicillin tosilate hydrate and cefotiam hydrochloride. However, he succumbed to panperitonitis 19 days after admission. The findings from this case indicate that the transverse colon can perforate into an inguinal hernia sac.

Partial cross sections for Rb- photodetachment in the region of the Rb(5p2Psub(1/2,3/2)) thresholds and their analysis by multichannel quantum defect theory

International Nuclear Information System (INIS)

Frey, P.; Lawen, M.; Breyer, F.; Klar, H.; Hotop, H.

1982-01-01

A crossed ion-laser beam apparatus has been used to measure accurate relative total and partial cross sections for photodetachment from Rb - ions with high photon energy resolution (0.1-0.6 cm -1 ) in the region of the Rb(5p 2 Psub(1/2,3/2)) thresholds (photon energy range 16.350-16.820 cm -1 ). Satisfactory fits to these data by multichannel quantum defect theory (MQDT) have been obtained, resulting in a reliable set of seven MQDT parameters. The electron angular distribution parameter for the Rb(5s) channel was found to be β(5s)=2, independent of photon energy, MQDT predicts a sharp, window-type variation of β(5s) around the minimum of the 5s-cross section below the Rb(5p 2 Psub(1/2)) threshold (where an accurate experimental measurement of β(5s) was not possible) and a similar behaviour of β(6s) in the case of Cs - photodetachment below the Cs(6p 2 Psub(1/2)) threshold. (orig.)

Does surgeon volume matter in the outcome of endoscopic inguinal hernia repair?

Science.gov (United States)

Köckerling, F; Bittner, R; Kraft, B; Hukauf, M; Kuthe, A; Schug-Pass, C

2017-02-01

For open and endoscopic inguinal hernia surgery, it has been demonstrated that low-volume surgeons with fewer than 25 and 30 procedures, respectively, per year are associated with significantly more recurrences than high-volume surgeons with 25 and 30 or more procedures, respectively, per year. This paper now explores the relationship between the caseload and the outcome based on the data from the Herniamed Registry. The prospective data of patients in the Herniamed Registry were analyzed using the inclusion criteria minimum age of 16 years, male patient, primary unilateral inguinal hernia, TEP or TAPP techniques and availability of data on 1-year follow-up. In total, 16,290 patients were enrolled between September 1, 2009, and February 1, 2014. Of the participating surgeons, 466 (87.6 %) had carried out fewer than 25 endoscopic/laparoscopic operations (low-volume surgeons) and 66 (12.4 %) surgeons 25 or more operations (high-volume surgeons) per year. Univariable (1.03 vs. 0.73 %; p = 0.047) and multivariable analysis [OR 1.494 (1.065-2.115); p = 0.023] revealed that low-volume surgeons had a significantly higher recurrence rate compared with the high-volume surgeons, although that difference was small. Multivariable analysis also showed that pain on exertion was negatively affected by a lower caseload <25 [OR 1.191 (1.062-1.337); p = 0.003]. While here, too, the difference was small, the fact that in that group there was a greater proportion of patients with small hernia defect sizes may have also played a role since the risk in that group was higher. In this analysis, no evidence was found that pain at rest [OR 1.052 (0.903-1.226); p = 0.516] or chronic pain requiring treatment [OR 1.108 (0.903-1.361); p = 0.326] were influenced by the surgeon volume. As confirmed by previously published studies, the data in the Herniamed Registry also demonstrated that the endoscopic/laparoscopic inguinal hernia surgery caseload impacted the outcome. However

Molecular studies of segmental aneusomy: FISHing for the atypical cry in del(5)(p15.3).

Science.gov (United States)

Hodge, J C; Lawson-Yuen, A; Stoler, J M; Ligon, A H

2007-01-01

We report a newborn male with multiple congenital anomalies including growth retardation, hypotonia, dysmorphic facies, widely-spaced nipples, micropenis, cryptorchidism, optic nerve hypoplasia, heart disease, and a striking, high-pitched cry. Chromosome analysis revealed de novo partial trisomy 11q due to a der(5)t(5;11)(p15.3;q22). Fluorescence in situ hybridization (FISH) showed loss of the 5p telomere signal on the der(5) chromosome, indicating the infant has partial monosomy 5p in addition to partial trisomy 11q. Among cases involving trisomy 11q, an unusual cry has only been documented in the presence of a der(5)t(5p;11q). This apparent dependence of the abnormal cry on monosomy 5p suggested the same genetic mechanism that occurs in Cri du chat syndrome (CDCS) may be responsible for the atypical cry in der(5)t(5p;11q) individuals. Neither a commercial CDCS probe (LSI D5S23, D5S721) nor a series of BAC clones encompassing distal regions implicated in the CDCS-associated cat-cry were deleted in our patient. These results suggest a second cry-modifying locus maps telomeric to BAC RP11-94J21 in band 5p15.33. This locus may not only cause the abnormal cry in individuals with a der(5)t(5p;11q) but could also contribute to the phenotypic variability and discordant mapping studies observed for CDCS. Copyright (c) 2007 S. Karger AG, Basel.

Long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair.

Science.gov (United States)

Iraniha, Andrew; Peloquin, Joshua

2018-06-01

Laparoscopic TAPP inguinal hernia repair is an established alternative to open hernia repair, which offers equivalent outcomes with less postoperative pain and faster recovery. Unfortunately, it remains technically challenging, requiring advanced laparoscopic skills which have limited its popularity among surgeons. The robotic platform has the potential to overcome these challenges. The objective of this study was to examine the long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair, since these data have not been reported up to now. From October 2012 to October 2015, 159 inguinal hernias in 82 consecutive patients were repaired with 3D mesh (BARD) using da Vinci Si Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). The patients' demographics and intraoperative data were documented. Patients were seen 2 and 6 weeks after the surgery and the complications were recorded. Patients were assessed 6 weeks after the surgery by a survey using a universal pain assessment tool to document their post-operative pain, narcotic use and time of return to work and exercise. A modified short form 12 (SF 12) was also sent out to the patients 12-36 months after the surgery to measure their health-related quality of life prior to surgery and at the 12- to 36-month follow-up, and to document any evidence of recurrence. Postoperative health-related quality of life scores were compared to the pre-operative baseline quality of life scores using the unpaired t test. Over the course of 3 years, 159 robotic assisted TAPP inguinal hernia repair were performed in 82 patients, 73 men and 9 women by one surgeon as an outpatient basis. The mean age was 53 and mean body mass index was 26. There were no intraoperative complications or conversions. The average operative time was 99 min. Four patients developed urinary retention post-operatively and one patient developed postoperative bowel obstruction requiring laparoscopic lysis of adhesion with no

The 3d8-(3d74p + 3p53d9) transitions in Br X: A striking case of configuration interaction

International Nuclear Information System (INIS)

Kleef, T.A.M. van; Uylings, P.H.M.; Ryabtsev, A.N.; Podobedova, L.I.; Joshi, Y.N.

1988-01-01

The spectrum of nine times ionized bromine (Br X) was photographed in the 90-120 A wavelength region on a variety of grazing incidence spectrographs using an open spark and a triggered spark as light sources. The analysis of the 3d 8 -(3d 7 4p + 3p 5 3d 9 ) transitions has resulted in establishing all 9 levels of the 3d 8 configuration, all 12 levels of the 3p 5 3d 9 configuration and 99 out of 110 levels of the 3d 7 4p configuration. The excitation probability of the 3p inner-shell electron increases with nuclear charge and in Br X is comparable with the excitation probability of the optical electrons resulting in a very strong configuration interaction between the 3p 5 3d 9 and 3d 7 4p configurations. Parametric calculations treating these configurations as one super configuration support the analysis. Two hundred and thirty two lines have been classified in this spectrum. (orig.)

Toxic shock syndrome following inguinal hernia repair: a rare condition

Directory of Open Access Journals (Sweden)

Rohit Prasad Yadav

2014-01-01

Full Text Available A 25-year-old man developed fulminant multisystem failure 28 hours after elective repair of an inguinal hernia. Toxic shock syndrome (TSS was diagnosed. The patient recovered fully with supportive care in ICU, antibiotics, and IV human immunoglobin . To the best of our knowledge, only one case of TSS following inguinal hernia repair have ever been previously published. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 57-59 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9689

Frequent deletion of 3p21.1 region carrying semaphorin 3G and aberrant expression of the genes participating in semaphorin signaling in the epithelioid type of malignant mesothelioma cells.

Science.gov (United States)

Yoshikawa, Yoshie; Sato, Ayuko; Tsujimura, Tohru; Morinaga, Tomonori; Fukuoka, Kazuya; Yamada, Shusai; Murakami, Aki; Kondo, Nobuyuki; Matsumoto, Seiji; Okumura, Yoshitomo; Tanaka, Fumihiro; Hasegawa, Seiki; Hashimoto-Tamaoki, Tomoko; Nakano, Takashi

2011-12-01

Array-based comparative genomic hybridization analysis was performed on 21 malignant mesothelioma (MM) samples (16 primary cell cultures and 5 cell lines) and two reactive mesothelial hyperplasia (RM) primary cell cultures. The RM samples did not have any genomic losses or gains. In MM samples, deletions in 1p, 3p21, 4q, 9p21, 16p13 and 22q were detected frequently. We focused on 3p21 because this deletion was specific to the epithelioid type. Especially, a deletion in 3p21.1 region carrying seven genes including SEMA3G was found in 52% of MM samples (11 of 14 epithelioid samples). The allele loss of 3p21.1 might be a good marker for the epithelioid MM. A homozygous deletion in this region was detected in two MM primary cell cultures. A heterozygous deletion detected in nine samples contained the 3p21.1 region and 3p21.31 one carrying the candidate tumor suppressor genes such as semaphorin 3F (SEMA3F), SEMA3B and Ras association (RalGDS/AF-6) domain family member 1 (RASSF1A). SEMA3B, 3F and 3G are class 3 semaphorins and inhibit growth by competing with vascular endothelial growth factor (VEGF) through binding to neuropilin. All MM samples downregulated the expression of more than one gene for SEMA3B, 3F and 3G when compared with Met5a, a normal pleura-derived cell line. Moreover, in 12 of 14 epithelioid MM samples the expression level of SEMA3A was lower than that in Met5a and the two RM samples. An augmented expression of VEGFA was detected in half of the MM samples. The expression ratio of VEGFA/SEMA3A was significantly higher in the epithelioid MMs than in Met5a, RMs and the non-epithelioid MMs. Our data suggest that the downregulated expression of SEMA3A and several SEMA3s results in a loss of inhibitory activities in tumor angiogenesis and tumor growth of VEGFA; therefore, it may play an important role on the pathogenesis of the epithelioid type of MM.

A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia.

LENUS (Irish Health Repository)

O'Reilly, Elma A

2012-05-01

Laparoscopic inguinal hernia repair (LIHR), using a transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) technique, is an alternative to conventional open inguinal hernia repair (OIHR). A consensus on outcomes of LIHR when compared with OIHR for primary, unilateral, inguinal hernia has not been reached.

Comparative Study of Fibrin Sealent versus Use of Tackers in Inguinal Hernia Repair

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Wasim Qadir Kar

2015-09-01

Full Text Available Purpose: To determine role and benefit of fibrin glue over tackers for mesh fixation in laparoscopic inguinal hernia repair. Backgroud: Mesh fixation by tackers may lead to many complications peroperatively like bleeding, increased hospital stay and overall more cost and later on chronic groin pain. Material and Methods: 60 inguinal hernia with age more than 18 years were taken and were divided in two groups; 30 patient group who underwent TAPP and 30 patient group who underwent TEPP. In 15 patients in both groups tackers were used and in other half fibrin glue was used for fixation of mesh using a 3mm catheter (Duplotip: Baxter Healthcare, which fits the Tisseel syringe. Results: The use of fibrin sealent has a distinct advantage in laparoscopic treatment of inguinal hernias compared with use of tackers as a method of mesh fixation. The use of fibrin sealant reduces the risk of post- and intraoperative complications, such as bleeding, seroma, chronic pain, has a lower incidence of postoperative neuralgia and provides an early faster return to social life. The recurrence rates do not vary much, but the operative time is slightly longer if the preparation time of the fibrin sealant is taken into consideration. In our study, we found a marginal difference in the cost of the two groups, fibrin sealant and stapled tackers. [Cukurova Med J 2015; 40(3.000: 457-465

Measuring of -1,3 Glucanase Activity in Trichoderma Virens Isolates and Selection of the Best Isolates for Biological Control of Cucumber Root Rot

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Fatemeh Zavvari

2013-02-01

Full Text Available In this study four isolates of  Trichoderma virens (T.virens 414, T.virens 414.8, T.virens 304 and  T.virens 404.4 were compared based on extra cellular β-1,3 glucanase production and biological control of root rot cucumber (Phytophthora drerchsleri in laboratory and green house experiments.The in vitro potential of those isolates were evaluated against  P.drechsleri  through production of volatile and dual culture. The pH (3, 5, 7, 8, 9 and temperature effects(5, 15, 20, 25, 30, 40˚C on Trichoderma mycelial growth were also evaluated. Colony growth rate of thease isolates were also studied in water agar culture medium containing carboxy methyle cellulose (CMC and showed direct correlation with β-1,3 glucanase secretion. According to results T. virens 304 and T. virens 414.8  were the best isolates in biocontrol of . drechsleri. Result also showed direct correlation between β-1,3 glucanase secretion and inhibition growth of phytophthora  mycelium and reduction of phytophthora infection.

Quantitative analysis of collagen and elastic fibers in the transversalis fascia in direct and indirect inguinal hernia Análise quantitativa do colágeno e de fibras elásticas na fascia transversal de pacientes com hernia inguinal direta e indireta

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Aldo Junqueira Rodrigues Junior

2002-01-01

Full Text Available PURPOSE: Our previous studies demonstrated structural and quantitative age-related changes of the elastic fibers in transversalis fascia, which may play a role in inguinal hernia formation. To verify whether there were differences in the extracellular matrix between direct and indirect inguinal hernia, we studied the amount of collagen and elastic fibers in the transversalis fascia of 36 male patients with indirect inguinal hernia and 21 with direct inguinal hernia. MATERIAL AND METHODS: Transversalis fascia fragments were obtained during surgical intervention and underwent histological quantitative analysis of collagen by colorimetry and analysis of elastic fibers by histomorphometry. RESULTS: We demonstrated significantly lower amounts of collagen and higher amounts of elastic fibers in transversalis fascia from patients with direct inguinal hernia compared to indirect inguinal hernia patients. The transversalis fascia from direct inguinal hernia patients showed structural changes of the mature and elaunin elastic fibers, which are responsible for elasticity, and lower density of oxytalan elastic fibers, which are responsible for resistance. These changes promoted loss of resiliency of the transversalis fascia. CONCLUSION: These results improve our understanding of the participation of the extracellular matrix in the genesis of direct inguinal hernia, suggesting a relationship with genetic defects of the elastic fiber and collagen synthesis.OBJETIVO: Estudos prévios nossos demonstraram alterações estruturais e quantitativas de fibras elásticas na fascia transversal com o envelhecimento, tendo papel na gênese da hérnia inguinal. Com o objetivo de verificar diferenças na matriz extracellular da fascia transversal de pacientes com hernia inguinal direta e indireta, quantificamos o colágeno e as fibras elásticas na fascia transversal de 36 pacientes masculinos com hernia inguinal indireta e 21 pacientes masculinos com hernia inguinal

Sexual dysfunction after inguinal hernia repair with the Onstep versus Lichtenstein technique

DEFF Research Database (Denmark)

Andresen, Kristoffer; Burcharth, Jakob; Fonnes, Siv

2017-01-01

BACKGROUND: Sequelae after inguinal hernia repair include pain-related impairment of sexual function. Pain during intercourse can originate from the scar, scrotum, penis, or during ejaculation. The aim of this study was to investigate if the Onstep technique resulted in better results than...... the Lichtenstein technique regarding pain-related impairment of sexual function. METHODS: This study was part of the randomized ONLI trial (NCT01753219, Onstep versus Lichtenstein for inguinal hernia repair). Separate reporting of pain-related impairment of sexual function was planned before the study start......, with a separate sample size calculation. Participants were randomized to the Onstep or Lichtenstein technique for repair of their primary inguinal hernia and followed up at 6 months postoperative with the use of a questionnaire specific for pain-related impairment of sexual function. RESULTS: A total of 259...

-5p and -3p strands of miR-145 and miR-140 during mesenchymal stem cell chondrogenic differentiation.

Science.gov (United States)

Kenyon, Jonathan D; Sergeeva, Olga; Somoza, Rodrigo A; Li, Ming; Caplan, Arnold I; Khalil, Ahmad M; Lee, Zhenghong

2018-04-20

The chondrogenic differentiation of mesenchymal stem cells (MSCs) is mediated by transcription factors and small non-coding RNAs such as micro-RNAs (miRNAs). Each miRNA is initially transcribed as a long transcript, which matures to produce -5p and -3p strands. It is widely believed that the mature and functional miRNA from any given pre-miRNA, usually the -5p strand, is functional, while the opposing -3p strand is degraded. However, recent cartilage literature started to show functional -3p stands for a few miRNAs. This study aimed at examining both -5p and -3p strands of two key miRNAs miR-140 and miR-145 that are known to be involved in the chondrogenic differentiation of MSCs. The level (copy number) of both -5p and -3p strands of miR-145 and miR-140 along the timeline of MSC chondrogenic differentiation was determined by PCR. The gene expression profiles of several genes related to MSC chondrogenesis were compared with these miRNA profiles along the same timeline. While miR-145-3p is declining in step with miR-145-5p in pellet cultures during the process, the -3p strand is only 1% - 2% of the total miR-145 products. In contrast, the mature -3p and -5p products of miR-140 are found to increase with near equal molar expression throughout chondrogenic differentiation. Numerous genes are expressed by cartilage progenitor cells during development. One such target gene, Sox9 is a regulatory target of the dominant miR-145-5p, consistent with the data. Further experimental validations are warranted to confirm that ACAN, FOXO1 and RUNX3 as direct targets of miR-145-5p in the context of MSC chondrogenesis. Similarly, TRSP1 and ACAN are worth further validation as direct targets of miR-145-3p. For miR-140, SOX4 shall be further validated as a direct target of miR-140-5p while KLF4, PTHLH, and WNT5A can be validated as direct targets of miR-140-3p.

Effect of addition of dexamethasone to ropivacaine on post-operative analgesia in ultrasonography-guided transversus abdominis plane block for inguinal hernia repair: A prospective, double-blind, randomised controlled trial.

Science.gov (United States)

Sharma, Uma Datt; Prateek; Tak, Himani

2018-05-01

Ultrasonography (USG)-guided transversus abdominis plane (TAP) block is an abdominal field block with high efficacy. This study was undertaken with the aim of determining the effect of the addition of dexamethasone to 0.5% ropivacaine on post-operative analgesia in USG-guided TAP block for inguinal hernia repair. A double-blind randomised control study was conducted on sixty patients posted for inguinal hernia repair with the American Society of Anesthesiologists physical Status I or II, who were allocated two groups of 30 each. Patients in Group RS received 0.5% ropivacaine (20 ml) and normal saline (2 ml) whereas patients in Group RD received 0.5% ropivacaine (20 ml) and dexamethasone (2 ml, i.e., 8 mg), in USG-guided TAP Block on the same side, after repair of inguinal hernia under spinal anaesthesia. Visual analogue scale (VAS) scores, time for request of first analgesia and total tramadol consumption in first 24 h were compared. Unpaired Student's t -test and Mann-Whitney U-test were performed using SPSS 23 Software. Patients in Group RD had significantly lower VAS scores as compared to Group RS from 4 th to 12 th h, postoperatively. Duration of analgesia was significantly more in Group RD (547.50 [530,530] min) when compared with Group RS (387.50 [370,400] min) ( P consumption.

PRE-OPERATIVE HAIR REMOVAL WITH TRIMMERS AND RAZORS AND ITS IMPACT ON SURGICAL SITE INFECTIONS IN ELECTIVE INGUINAL HERNIA REPAIR

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John S. Kurien

2018-02-01

. Most of the symptoms of surgical site infections were during the initial 3 days (69%, with the most common symptom being erythema (18.1% followed by induration (12.5%. Gaping (0.6% and discharge from wound (3% were very minimal. Those individuals who had undergone preoperative hair removal with trimmers (11.2% had a lower incidence of surgical site infection when compared to those with razors (20%. The difference was statistically significant, with a p value of 0.024 by Chi-Square tests. The difference in erythema (p- 0.024 and induration (p-0.017 between the two groups was also found to be statistically significant. Other factors, namely type of surgery, age of the individual and sex did not have a statistically significant difference. CONCLUSION In this study there is evidence of definite reduction in surgical site infection rates when trimmers were used for pre-operative hair removal than razors in elective inguinal hernia surgery. The difference is statistically significant (p Value – 0.024.

Evaluation of Anesthesia Profile in Pediatric Patients after Inguinal Hernia Repair with Caudal Block or Local Wound Infiltration.

Science.gov (United States)

Gavrilovska-Brzanov, Aleksandra; Kuzmanovska, Biljana; Kartalov, Andrijan; Donev, Ljupco; Lleshi, Albert; Jovanovski-Srceva, Marija; Spirovska, Tatjana; Brzanov, Nikola; Simeonov, Risto

2016-03-15

The aim of this study is to evaluate anesthesia and recovery profile in pediatric patients after inguinal hernia repair with caudal block or local wound infiltration. In this prospective interventional clinical study, the anesthesia and recovery profile was assessed in sixty pediatric patients undergoing inguinal hernia repair. Enrolled children were randomly assigned to either Group Caudal or Group Local infiltration. For caudal blocks, Caudal Group received 1 ml/kg of 0.25% bupivacaine; Local Infiltration Group received 0.2 ml/kg 0.25% bupivacaine. Investigator who was blinded to group allocation provided postoperative care and assessments. Postoperative pain was assessed. Motor functions and sedation were assessed as well. The two groups did not differ in terms of patient characteristic data and surgical profiles and there weren't any hemodynamic changes between groups. Regarding the difference between groups for analgesic requirement there were two major points - on one hand it was statistically significant p < 0.05 whereas on the other hand time to first analgesic administration was not statistically significant p = 0.40. There were significant differences in the incidence of adverse effects in caudal and local group including: vomiting, delirium and urinary retention. Between children undergoing inguinal hernia repair, local wound infiltration insures safety and satisfactory analgesia for surgery. Compared to caudal block it is not overwhelming. Caudal block provides longer analgesia, however complications are rather common.

Collagen and elastic fibers of skin connective tissue in patients with and without primary inguinal hernia

OpenAIRE

Bórquez M, Pablo; Garrido O, Luis; Manterola D, Carlos; Peña S, Patricio; Schlageter T, Carol; Orellana C, Juan José; Ulloa U, Hugo; Peña R, Juan Luis

2003-01-01

There are few studies looking for collagen matrix defects in patients with inguinal hernia. Aim: To study the skin connective tissue in patients with and without inguinal hernia. Patients and methods: Skin from the surgical wound was obtained from 23 patients with and 23 patients without inguinal hernia. The samples were processed for conventional light microscopy. Collagen fibers were stained with Van Giesson and elastic fibers with Weigert stain. Results: Patients without hernia had compact...

The interaction of diadenosine polyphosphates with P2x-receptors in the guinea-pig isolated vas deferens.

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Westfall, T D; McIntyre, C A; Obeid, S; Bowes, J; Kennedy, C; Sneddon, P

1997-05-01

1. The site(s) at which diadenosine 5',5"'-P1,P4-tetraphosphate (AP4A) and diadenosine 5', 5"'-P1,P5-pentaphosphate (AP5A) act to evoke contraction of the guinea-pig isolated vas deferens was studied by use of a series of P2-receptor antagonists and the ecto-ATPase inhibitor 6-N,N-diethyl-D-beta,gamma-dibromomethyleneATP (ARL 67156). 2. Pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (PPADS) (300 nM - 30 microM), suramin (3-100 microM) and pyridoxal-5'-phosphate (P-5-P) (3-1000 microM) inhibited contractions evoked by equi-effective concentrations of AP5A (3 microM), AP4A (30 microM) and alpha,beta-methyleneATP (alpha,beta-meATP) (1 microM), in a concentration-dependent manner and abolished them at the highest concentrations used. 3. PPADS was more potent than suramin, which in turn was more potent than P-5-P. PPADS inhibited AP5A, AP4A and alpha,beta-meATP with similar IC50 values. No significant difference was found between IC50 values for suramin against alpha,beta-meATP and AP5A or alpha,beta-meATP and AP4A, but suramin was more than 2.5 times more potent against AP4A than AP5A. P-5-P showed the same pattern of antagonism. 4. Desensitization of the P2xi-receptor by alpha,beta-meATP abolished contractions evoked by AP5A (3 microM) and AP4A (30 microM), but had no effect on those elicited by noradrenaline (100 microM). 5. ARL 67156 (100 microM) reversibly potentiated contractions evoked by AP4A (30 microM) by 61%, but caused a small, significant decrease in the mean response to AP5A (3 microM). 6. It is concluded that AP4A and AP5A act at the P2xi-receptor, or a site similar to the P2xi-receptor, to evoke contraction of the guinea-pig isolated vas deferens. Furthermore, the potency of AP4A, but not AP5A, appears to be inhibited by an ecto-enzyme which is sensitive to ARL 67156.

[Genomic characteristics and recombination of enterovirus 71 strains isolated in Henan Province between 2008 and 2010].

Science.gov (United States)

Wei, Hai-Yan; Xu, Yu-Ling; Huang, Xue-Yong; Ma, Hong; Chen, Hao-Min; Xu, Bian-Li

2011-09-01

To reveal the genetic features and recombination of enterovirus 71 isolates between 2008 and 2010. A total of 5 enterovirus 71 isolates were sequenced completely and phylogenetic analysis and recombination were performed. Phylogenetic analysis based on VP1 regions revealed that the Henan enterovirus 71 between 2008 and 2010 belonged to C4a in subgenotype C4. Bootscan analyses and phylogenetic analysis based on the 5'UTR, P1, P2, P3 genomic regions revealed the recombinations between EV71 genotypes B and C at the 2A-2B junction, and between EV71 genotype B and CA16 strain G-10 at the 3B-3C junction. Henan enterovirus 71 isolates between 2008 and 2010 belonged to C4a in subgenotype C4 which was the predominant virus genotype circulating in mainland China since 2004, a combination of intratypic and intertypic recombination were found in EV71 subgenotype C4.

Comparación entre la reparación abierta con malla y la técnica de Desarda en la hernia inguinal Comparison between open repair with mesh and the Desarda technique in inguinal hernia

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Pedro Rolando López Rodríguez

2009-12-01

Full Text Available INTRODUCCIÓN. Con el presente trabajo se buscó dar respuesta a algunas controversias en torno de la reparación de las hernias inguinales, así como realizar una valoración sobre el dolor posoperatorio y analizar los costos de las técnicas de reparación protésicas y la técnica que refuerza la pared posterior del canal inguinal con una franja aponeurótica pediculada del músculo oblicuo mayor. MÉTODOS. Se realizó un estudio prospectivo aleatorio de 836 pacientes con hernia inguinal, operados entre septiembre del 2001 y diciembre del 2007. A un grupo se le practicó una hernioplastia anterior con malla y al otro la técnica de Mohan P. Desarda, la cual consiste en una herniorrafia sin malla. RESULTADOS. Ambos grupos de pacientes fueron comparables, sin diferencias con respecto a la edad, la localización y el tipo de hernia. El tiempo quirúrgico fue menor en la hernioplastia con malla y no hubo diferencias significativas en cuanto al dolor durante el primer y tercer día del posoperatorio, pero en el grupo de la hernioplastia éste fue superior al quinto día. En tres pacientes hubo rechazo a la malla de polipropileno. CONCLUSIONES. La técnica de Desarda, al no utilizar malla, fue más económica que la hernioplastia con malla; esta diferencia fue estadísticamente significativa.INTRODUCTION: With present paper we gave response to some controversies around the repair of inguinal hernias as well as to make a valuation on postoperative pain and to analyze the costs of prosthetic repair techniques and the technique reinforcing the posterior wall of inguinal channel with a pediculate aponeurotic band of major obliquus muscle. METHODS: A random prospective study was conducted in 836 patients presenting with inguinal hernia, operated on between September, 2001 and December, 2007. A group underwent anterior hernioplasty with mesh and in the other we used Mohan P. Desarda technique, which is a herniorrhaphy without mesh. RESULTS: Both groups

Interchannel interaction in orientation and alignment of Kr 4p4mp states in the region of 3d9np resonances

International Nuclear Information System (INIS)

Lagutin, B M; Petrov, I D; Sukhorukov, V L; Werner, L; Klumpp, S; Ehresmann, A; Schartner, K-H; Schmoranzer, H

2009-01-01

The interaction between intermediate channels which influence the population of Kr 4p 4 mp ionic states in the region of the 3d 9 np resonances by the photon-induced Auger decay was investigated. The most important influence on the investigated process stems from 4p 5 ε'l and 3d 9 ε'l channels.

Tratamento de linfocele inguinal pós-operatória com injeção de cola de fibrina: relato de caso Treatment of postoperative inguinal lymphocele with fibrin glue injection: case report

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Priscila Nunes Boaventura

2007-06-01

Full Text Available O paciente desenvolveu linforragia na região inguinal direita, depois de ponte aorto-bifemoral com enxerto de dácron®. Não respondeu ao tratamento conservador com cuidados locais e compressão. Foi realizado exame de ultra-sonografia Doppler, que evidenciou grande linfocele (6,4 x 3,36 x 6,1 cm, tratada pelo esvaziamento da loja por aspiração e injeção de cola de fibrina (1,6 mL em seu interior. O paciente se recuperou sem intercorrências e sem recidiva, após 3 meses de seguimento.The patient developed lymphatic drainage in the right groin after an aortobifemoral bypass with Dacron® graft. Conservative treatment with local wound care and compression was unsuccessful. Duplex scan showed a 6.4 x 3.36 x 6.1 cm lymphocele, which was treated by aspiration and injection of fibrin glue (1.6 mL. The patient recovered uneventfully and without recurrence after a 3-month follow-up.

Orchiectomy as a result of ischemic orchitis after laparoscopic inguinal hernia repair: case report of a rare complication.

Science.gov (United States)

Moore, John B; Hasenboehler, Erik A

2007-11-07

Ischemic orchitis is an established complication after open inguinal hernia repair, but ischemic orchitis resulting in orchiectomy after the laparoscopic approach has not been reported. The patient was a thirty-three year-old man who presented with bilateral direct inguinal hernias, right larger than left. He was a thin, muscular male with a narrow pelvis who underwent bilateral extraperitoneal mesh laparoscopic inguinal hernia repair. The case was complicated by pneumoperitoneum which limited the visibility of the pelvic anatomy; however, the mesh was successfully deployed bilaterally. Cautery was used to resect the direct sac on the right. The patient was discharged the same day and doing well with minimal pain and swelling until the fourth day after surgery. That night he presented with sudden-onset pain and swelling of his right testicle and denied both trauma to the area and any sexual activity. Ultrasound of the testicle revealed no blood flow to the testicle which required exploration and subsequent orchiectomy. Ischemic orchitis typically presents 2-3 days after inguinal hernia surgery and can progress to infarction. This ischemic injury is likely due to thrombosis of the venous plexus, rather than iatrogenic arterial injury or inappropriate closure of the inguinal canal. Ultrasound/duplex scanning of the postoperative acute scrotum can help differentiate ischemic orchitis from infarction. Unfortunately, testicular torsion cannot be ruled out and scrotal exploration may be necessary. Although ischemic orchitis, atrophy, and orhiectomy are uncommon complications, all patients should be warned of these potential complications and operative consent should include these risks irrespective of the type of hernia or the surgical approach.

[The transrectus sheath preperitoneal procedure: a safe, effective and cheap surgical approach to inguinal hernia?

NARCIS (Netherlands)

Prins, M.W.; Voropai, D.A.; Laarhoven, C.J.H.M. van; Akkersdijk, W.L.

2013-01-01

The main complication of surgery for inguinal hernia is chronic postoperative pain. This is often reported following the Lichtenstein procedure. A new, open surgical technique for the repair of inguinal hernia has been developed. This procedure is called the transrectus sheath preperitoneal

Glass formation and properties of glasses in V/sub 2/O/sub 5/-B/sub 2/O/sub 3/-P/sub 2/O/sub 5/ system

Energy Technology Data Exchange (ETDEWEB)

Sedmale, G P; Vajvad, Ya A; Arkhipova, S E; Laukmanis, L A

1987-01-01

The glass formation in the system V/sub 2/O/sub 5/-B/sub 2/O/sub 3/-P/sub 2/O/sub 5/ and the properties of the obtained glasses have been studied by methods including that of the mathematical design and the treatment of the obtained data on ECM. The glass formation region is limited by the molar content of V/sub 2/O/sub 5/ 30-80%, B/sub 2/O/sub 3/ 0-45%, P/sub 2/O/sub 5/ 20-65%. The chemical stability data show that at the molar content of V/sub 2/O/sub 5/ 45-50% the transfer of vanadium from the state of the modificator to the glass-forming agent takes place. For the studied glasses the electron mechanism of conductivity is the dominating one.

Sonography in the postoperative evaluation of laparoscopic inguinal hernia repair.

Science.gov (United States)

Furtschegger, A; Sandbichler, P; Judmaier, W; Gstir, H; Steiner, E; Egender, G

1995-09-01

We evaluated the use of sonography as a means of assessing hernial occlusion and possible postoperative changes such as hematomas or seromas in the inguinal and scrotal regions after 1139 laparoscopic repairs of hernias between August 1992 and November 1994. Changes after laparoscopic hernia repair were found in 307 patients (27%). Hematomas or seromas were seen in 132 patients, protrusion of the prosthetic mesh in 17, mesh infection in two, and small bowel entrapment in an insufficient peritoneal suture in two. Recurrences were diagnosed correctly in six patients, mobile preperitoneal lipomas in five. Sonography is useful in the evaluation of complications after laparoscopic hernia repair, including recurrent hernia. In the absence of symptoms, sonography is not indicated.

Mesh Inguinal Hernia Repair and Appendectomy in the Treatment of Amyand’s Hernia with Non-Inflamed Appendices

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Emin Kose

2017-01-01

Full Text Available Amyand’s hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand’s hernia with noninflamed appendices. There were five male patients with a mean age of 42.4 ± 16.1 years in this retrospective study in which Amyand’s hernia was treated with mesh inguinal hernia repair plus appendectomy for noninflamed appendices. Patients with acute appendicitis and perforated vermiform appendix were excluded. There were four right sided and one bilateral inguinal hernia. Postoperative courses were uneventful. During the follow-up period (14.0 ± 7.7 months, there was no inguinal hernia recurrence. Mesh inguinal hernia repair with appendectomy can be performed for Amyand’s hernia in the absence of acute appendicitis. However, presence of fibrous connections between the vermiform appendix and the surrounding hernia sac may be regarded as a parameter to perform appendectomy.

Effect of cooled hyperbaric bupivacaine on unilateral spinal anesthesia success rate and hemodynamic complications in inguinal hernia surgery.

Science.gov (United States)

Tomak, Yakup; Erdivanli, Basar; Sen, Ahmet; Bostan, Habib; Budak, Ersel Tan; Pergel, Ahmet

2016-02-01

We hypothesized that cooling hyperbaric bupivacaine from 23 to 5 °C may limit the intrathecal spread of bupivacaine and therefore increase the success rate of unilateral spinal anesthesia and decrease the rate of hemodynamic complications. A hundred patients scheduled for elective unilateral inguinal hernia surgery were randomly allocated to receive 1.8 ml of 0.5 % hyperbaric bupivacaine intrathecally at either 5 °C (group I, n = 50) or at 23 °C (group II, n = 50). Following spinal block at the L2-3 interspace, the lateral decubitus position was maintained for 15 min. Unilateral spinal anesthesia was assessed and confirmed at 15 and 30 min. The levels of sensory and motor block on the operative side were evaluated until complete resolution. The rate of unilateral spinal anesthesia at 15 and 30 min was significantly higher in group I (p = 0.015 and 0.028, respectively). Hypotensive events and bradycardia were significantly rarer in group I (p = 0.014 and 0.037, respectively). The density and viscosity of the solution at 5 °C was significantly higher than at 23 °C (p < 0.0001). Compared with group II, sensory block peaked later in group I (17.4 vs 12.6 min) and at a lower level (T9 vs T7), and two-segment regression of sensory block (76.4 vs 84.3 min) and motor block recovery was shorter (157.6 vs 193.4 min) (p < 0.0001). Cooling of hyperbaric bupivacaine to 5 °C increased the density and viscosity of the solution and the success rate of unilateral spinal anesthesia, and decreased the hemodynamic complication rate.

Probiotic attributes of Lactobacillus strains isolated from food and of human origin.

Science.gov (United States)

Gaudana, Sandeep B; Dhanani, Akhilesh S; Bagchi, Tamishraha

2010-06-01

Lactobacilli isolated from various sources were identified on the basis of 16S-23S rRNA gene intergenic region amplification and subsequent sequencing of the smaller intergenic region. An in vitro analysis of probiotic properties including binding, ability to tolerate different concentrations of bile, survival in acidic buffer and antimicrobial activity of four different isolates and two standard strains (Lactobacillus plantarum American Type Culture Collection (ATCC) 8014 and L. rhamnosus GG (LGG)) was carried out. The ability of each isolate to stimulate Caco-2 cells, human peripheral blood mononuclear cells (PBMC) and THP-1 cells resulting in immunomodulation of these cells was analysed. Isolates L. rhamnosus CS25 and L. delbrueckii M and standard strain ATCC 8014 showed broad antimicrobial activity, and isolates CS25 (percentage of survival 6.9 % at pH 2.5, 5.1 % at pH 2.0) and L. plantarum CS23 (5.7 % at pH 2.5, 4.9 % at pH 2.0) have shown good tolerance to acidic pH. Isolate CS23 showed a good survival (14 %) after 2 h incubation in de Man, Rogosa and Sharpe (MRS) medium containing 3 % bile salts. Isolates CS23, CS25 and L. fermentum ASt1 could stimulate Caco-2 cells, human PBMC and THP-1 cells for a strong and varied immunomodulatory response in these cells. Though LGG showed poor antimicrobial activity as well as bile and acid tolerance, it was found to be the best binding strain tested. Child faecal isolate CS23 from the present study showed high binding ability (seventeen bacteria/Caco-2), high tolerance to acidic pH and bile salts and significant immunomodulation; therefore it is a good potential probiotic candidate.

Costs and cost-effectiveness of pediatric inguinal hernia repair in Uganda.

Science.gov (United States)

Eeson, Gareth; Birabwa-Male, Doreen; Pennington, Mark; Blair, Geoffrey K

2015-02-01

Surgically treatable diseases contribute approximately 11% of disability-adjusted life years (DALYs) worldwide yet they remain a neglected public health priority in low- and middle-income countries (LMICs). Pediatric inguinal hernia is the most common congenital abnormality in newborns and a major cause of morbidity and mortality yet elective repair remains largely unavailable in LMICs. This study is aimed to determine the costs and cost-effectiveness of pediatric inguinal hernia repair (PIHR) in a low-resource setting. Medical costs of consecutive elective PIHRs were recorded prospectively at two centers in Uganda. Decision modeling was used to compare two different treatment scenarios (adoption of PIHR and non-adoption) from a provider perspective. A Markov model was constructed to estimate health outcomes under each scenario. The robustness of the cost-effectiveness results in the base case analysis was tested in one-way and probabilistic sensitivity analysis. The primary outcome of interest was cost per DALY averted by the intervention. Sixty-nine PIHRs were performed in 65 children (mean age 3.6 years). Mean cost per procedure was $86.68 US (95% CI 83.1-90.2 USD) and averted an average of 5.7 DALYs each. Incremental cost-effectiveness ratio was $12.41 per DALY averted. The probability of cost-effectiveness was 95% at a cost-effectiveness threshold of $35 per averted DALY. Results were robust to sensitivity analysis under all considered scenarios. Elective PIHR is highly cost-effective for the treatment and prevention of complications of hernia disease even in low-resource settings. PIHR should be prioritized in LMICs alongside other cost-effective interventions.

Transperitoneal rectus sheath block and transversus abdominis plane block for laparoscopic inguinal hernia repair: A novel approach.

Science.gov (United States)

Nagata, Jun; Watanabe, Jun; Nagata, Masato; Sawatsubashi, Yusuke; Akiyama, Masaki; Tajima, Takehide; Arase, Koichi; Minagawa, Noritaka; Torigoe, Takayuki; Nakayama, Yoshifumi; Horishita, Reiko; Kida, Kentaro; Hamada, Kotaro; Hirata, Keiji

2017-08-01

A laparoscopic approach for inguinal hernia repair is now considered the gold standard. Laparoscopic surgery is associated with a significant reduction in postoperative pain. Epidural analgesia cannot be used in patients with perioperative anticoagulant therapy because of complications such as epidural hematoma. As such, regional anesthetic techniques, such as ultrasound-guided rectus sheath block and transversus abdominis plane block, have become increasingly popular. However, even these anesthetic techniques have potential complications, such as rectus sheath hematoma, if vessels are damaged. We report the use of a transperitoneal laparoscopic approach for rectus sheath block and transversus abdominis plane block as a novel anesthetic procedure. An 81-year-old woman with direct inguinal hernia underwent laparoscopic transabdominal preperitoneal inguinal repair. Epidural anesthesia was not performed because anticoagulant therapy was administered. A Peti-needle™ was delivered through the port, and levobupivacaine was injected though the peritoneum. Surgery was performed successfully, and the anesthetic technique did not affect completion of the operative procedure. The patient was discharged without any complications. This technique was feasible, and the procedure was performed safely. Our novel analgesia technique has potential use as a standard postoperative regimen in various laparoscopic surgeries. Additional prospective studies to compare it with other techniques are required. © 2017 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.

(5'-32P)-8-azidoguanosine-3',5'-monophosphate. I. Synthesis and properties. II. Interaction with E. coli proteins

International Nuclear Information System (INIS)

Owens, J.R.

1983-01-01

Under certain conditions of nutritional deprivation, microorganisms produce the magic spot nucleotides guanosine-3'-diphosphate-5'-triphosphate(pppGpp) and the tetraphosphate ppGpp. The latter is known to be a pleiotypic effector, i.e. it inhibits (and sometimes stimulates) many biological processes including transcription, translation, and metabolic pathways. It is unknown whether pppGpp, ppGp, pGpp, and pGp, other members of this family of guanosine-3',5'-phosphates, also have regulatory properties. To begin to investigate this question, a radioactive photoaffinity analog of pGp was prepared: (5' 32 P)pN 3 Gp. The interaction of this photoprobe with E. coli sonicates and a purified protein (RNA polymerase) was examined. At physiological salt concentrations two proteins (RNA polymerase) was examined. At physiological salt concentrations two proteins of 86,000 and 65,000 daltons (p86 and p65) were primarily photolabeled. Competition studies with guanosine and adenosine nucleotides indicated (5 32 P)pN 3 Gp was labeling a ppGpp binding site on p86, and a pGp (or GMP) site on p65. ATP phosphorylation of p86 increased photoincorporation, while it decreased labeling of p65. The data also provide evidence of a different type of regulatory mechanism, i.e. phosphorylation modulates binding of an allosteric effector (ppGpp) to a protein(enzyme). Both ATP and GTP were found to phosphorylate the same proteins, although GTP was the preferred substrate in some cases

Postoperative analgesic efficacy of ultrasound-guided ilioinguinal-iliohypogastric nerve block compared with medial transverse abdominis plane block in inguinal hernia repair: A prospective, randomised trial.

Science.gov (United States)

Bhatia, Nidhi; Sen, Indu Mohini; Mandal, Banashree; Batra, Ankita

2018-03-29

Analgesic efficacy of ultrasound-guided transverse abdominis plane block, administered a little more medially, just close to the origin of the transverse abdominis muscle has not yet been investigated in patients undergoing unilateral inguinal hernia repair. We hypothesised that medial transverse abdominis plane block would provide comparable postoperative analgesia to ilioinguinal-iliohypogastric nerve block in inguinal hernia repair patients. This prospective, randomised trial was conducted in 50 ASA I and II male patients≥18 years of age. Patients were randomised into two groups to receive either pre-incisional ipsilateral ultrasound-guided ilioinguinal-iliohypogastric nerve block or medial transverse abdominis plane block, with 0.3ml/kg of 0.25% bupivacaine. Our primary objective was postoperative 24-hour analgesic consumption and secondary outcomes included pain scores, time to first request for rescue analgesic and side effects, if any, in the postoperative period. There was no significant difference in the total postoperative analgesic consumption [group I: 66.04mg; group II: 68.33mg (P value 0.908)]. Time to first request for rescue analgesic was delayed, though statistically non-significant (P value 0.326), following medial transverse abdominis plane block, with excellent pain relief seen in 58.3% patients as opposed to 45.8% patients in ilioinguinal-iliohypogastric nerve block group. Medial transverse abdominis plane block being a novel, simple and easily performed procedure can serve as an useful alternative to ilioinguinal-iliohypogastric nerve block for providing postoperative pain relief in inguinal hernia repair patients. Copyright © 2018 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

[Diagnostic issues of lymphogranuloma venereum: A case series of 5 patients].

Science.gov (United States)

Fabre-Baudouin, A; Roux, A L; Marin, C; Lachatre, M; De Laroche, M; Ponsoye, M; Hanslik, T; Trad, S

2017-12-01

Lymphogranuloma venereum (LG) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis L serovar. These five consecutive cases aim to highlight the risk of LG misdiagnosis, in case of initial presentation with isolated inguinal adenitis. Five men (mean age: 30±7 years) were seen in an internal medicine department, for inguinal adenopathy. One patient had clinical signs of urethritis. None presented an associated rectitis. Three patients had a history of STI, and two had a discovery of related HIV disease. Urinary polymerase chain reaction (PCR) was positive for the symptomatic patient and negative for the others. Lymph node PCR was positive in all patients within a L2b serotype (searched in 4 out of 5 cases). LG should be evoked in any patient with inguinal adenomegaly, particularly in case of STI history or risk factors. Negativity of urinary PCR should lead to further investigations, essentially a lymph node cytopuncture to evidence C. trachomatis. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

"Laparoscopic excision of a large ovarian cyst herniating into the inguinal canal: a rare presentation".

Science.gov (United States)

Machado, Norman Oneil; Machado, Lovina S M; Al Ghafri, Wadha

2011-08-01

Inguinal hernia repair is one of the most common operation in surgical practice. Despite its common occurrence, hernia often poses a surgical dilemma even for a skilled surgeon. The unexpected hernial content constitutes one of these cases. Although the often-reported, unusual contents of a hernia sac include ovary, fallopian tube, vermiform appendix, Meckel diverticulum, and urinary bladder, the herniation of a large ovarian cyst into the inguinal canal has been hardly reported. Majority of the ovarian cysts are asymptomatic or present with vague lower abdominal pain, whereas the presentation of a large ovarian cyst as an inguinolabial swelling as in our patient is extremely rare. We present here one of the few reported cases of a laparoscopic excision of a large ovarian cyst herniating into the inguinal canal and discuss the pathogenesis of an ovarian cyst as hernial content, the advantages and concerns of a laparoscopic approach in resecting large ovarian cysts, and simultaneous management of the inguinal hernia.

LLNL-G3Dv3: Global P wave tomography model for improved regional and teleseismic travel time prediction: LLNL-G3DV3---GLOBAL P WAVE TOMOGRAPHY

Energy Technology Data Exchange (ETDEWEB)

Simmons, N. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Myers, S. C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Johannesson, G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Matzel, E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2012-10-06

[1] We develop a global-scale P wave velocity model (LLNL-G3Dv3) designed to accurately predict seismic travel times at regional and teleseismic distances simultaneously. The model provides a new image of Earth's interior, but the underlying practical purpose of the model is to provide enhanced seismic event location capabilities. The LLNL-G3Dv3 model is based on ∼2.8 millionP and Pnarrivals that are re-processed using our global multiple-event locator called Bayesloc. We construct LLNL-G3Dv3 within a spherical tessellation based framework, allowing for explicit representation of undulating and discontinuous layers including the crust and transition zone layers. Using a multiscale inversion technique, regional trends as well as fine details are captured where the data allow. LLNL-G3Dv3 exhibits large-scale structures including cratons and superplumes as well numerous complex details in the upper mantle including within the transition zone. Particularly, the model reveals new details of a vast network of subducted slabs trapped within the transition beneath much of Eurasia, including beneath the Tibetan Plateau. We demonstrate the impact of Bayesloc multiple-event location on the resulting tomographic images through comparison with images produced without the benefit of multiple-event constraints (single-event locations). We find that the multiple-event locations allow for better reconciliation of the large set of direct P phases recorded at 0–97° distance and yield a smoother and more continuous image relative to the single-event locations. Travel times predicted from a 3-D model are also found to be strongly influenced by the initial locations of the input data, even when an iterative inversion/relocation technique is employed.

Ultrasound-guided nerve block for inguinal hernia repair

DEFF Research Database (Denmark)

Bærentzen, Finn; Maschmann, Christian; Jensen, Kenneth

2012-01-01

Open inguinal hernia repair in adults is considered a minor surgical procedure but can be associated with significant pain. We aimed to evaluate acute postoperative pain management in male adults randomized to receive an ultrasound-guided ilioinguinal and iliohypogastric nerve block administered...

D-6-Deoxy-myo-inositol 1,3,4,5-tetrakisphosphate, a mimic of D-myo-inositol 1,3,4,5-tetrakisphosphate: biological activity and pH-dependent conformational properties

International Nuclear Information System (INIS)

Horne, Graeme; Maechling, Clarisse; Fleig, Andrea; Hirata, Masato; Penner, Reinhold; Spiess, Bernard; Potter, Barry V.L.

2004-01-01

D-6-Deoxy-myo-inositol 1,3,4,5-tetrakisphosphate [D-6-deoxy-Ins(1,3,4,5)P 4 ] 3 is a novel deoxygenated analogue of D-myo-inositol 1,3,4,5-tetrakisphosphate [Ins(1,3,4,5)P 4 ] 2, a central and enigmatic molecule in the polyphosphoinositide pathway of cellular signalling. D-6-Deoxy-Ins(1,3,4,5)P 4 is a moderate inhibitor of Ins(1,4,5)P 3 5-phosphatase [1.8 μM] compared to Ins(1,3,4,5)P 4 [0.15 μM] and similar to that of L-Ins(1,3,4,5)P 4 [1.8 μM]. In displacement of [ 3 H] Ins(1,4,5)P 3 from the rat cerebellar Ins(1,4,5)P 3 receptor, while slightly weaker [IC 50 =800 nM] than that of D-Ins(1,3,4,5)P 4 [IC 50 =220 nM], 3 is less markedly different and again similar to that of L-Ins(1,3,4,5)P 4 [IC 50 =660 nM]. 3 is an activator of I CRAC when inward currents are measured in RBL-2H3-M1 cells using patch-clamp electrophysiological techniques with a facilitation curve different to that of Ins(1,3,4,5)P 4 . Physicochemical properties were studied by potentiometric 31 P and 1 H NMR titrations and were similar to those of Ins(1,3,4,5)P 4 apart from the observation of a biphasic titration curve for the P1 phosphate group. A novel vicinal phosphate charge-induced conformational change of the inositol ring above pH 10 was observed for D-6-deoxy-Ins(1,3,4,5)P 4 that would normally be hindered because of the central stabilising role played by the 6-OH group in Ins(1,3,4,5)P 4 . We conclude that the 6-OH group in Ins(1,3,4,5)P 4 is crucial for its physicochemical behaviour and biological properties of this key inositol phosphate

Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair

Directory of Open Access Journals (Sweden)

Venkatraman R

2016-01-01

Full Text Available Rajagopalan Venkatraman, Ranganathan Jothi Abhinaya, Ayyanar Sakthivel, Govindarajan Sivarajan Department of Anaesthesia, SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India Background and aim: Transversus abdominis plane block (TAP block is a novel procedure to provide postoperative analgesia following inguinal hernia surgery. The utilization of ultrasound has greatly augmented the success rate of this block and additionally avoiding complications. The aim of our study was to gauge the analgesic efficacy of ultrasound-guided TAP block in patients undergoing unilateral inguinal hernia repair. Materials and methods: Sixty patients scheduled for elective inguinal hernia repair were selected for the study. At the end of the surgical procedure, they were randomly divided into two groups. Ultrasound-guided TAP block was performed with 20 mL of ropivacaine 0.2% (group A or normal saline (group B. Visual analog scale (VAS scores were used to assess pain. Paracetamol was given if VAS >3 and tramadol was used when VAS >6. Patients were monitored for VAS scores and total analgesic consumption for the 24-hour period. Results: The TAP block with ropivacaine (group A reduced VAS scores at 4, 6, and 12 hours. There was no distinction in VAS scores at 0, 2, and 24 hours between the two groups. The duration of analgesia for TAP block with ropivacaine lasted for 390 minutes. Total analgesics consumption was also significantly reduced in group A than group B. No complication was reported to TAP block in both the groups. Conclusion: The ultrasound-guided TAP block provides good postoperative analgesia, reduces analgesic requirements, and provides good VAS scores with fewer complications following inguinal hernia surgery. Keywords: inguinal hernia repair, postoperative analgesia, ropivacaine, transversus abdominis block, ultrasound

Orchiectomy as a result of ischemic orchitis after laparoscopic inguinal hernia repair: case report of a rare complication

Directory of Open Access Journals (Sweden)

Moore John B

2007-11-01

Full Text Available Abstract Background Ischemic orchitis is an established complication after open inguinal hernia repair, but ischemic orchitis resulting in orchiectomy after the laparoscopic approach has not been reported. Case presentation The patient was a thirty-three year-old man who presented with bilateral direct inguinal hernias, right larger than left. He was a thin, muscular male with a narrow pelvis who underwent bilateral extraperitoneal mesh laparoscopic inguinal hernia repair. The case was complicated by pneumoperitoneum which limited the visibility of the pelvic anatomy; however, the mesh was successfully deployed bilaterally. Cautery was used to resect the direct sac on the right. The patient was discharged the same day and doing well with minimal pain and swelling until the fourth day after surgery. That night he presented with sudden-onset pain and swelling of his right testicle and denied both trauma to the area and any sexual activity. Ultrasound of the testicle revealed no blood flow to the testicle which required exploration and subsequent orchiectomy. Conclusion Ischemic orchitis typically presents 2–3 days after inguinal hernia surgery and can progress to infarction. This ischemic injury is likely due to thrombosis of the venous plexus, rather than iatrogenic arterial injury or inappropriate closure of the inguinal canal. Ultrasound/duplex scanning of the postoperative acute scrotum can help differentiate ischemic orchitis from infarction. Unfortunately, testicular torsion cannot be ruled out and scrotal exploration may be necessary. Although ischemic orchitis, atrophy, and orhiectomy are uncommon complications, all patients should be warned of these potential complications and operative consent should include these risks irrespective of the type of hernia or the surgical approach.

The first quinary rare earth thiophosphates. Cs{sub 5}Ln{sub 3}X{sub 3}(P{sub 2}S{sub 6}){sub 2}(PS{sub 4}) (Ln = La, Ce, X = Br, Cl) and the quasi-quaternary Cs{sub 10}Y{sub 4}Cl{sub 10}(P{sub 2}S{sub 6}){sub 3}

Energy Technology Data Exchange (ETDEWEB)

Schoop, Leslie Mareike; Eger, Roland; Nuss, Juergen; Pielnhofer, Florian [Max Planck Institute for Solid State Research, Stuttgart (Germany); Lotsch, Bettina Valeska [Max Planck Institute for Solid State Research, Stuttgart (Germany); Nanosystems Initiative Munich (NIM) and Center for Nanoscience, Muenchen (Germany)

2017-12-13

We report the first examples of quinary rare earth thiophosphates with a fully ordered cation and anion distribution, Cs{sub 5}Ln{sub 3}X{sub 3}(P{sub 2}S{sub 6}){sub 2}(PS{sub 4}), (Ln = La, Ce and X = Br, Cl) as well as the quasi-quaternary Cs{sub 10}Y{sub 4}Cl{sub 10}(P{sub 2}S{sub 6}){sub 3}. These four new compounds crystallize in three different, unknown structure types. The yellowish, transparent, brittle Cs{sub 5}Ce{sub 3}Br{sub 3}(P{sub 2}S{sub 6}){sub 2}(PS{sub 4}) crystallizes in the orthorhombic space group Pnma (no. 62) with a = 13.276(3), b = 14.891(3), c = 19.593(4) Aa, and V = 3873(1) Aa{sup 3} in a novel structure type. Colorless crystals of Cs{sub 5}La{sub 3}Br{sub 3}(P{sub 2}S{sub 6}){sub 2}(PS{sub 4}) and Cs{sub 5}La{sub 3}Cl{sub 3}(P{sub 2}S{sub 6}){sub 2}(PS{sub 4}) are isotypic and were obtained in the monoclinic space group P2{sub 1}/m (no. 11) with a = 9.715(2), b = 14.310(3), c = 13.685(3) Aa, β = 100.16(3) and V = 1873(1) Aa{sup 3} and a = 9.513(2), b = 14.182(3), c = 13.699(3) Aa, β = 99.39(3) and V = 1823(1) Aa{sup 3}, respectively. Both structures contain isolated hexathiohypodiphosphate(IV) [P{sub 2}S{sub 6}]{sup 4-} and thiophosphate [PS{sub 4}]{sup 3-} units that are arranged alternately in layers. Cs{sub 10}Y{sub 4}Cl{sub 10}(P{sub 2}S{sub 6}){sub 3} crystallizes in colorless transparent platelets in the orthorhombic space group Pnnm (no. 58) with a = 13.153(3), b = 28.964(6), c = 7.780(2) Aa, and V = 2964(1) Aa{sup 3}. The structure is composed of isolated [P{sub 4/2}S{sub 6}]{sup 4-} octahedra containing four half occupied P positions surrounded octahedrally by sulfur. We show with Raman scattering that this disordered thiophosphate anion shows a Raman spectrum that is distinct from spectra published for other literature-known thiophosphate anions. (copyright 2017 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

Unique regional distribution of delta 4-3-ketosteroid-5 alpha-oxidoreductase and associated epididymal morphology in the marsupial, Didelphis virginiana.

Science.gov (United States)

Kelce, W R; Krause, W J; Ganjam, V K

1987-09-01

The epididymal epithelial ultrastructure has been described in the adult male North American opossum, Didelphis virginiana. Morphological results have suggested that absorptive activity is prominent in the proximal epididymal region by virtue of numerous microvilli, an endocytotic complex, dense granules, and multivesicular bodies in the apical cytoplasm. In contrast, the middle and distal epididymal regions exhibit ultrastructural features indicative of protein synthesis such as large invaginated euchromatic nuclei, large nucleoli, and increased amounts of granular endoplasmic reticulum. It is in the middle and distal epididymal regions where sperm head rotation and sperm pairing take place. Epididymal delta 4-3-ketosteroid-5 alpha-oxidoreductase (5 alpha-reductase) activity also has been measured. It has been found that the level of enzyme activity differs significantly (p less than 0.01) between the proximal, middle, and distal epididymal regions. Enzyme-specific activity has been found to be highest in the middle region (47.6 +/- 5.4 picomoles 5 alpha-reduced androgens formed/b/mg protein), lower in the distal region (18.3 +/- 0.7 picomoles 5 alpha-reduced androgens formed/b/mg protein), with little activity (2.4 +/- 1.2 picomoles 5 alpha-reduced androgens formed/h/mg protein) found in the proximal epididymal region. This regional distribution of enzyme activity differs markedly from that reported for eutherian mammals. Both the suggested epididymal protein synthetic and secretory activity and the level of epididymal 5 alpha-reductase activity appear to correlate regionally with the morphological changes that occur in the opossum spermatozoa as they transit the epididymis.

Laporoscopic Surgery as the Gold Standard Surgery for Inguinal Hernia in Children

Directory of Open Access Journals (Sweden)

Elena Yu. Dyakonova

2018-01-01

Full Text Available Inguinal hernia in children is one of the most common diseases requiring surgical treatment. There are two methods of surgical interventions for inguinal hernia in children: open and laparoscopic. In international clinical practice, open hernia repair is widely used due to the simplicity of the technique which does not require special tools. However, the percentage of complications and relapse frequency remain high when open hernia repair is performed. The article presents the analysis of the treatment results in 209 children with strangulated inguinal hernia who underwent open and laparoscopic surgery in the period from 2003 to 2014. The open hernia repair (Krasnobaev or Martynov technique was performed in 89 children. The following complications were registered: edema of the spermatic cord — in 34 patients, non-viable loop of the intestine — in 2; one child had a vermicular appendix with signs of striation in the hernial sac, 4 patients — a vermiform appendix with signs of inflammation. In 6 cases the contents of the hernial sac included the strand of the greater omentum, in 1 — the strand of the greater omentum with signs of acute ischemia. In 12 children, the hernial protrusion was absorbed to the abdominal, and therefore no revision was required. In 1 patient, the early postoperative period was complicated by peritonitis due to bowel wall necrosis. Laparoscopic hernioplasty was performed in 120 pediatric patients. The contents of the hernial sac in 86 cases included a loop of the small intestine, in 7 — an appendix and a site of the caecum, in 15 — the ovary and fallopian tubes, in 5 — the strand of the greater omentum. In 14 children, unobliterated internal inguinal rings previously not diagnosed were detected when examining the abdomen. Simultaneous appendectomy was performed when the cecum and the appendix were strangulated. Laparoscopic techniques omitting the disadvantages of an open repair method make it possible to

SOX9 regulates microRNA miR-202-5p/3p expression during mouse testis differentiation

DEFF Research Database (Denmark)

Wainwright, Elanor N; Jorgensen, Joan S; Kim, Youngha

2013-01-01

MicroRNAs are important regulators of developmental gene expression, but their contribution to fetal gonad development is not well understood. We have identified the evolutionarily conserved gonadal microRNAs miR-202-5p and miR-202-3p as having a potential role in regulating mouse embryonic gonad....... Expression of the primary transcript of miR-202-5p/3p remained low in XY gonads in a conditional Sox9-null mouse model, suggesting that pri-miR-202 transcription is downstream of SOX9, a transcription factor that is both necessary and sufficient for male sex determination. We identified the pri-miR-202...

Thermo-physical characterization of the Fe_6_7Mo_6Ni_3_._5Cr_3_._5P_1_2C_5_._5B_2_._5 bulk metallic glass forming alloy

International Nuclear Information System (INIS)

Bochtler, Benedikt; Gross, Oliver; Gallino, Isabella; Busch, Ralf

2016-01-01

The iron-phosphorus based bulk metallic glass forming alloy Fe_6_7Mo_6Ni_3_._5Cr_3_._5P_1_2C_5_._5B_2_._5 is characterized with respect to its thermophysical properties, crystallization and relaxation behavior, as well as its viscosity. The alloy provides a high critical casting thickness of 13 mm, thus allowing for the casting of amorphous parts with a considerable size. Calorimetric measurements reveal the characteristic transformation temperatures, transformation enthalpies, and the specific heat capacity. The analyses show that no stable supercooled liquid region exists upon heating. The specific heat capacity data are used to calculate the enthalpy, entropy, and Gibbs free energy differences between the crystalline and the supercooled liquid state. The crystallization behavior of amorphous samples upon heating is analyzed by differential scanning calorimetry and X-ray diffraction, and a time-temperature-transformation diagram is constructed. Dilatometry is used to determine the thermal expansion behavior. The equilibrium viscosity below the glass transition as well as volume relaxation behavior are measured by three-point beam bending and dilatometry, respectively, to assess the kinetic fragility. With a kinetic fragility parameter of D* = 21.3, the alloy displays a rather strong liquid behavior. Viscosity above the melting point is determined using electromagnetic levitation in microgravity on a reduced gravity aircraft in cooperation with the German Aerospace Center (DLR). These high-temperature viscosity data are compared with the low-temperature three-point beam bending measurements. The alloy displays a strong liquid behavior at low temperatures and a fragile behavior at high temperatures. These results are analogous to the ones observed in several Zr-based bulk metallic glass forming liquids, indicating a strong to fragile liquid-liquid transition in the undercooled liquid, which is obscured by crystallization.

The RNA 5 of Prunus necrotic ringspot virus is a biologically inactive copy of the 3'-UTR of the genomic RNA 3.

Science.gov (United States)

Di Terlizzi, B; Skrzeczkowski, L J; Mink, G I; Scott, S W; Zimmerman, M T

2001-01-01

In addition to the four RNAs known to be encapsidated by Prunus necrotic ringspot virus (PNRSV) and Apple mosaic virus (ApMV), an additional small RNA (RNA 5) was present in purified preparations of several isolates of both viruses. RNA 5 was always produced following infection of a susceptible host by an artificial mixture of RNAs 1, 2, 3, and 4 indicating that it was a product of viral replication. RNA 5 does not activate the infectivity of mixtures that contain the three genomic RNAs (RNA 1 + RNA 2 + RNA 3) nor does it appear to modify symptom expression. Results from hybridization studies suggested that RNA 5 had partial sequence homology with RNAs 1, 2, 3, and 4. Cloning and sequencing the RNA 5 of isolate CH 57/1-M of PNRSV, and the 3' termini of the RNA 1, RNA 2 and RNA 3 of this isolate indicated that it was a copy of the 3' untranslated terminal region (3'-UTR) of the genomic RNA 3.

Effect of addition of dexamethasone to ropivacaine on post-operative analgesia in ultrasonography-guided transversus abdominis plane block for inguinal hernia repair: A prospective, double-blind, randomised controlled trial

Directory of Open Access Journals (Sweden)

Uma Datt Sharma

2018-01-01

Full Text Available Background and Aims: Ultrasonography (USG-guided transversus abdominis plane (TAP block is an abdominal field block with high efficacy. This study was undertaken with the aim of determining the effect of the addition of dexamethasone to 0.5% ropivacaine on post-operative analgesia in USG-guided TAP block for inguinal hernia repair. Methods: A double-blind randomised control study was conducted on sixty patients posted for inguinal hernia repair with the American Society of Anesthesiologists physical Status I or II, who were allocated two groups of 30 each. Patients in Group RS received 0.5% ropivacaine (20 ml and normal saline (2 ml whereas patients in Group RD received 0.5% ropivacaine (20 ml and dexamethasone (2 ml, i.e., 8 mg, in USG-guided TAP Block on the same side, after repair of inguinal hernia under spinal anaesthesia. Visual analogue scale (VAS scores, time for request of first analgesia and total tramadol consumption in first 24 h were compared. Unpaired Student's t-test and Mann–Whitney U-test were performed using SPSS 23 Software. Results: Patients in Group RD had significantly lower VAS scores as compared to Group RS from 4th to 12th h, postoperatively. Duration of analgesia was significantly more in Group RD (547.50 [530,530] min when compared with Group RS (387.50 [370,400] min (P < 0.001. The demand for intravenous tramadol was significantly low in Group RD (223.33 ± 56.83 mg as compared to Group RS (293.33 ± 25.71 mg (P < 0.001. Conclusion: Addition of dexamethasone to ropivacaine in USG-guided TAP block significantly reduces post-operative pain and prolongs the duration of post-operative analgesia, thereby reducing analgesic consumption.

Chronic Post Inguinal Herniorraphy Pain: Prevalence and Risk Factors

African Journals Online (AJOL)

Keywords: Chronic Pain, Inguinal Hernia Repair, Pain,. Surgery. Ann Afr ... operator's experience and method used though a special interest is ... Bilateral hernia. 4. Repair due to .... after Laparoscopic and Open Mesh Repair of. Groin Hernia.

Detection of radiation transitions between 4d9(D5/3,3/2)5s2nl and 4d105p(2P1/2,3/20)nl of self-ionized states of cadmium atom at electron-ion collisions

International Nuclear Information System (INIS)

Gomonaj, A.N.; Imre, A.I.

2005-01-01

Radiation transitions between 4d 9 ( 2 D 5/2,3/2 )5s 2 nl and 4d 10 5p( 2 P 1/2,3/2 0 )nl self-ionized states of Cd atom being dielectron satellites of λ325.0 nm (4d 9 5s 22 D 3/2 →4d 10 5p 2 P 1/2 0 ) and λ353.6 nm (4d 9 5s 22 D 3/2 → 4d 10 5p 2 P 3/2 0 ) laser lines of Cd + ion were detected for the first time at electron-ion collisions. One studied energy dependences of the effective cross sections of electron excitation of the satellite lines within 7-10 eV energy range. The effective cross sections of excitation of dielectron satellites constitutes ∼ 10 -17 cm 2 that is comparable with the efficiency of excitation of the laser lines [ru

Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques

Directory of Open Access Journals (Sweden)

Abdurrahman Demirci

2014-09-01

Full Text Available Objectives: The purpose of this study is to compare the efficacy of iliohypogastric/ilioinguinal nerve blocks performed with the ultrasound guided and the anatomical landmark techniques for postoperative pain management in cases of adult inguinal herniorrhaphy. Methods: 40 patients, ASA I–II status were randomized into two groups equally: in Group AN (anatomical landmark technique and in Group ultrasound (ultrasound guided technique, iliohypogastric/ilioinguinal nerve block was performed with 20 ml of 0.5% levobupivacaine prior to surgery with the specified techniques. Pain score in postoperative assessment, first mobilization time, duration of hospital stay, score of postoperative analgesia satisfaction, opioid induced side effects and complications related to block were assessed for 24 h postoperatively. Results: VAS scores at rest in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p < 0.01 or p < 0.001. VAS scores at movement in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p < 0.001 in all time points. While duration of hospital stay and the first mobilization time were being found significantly shorter, analgesia satisfaction scores were found significantly higher in ultrasound Group (p < 0.05, p < 0.001, p < 0.001 respectively. Conclusion: According to our study, US guided iliohypogastric/ilioinguinal nerve block in adult inguinal herniorrhaphies provides a more effective analgesia and higher satisfaction of analgesia than iliohypogastric/ilioinguinal nerve block with the anatomical landmark technique. Moreover, it may be suggested that the observation of anatomical structures with the US may increase the success of the block, and minimize the block-related complications. Resumo: Objetivo: Comparar a eficácia de bloqueios dos nervos ílio-hipogástrico/ilioinguinal feitos com a técnica guiada por

Anorectal and inguinal lymphogranuloma venereum among men who have sex with men in Amsterdam, The Netherlands: trends over time, symptomatology and concurrent infections.

Science.gov (United States)

de Vrieze, Nynke Hesselina Neeltje; van Rooijen, Martijn; Schim van der Loeff, Maarten Franciscus; de Vries, Henry John C

2013-11-01

To examine lymphogranuloma venereum (LGV) trends over time among men who have sex with men (MSM) visiting the Amsterdam sexually transmitted infection (STI) clinic; to investigate anal LGV symptomatology; and to examine the positivity and characteristics of anorectal and inguinal LGV. We included MSM consultations from whom a swab (from anorectum, bubo or an genital ulcer) was taken for Chlamydia trachomatis (Ct) screening. Anorectal swabs were taken from all MSM who reported receptive anorectal intercourse in the preceding 6 months. Ct positive samples were further tested with a pmpH PCR to identify L-genovars. Patient symptoms, clinical and anoscopic inflammatory signs, and STI co-infections were noted; Gram-stained anorectal mucosal smears were examined. Between January 2005 and June 2012, 48 570 consultations among MSM were conducted. In 3628/35 650 visits, anorectal Ct infections were diagnosed, including 411 anal LGV (1.2%). Moreover, 65/1649 genital ulcer swabs were Ct positive; 10 were inguinal LGV (0.6%) Since January 2011 a significant increase in the positivity of LGV occurred (p<0.0001). 89 (27.2%) anorectal LGV cases were asymptomatic. HIV prevalence among anorectal LGV cases was significantly higher (p=0.008) than among inguinal LGV cases. STI co-morbidity in anorectal LGV cases remained invariably high during the study period. Since January 2011, LGV positivity in MSM consultations in Amsterdam has risen significantly. The great majority comprise anal LGV; inguinal LGV is rare. Anal LGV is asymptomatic in a quarter of cases. In all MSM with anal Ct infections LGV should be excluded, irrespective of symptoms or inflammatory signs.

Lichtenstein Mesh Repair (LMR) v/s Modified Bassini's Repair (MBR) + Lichtenstein Mesh Repair of Direct Inguinal Hernias in Rural Population - A Comparative Study.

Science.gov (United States)

Patil, Santosh M; Gurujala, Avinash; Kumar, Ashok; Kumar, Kuthadi Sravan; Mithun, Gorre

2016-02-01

Lichtenstein's tension free mesh hernioplasty is the commonly done open technique for inguinal hernias. As our hospital is in rural area, majority of patients are labourers, open hernias are commonly done. The present study was done by comparing Lichtenstein Mesh Repair (LMR) v/s Modified Bassini's repair (MBR) + Lichtenstein mesh repair (LMR) of direct Inguinal Hernias to compare the technique of both surgeries and its outcome like postoperative complications and recurrence rate. A comparative randomized study was conducted on patients reporting to MNR hospital, sangareddy with direct inguinal hernias. A total of fifty consecutive patients were included in this study of which, 25 patients were operated by LMR and 25 patients were operated by MBR+LMR and followed up for a period of two years. The outcomes of the both techniques were compared. Study involved 25 each of Lichtenstein's mesh repair (LMR) and modified bassini's repair (MBR) + LMR, over a period of 2 years. The duration of surgery for lichtenstein mesh repair is around 34.56 min compared to LMR+MBR, which is 47.56 min which was statistically significant (p-value is MBR group in POD 1, but not statistically significant (p-value is 0.0949) and from POD 7 the pain was almost similar in both groups. The recurrence rate is 2% for LMR and 0% for MBR+LMR. LMR+MBR was comparatively better than only LMR in all direct inguinal hernias because of low recurrence rate (0%) and low postoperative complications, which showed in our present study.

Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.

Science.gov (United States)

Taylor, D C; Meyers, W C; Moylan, J A; Lohnes, J; Bassett, F H; Garrett, W E

1991-01-01

There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months.

Assessing the impact of short-term surgical education on practice: a retrospective study of the introduction of mesh for inguinal hernia repair in sub-Saharan Africa.

Science.gov (United States)

Wang, Y T; Meheš, M M; Naseem, H-R; Ibrahim, M; Butt, M A; Ahmed, N; Wahab Bin Adam, M A; Issah, A-W; Mohammed, I; Goldstein, S D; Cartwright, K; Abdullah, F

2014-08-01

Inguinal hernia repair is the most common general surgery operation performed globally. However, the adoption of tension-free hernia repair with mesh has been limited in low-income settings, largely due to a lack of technical training and resources. The present study evaluates the impact of a 2-day training course instructing use of polypropylene mesh for inguinal hernia repair on the practice patterns of sub-Saharan African physicians. A surgical training course on tension-free mesh repair of hernias was provided to 16 physicians working in rural Ghanaian and Liberian hospitals. Three physicians were requested to prospectively record all their inguinal hernia surgeries, performed with or without mesh, during the 14-month period following the training. Demographic variables, diagnoses, and complications were collected by an independent data collector for mesh and non-mesh procedures. Surgery with mesh increased significantly following intervention, from near negligible levels prior to the training to 8.1 % of all inguinal hernia repairs afterwards. Mesh repair accounted for 90.8 % of recurrent hernia repairs and 2.9 % of primary hernia repairs after training. Overall complication rates between mesh and non-mesh procedures were not significantly different (p = 0.20). Three physicians who participated in an intensive education course were routinely using mesh for inguinal hernia repair 14 months after the training. This represents a significant change in practice pattern. Complication rates between patients who underwent inguinal hernia repairs with and without mesh were comparable. The present study provides evidence that short-term surgical training initiatives can have a substantial impact on local healthcare practice in resource-limited settings.

Ectopic decidual reaction mimicking inguinal lymphoma on ultrasound

DEFF Research Database (Denmark)

Lorentzen, C.; Prangsgaard, Tina; Lorentzen, Torben

2014-01-01

Ectopic decidual reaction has been described in various intraperitoneal locations. We present a case of unusual ectopic decidual reaction in the groin mimicking inguinal lymphoma on ultrasound in a pregnant woman. This case contributes evidence illustrating the variability of the clinical...... presentation of ectopic decidual reaction....

The T-cell receptor beta chain CDR3 region of BV8S1/BJ1S5 transcripts in type 1 diabetes.

Science.gov (United States)

Naserke, H E; Durinovic-Bellò, I; Seidel, D; Ziegler, A G

1996-01-01

We recently described the T-cell receptor (TCR) beta chain CDR3 motif S-SDRLG-NQPQH (BV8S1-BJ1S5) in an islet-specific T-cell clone (K2.12) from a type 1 diabetic patient (AS). A similar motif (RLGNQ) was also reported in a T-cell clone of non-obese diabetic (NOD) mice by others. In order to determine the frequency of our motif in selected and unselected T-cell populations, we cloned and sequenced the CDR3 region of BV8S1-BJ1S5 transcripts. These transcripts were derived from unstimulated peripheral blood T lymphocytes from two type 1 diabetic patients (AS and FS) and their non-diabetic sibling (WS), as well as from an islet-specific T-cell line of one of the patients. In addition, we compared the structure and composition of the CDR3 region in BV8S1-BJ1S5 transcripts from peripheral blood T cells between the patients and their non-diabetic sibling (>50 sequences each). We found that 30% of the islet-specific T-cell line cDNA clones expressed the entire sequence-motif, whereas it was absent in the clones of unstimulated peripheral blood T cells from both patients and their non-diabetic sibling. The average length of the CDR3 region was shorter in the patients (mean AS 9.9, FS 9.9, versus WS 10.7, p = 0.0037) and the number of inserted nucleotides in N nucleotide addition at the DJ-junction lower (mean AS 3.5, FS 3. 2, versus WS 5.2, P = diabetic sibling. Moreover, the pattern of amino acid usage in the CDR3 region was dissimilar at positions 5 and 6, where polar amino acids predominated in both diabetic siblings. In contrast, basic amino acids are preferentially used at position 5 in the clones of the non-diabetic sibling. These data provide information on the general structure of the TCR(BV8S1-BJ1S5) CDR3 region in type 1 diabetes and may indicate differences in the amino and nucleic acid composition of the TCR beta chain CDR3 region between two type 1 diabetic patients and their non-diabetic sibling.

Lack of association between inguinal hernia and abdominal aortic aneurysm in a population-based male cohort

DEFF Research Database (Denmark)

Henriksen, N A; Sorensen, L T; Jorgensen, L N

2013-01-01

Previous studies have reported a higher prevalence of inguinal hernia in patients with abdominal aortic aneurysm (AAA). The aim of this study was to explore the association between inguinal hernia and AAA in a large population-based cohort of men who had screening for AAA....

Orchiectomy as a result of ischemic orchitis after laparoscopic inguinal hernia repair: case report of a rare complication

OpenAIRE

Moore, John B; Hasenboehler, Erik A

2007-01-01

Abstract Background Ischemic orchitis is an established complication after open inguinal hernia repair, but ischemic orchitis resulting in orchiectomy after the laparoscopic approach has not been reported. Case presentation The patient was a thirty-three year-old man who presented with bilateral direct inguinal hernias, right larger than left. He was a thin, muscular male with a narrow pelvis who underwent bilateral extraperitoneal mesh laparoscopic inguinal hernia repair. The case was compli...

Electron-impact excitation of atomic-argon 3p54s-3p55p spectral transitions

International Nuclear Information System (INIS)

Bogdanova, I.P.; Yurgenson, S.V.

1990-01-01

Cross sections of excitation of some spectral lines of argon corresponding to transitions from 3p 5 5p-levels are measured using a pulsed electron beam. Cross sections of level excitation are estimated. It is shown that in transition from 3p 5 4p-levels to 3p 5 5p-levels, the cross section of levels by means of the electron impact decreases 20 times

Exploring the dynamics of hydrogen atom release from the radical-radical reaction of O(3P) with C3H5

International Nuclear Information System (INIS)

Joo, Sun-Kyu; Kwon, Lee-Kyoung; Lee, Hohjai; Choi, Jong-Ho

2004-01-01

The gas-phase radical-radical reaction dynamics of O( 3 P)+C 3 H 5 →H( 2 S)+C 3 H 4 O was studied at an average collision energy of 6.4 kcal/mol in a crossed beam configuration. The ground-state atomic oxygen [O( 3 P)] and allyl radicals (C 3 H 5 ) were generated by the photolysis of NO 2 and the supersonic flash pyrolysis of allyl iodide, respectively. Nascent hydrogen atom products were probed by the vacuum-ultraviolet-laser induced fluorescence spectroscopy in the Lyman-α region centered at 121.6 nm. With the aid of the CBS-QB3 level of ab initio theory, it has been found that the barrierless addition of O( 3 P) to C 3 H 5 forms the energy-rich addition complexes on the lowest doublet potential energy surface, which are predicted to undergo a subsequent direct decomposition step leading to the reaction products H+C 3 H 4 O. The major counterpart C 3 H 4 O of the probed hydrogen atom is calculated to be acrolein after taking into account the factors of barrier height, reaction enthalpy, and the number of intermediates involved along the reaction pathway. The nascent H-atom Doppler profile analysis shows that the average center-of-mass translational energy of the H+C 3 H 4 O products and the fraction of the total available energy released as the translational energy were determined to be 3.83 kcal/mol and 0.054, respectively. On the basis of comparison with statistical calculations, the reaction proceeds through the formation of short-lived addition complexes rather than statistical, long-lived intermediates, and the polyatomic acrolein product is significantly internally excited at the moment of the decomposition

Exploring the dynamics of hydrogen atom release from the radical-radical reaction of O(3P) with C3H5

Science.gov (United States)

Joo, Sun-Kyu; Kwon, Lee-Kyoung; Lee, Hohjai; Choi, Jong-Ho

2004-05-01

The gas-phase radical-radical reaction dynamics of O(3P)+C3H5→H(2S)+C3H4O was studied at an average collision energy of 6.4 kcal/mol in a crossed beam configuration. The ground-state atomic oxygen [O(3P)] and allyl radicals (C3H5) were generated by the photolysis of NO2 and the supersonic flash pyrolysis of allyl iodide, respectively. Nascent hydrogen atom products were probed by the vacuum-ultraviolet-laser induced fluorescence spectroscopy in the Lyman-α region centered at 121.6 nm. With the aid of the CBS-QB3 level of ab initio theory, it has been found that the barrierless addition of O(3P) to C3H5 forms the energy-rich addition complexes on the lowest doublet potential energy surface, which are predicted to undergo a subsequent direct decomposition step leading to the reaction products H+C3H4O. The major counterpart C3H4O of the probed hydrogen atom is calculated to be acrolein after taking into account the factors of barrier height, reaction enthalpy, and the number of intermediates involved along the reaction pathway. The nascent H-atom Doppler profile analysis shows that the average center-of-mass translational energy of the H+C3H4O products and the fraction of the total available energy released as the translational energy were determined to be 3.83 kcal/mol and 0.054, respectively. On the basis of comparison with statistical calculations, the reaction proceeds through the formation of short-lived addition complexes rather than statistical, long-lived intermediates, and the polyatomic acrolein product is significantly internally excited at the moment of the decomposition.

Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques

Directory of Open Access Journals (Sweden)

Abdurrahman Demirci

2014-10-01

Full Text Available Objectives:The purpose of this study is to compare the efficacy of iliohypogastric/ilioinguinal nerve blocks performed with the ultrasound guided and the anatomical landmark techniques for postoperative pain management in cases of adult inguinal herniorrhaphy.Methods:40 patients, ASA I-II status were randomized into two groups equally: in Group AN (anatomical landmark technique and in Group ultrasound (ultrasound guided technique, iliohypogastric/ilioinguinal nerve block was performed with 20 ml of 0.5% levobupivacaine prior to surgery with the specified techniques. Pain score in postoperative assessment, first mobilization time, duration of hospital stay, score of postoperative analgesia satisfaction, opioid induced side effects and complications related to block were assessed for 24 h postoperatively.Results:VAS scores at rest in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p < 0.01 or p < 0.001. VAS scores at movement in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p < 0.001 in all time points. While duration of hospital stay and the first mobilization time were being found significantly shorter, analgesia satisfaction scores were found significantly higher in ultrasound Group (p < 0.05, p < 0.001, p < 0.001 respectively.Conclusion:According to our study, US guided iliohypogastric/ilioinguinal nerve block in adult inguinal herniorrhaphies provides a more effective analgesia and higher satisfaction of analgesia than iliohypogastric/ilioinguinal nerve block with the anatomical landmark technique. Moreover, it may be suggested that the observation of anatomical structures with the US may increase the success of the block, and minimize the block-related complications.

Epithelioid malignant mesothelioma of tunica vaginalis with deciduoid features: An unusual malignancy clinically masquerading an inguinal hernia

Directory of Open Access Journals (Sweden)

Sharique Ahmed

2012-01-01

Full Text Available Paratesticular/scrotal and inguinal canal mass lesions in elderly patients may pose a diagnostic challenge to both the surgeon as well as the pathologist. In most cases, these represent hernial sacs with their contents, and true neoplasms like lipomas, rhabdomyosarcomas, and fibrous pseudotumors are infrequent. Malignant mesotheliomas arising from the tunica layers are rare cause of inguinal and paratesticular tumors. Herein, we report a case of an elderly patient who presented with an inguinal hernia which pathologically had features of deciduoid malignant mesothelioma.

Inactivation of Cytochrome P450 (P450) 3A4 but not P450 3A5 by OSI-930, a Thiophene-Containing Anticancer DrugS⃞

Science.gov (United States)

Lin, Hsia-lien; Zhang, Haoming; Medower, Christine; Johnson, William W.

2011-01-01

An investigational anticancer agent that contains a thiophene moiety, 3-[(quinolin-4-ylmethyl)-amino]-N-[4-trifluoromethox)phenyl] thiophene-2-carboxamide (OSI-930), was tested to investigate its ability to modulate the activities of several cytochrome P450 enzymes. Results showed that OSI-930 inactivated purified, recombinant cytochrome P450 (P450) 3A4 in the reconstituted system in a mechanism-based manner. The inactivation was dependent on cytochrome b5 and required NADPH. Catalase did not protect against the inactivation. No inactivation was observed in studies with human 2B6, 2D6, or 3A5 either in the presence or in the absence of b5. The inactivation of 3A4 by OSI-930 was time- and concentration-dependent. The inactivation of the 7-benzyloxy-4-(trifluoromethyl)coumarin catalytic activity of 3A4 was characterized by a KI of 24 μM and a kinact of 0.04 min−1. This KI is significantly greater than the clinical OSI-930 Cmax of 1.7 μM at the maximum tolerated dose, indicating that clinical drug interactions of OSI-930 via this pathway are not likely. Spectral analysis of the inactivated protein indicated that the decrease in the reduced CO spectrum at 450 nm was comparable to the amount of inactivation, thereby suggesting that the inactivation was primarily due to modification of the heme. High-pressure liquid chromatography (HPLC) analysis with detection at 400 nm showed a loss of heme comparable to the activity loss, but a modified heme was not detected. This result suggests either that the heme must have been modified enough so as not to be observed in a HPLC chromatograph or, possibly, that it was destroyed. The partition ratio for the inactivation of P450 3A4 was approximately 23, suggesting that this P450 3A4-mediated pathway occurs with approximately 4% frequency during the metabolism of OSI-930. Modeling studies on the binding of OSI-930 to the active site of the P450 3A4 indicated that OSI-930 would be oriented properly in the active site for oxidation

High genetic diversity in the coat protein and 3' untranslated regions

Indian Academy of Sciences (India)

The 3′ terminal region consisting of the coat protein (CP) coding sequence and 3′ untranslated region (3′UTR) was cloned and sequenced from seven isolates. Sequence comparisons revealed considerable genetic diversity among the isolates in their CP and 3′UTR, making CdMV one of the highly variable members ...

Isolation, identification, and complete genome sequence of a bovine adenovirus type 3 from cattle in China

Directory of Open Access Journals (Sweden)

Zhu Yuan-Mao

2011-12-01

Full Text Available Abstract Background Bovine adenovirus type 3 (BAV-3 belongs to the Mastadenovirus genus of the family Adenoviridae and is involved in respiratory and enteric infections of calves. The isolation of BAV-3 has not been reported prior to this study in China. In 2009, there were many cases in cattle showing similar clinical signs to BAV-3 infection and a virus strain, showing cytopathic effect in Madin-Darby bovine kidney cells, was isolated from a bovine nasal swab collected from feedlot cattle in Heilongjiang Province, China. The isolate was confirmed as a bovine adenovirus type 3 by PCR and immunofluorescence assay, and named as HLJ0955. So far only the complete genome sequence of prototype of BAV-3 WBR-1 strain has been reported. In order to further characterize the Chinese isolate HLJ0955, the complete genome sequence of HLJ0955 was determined. Results The size of the genome of the Chinese isolate HLJ0955 is 34,132 nucleotides in length with a G+C content of 53.6%. The coding sequences for gene regions of HLJ0955 isolate were similar to the prototype of BAV-3 WBR-1 strain, with 80.0-98.6% nucleotide and 87.5-98.8% amino acid identities. The genome of HLJ0955 strain contains 16 regions and four deletions in inverted terminal repeats, E1B region and E4 region, respectively. The complete genome and DNA binding protein gene based phylogenetic analysis with other adenoviruses were performed and the results showed that HLJ0955 isolate belonged to BAV-3 and clustered within the Mastadenovirus genus of the family Adenoviridae. Conclusions This is the first study to report the isolation and molecular characterization of BAV-3 from cattle in China. The phylogenetic analysis performed in this study supported the use of the DNA binding protein gene of adenovirus as an appropriate subgenomic target for the classification of different genuses of the family Adenoviridae on the molecular basis. Meanwhile, a large-scale pathogen and serological epidemiological

XPS study of the Ln 5p,4f-electronic states of lanthanides in Ln2O3

International Nuclear Information System (INIS)

Teterin, Yu.A.; Teterin, A.Yu.; Utkin, I.O.; Ryzhkov, M.V.

2004-01-01

The present work analyses the fine structure of the low binding energy (E b , 0-50 eV) X-ray photoelectron spectra XPS of lanthanide (La through Lu excepted for Pm) oxides, and compares it with the non-relativistic X α -discrete variation calculation results for the clusters reflecting the close environment of lanthanides in oxides. The obtained results show that the Ln 4f n -electrons of lanthanides in oxides by their spectral parameters have much in common with the M 3d-electrons in oxides of the 3d-transition metals. According to these data, the Ln 4f shell of lanthanides is rather outer and can participate in the formation of molecular orbitals in compounds. The XPS data at least do not contradict the theoretical suggestion about the significant participation of the Ln 4f-electrons in formation of the molecular orbitals in the studied materials. The spectra in the Ln 5p-O 2s binding energy region of the studied lanthanide oxides were found to exhibit the complicated structure instead of separated peaks due to the electrons of the Ln 5p 3/2,5/2 and O 2s atomic shells. Taking into account the energy differences between the inner (Ln 3d) and outer (Ln 5p) electronic shells for some metallic lanthanides and their oxides, the Ln 5p atomic shells were shown to participate in the formation of the inner valence molecular orbitals (IVMO). That agrees qualitatively with the calculation results

Isolation of pathogenic Yersinia enterocolitica strains from different sources in Izmir region, Turkey.

Science.gov (United States)

Bozcal, Elif; Uzel, Atac; Aydemir, Sohret; Skurnik, Mikael

2015-11-01

Yersinia enterocolitica is a foodborne pathogen that is very rarely encountered in Turkey. In this work, several human, porcine, and environmental samples collected from Izmir region in Turkey were examined for the presence of Y. enterocolitica using different cultivation and enrichment methods. A total of nine pathogenic Y. enterocolitica strains were isolated; five strains from pig stool and manure samples and four strains from waste water samples. On the other hand, no Y. enterocolitica was isolated from human diarrheal stool samples (n = 102) and from 12 gulf, canal, municipal pool, and well water samples. Biochemical and serological characterization of the nine Y. enterocolitica strains revealed that they belonged to three different bioserotypes: 4/O:3, 2/O:9, and 2/O:5,27. All the strains were deemed pathogenic based on virulence factor-specific PCR analysis. Detection of pathogenic Y. enterocolitica strains from the pig and waste water samples from the Izmir region indicates that Y. enterocolitica is a potential risk for public health.

Cyclic [G(2′,5′)pA(3′,5′)p] Is the Metazoan Second Messenger Produced by DNA-Activated Cyclic GMP-AMP Synthase

OpenAIRE

Gao, Pu; Ascano, Manuel; Wu, Yang; Barchet, Winfried; Gaffney, Barbara L.; Zillinger, Thomas; Serganov, Artem A.; Liu, Yizhou; Jones, Roger A.; Hartmann, Gunther; Tuschl, Thomas; Patel, Dinshaw J.

2013-01-01

Recent studies identified cyclic GMP-AMP (cGAMP) as a metazoan second messenger triggering an interferon response. cGAMP is generated from GTP and ATP by cytoplasmic dsDNA sensor cGAMP synthase (cGAS). We combined structural, chemical, biochemical, and cellular assays to demonstrate that this second messenger contains G(2′,5′)pA and A(3′,5′)pG phosphodiester linkages, designated c[G(2′,5′) pA(3′,5′)p]. We show that, upon dsDNA binding, cGAS is activated through conformational transitions, res...

Minimal access surgery of pediatric inguinal hernias: a review.

Science.gov (United States)

Saranga Bharathi, Ramanathan; Arora, Manu; Baskaran, Vasudevan

2008-08-01

Inguinal hernia is a common problem among children, and herniotomy has been its standard of care. Laparoscopy, which gained a toehold initially in the management of pediatric inguinal hernia (PIH), has managed to steer world opinion against routine contralateral groin exploration by precise detection of contralateral patencies. Besides detection, its ability to repair simultaneously all forms of inguinal hernias (indirect, direct, combined, recurrent, and incarcerated) together with contralateral patencies has cemented its role as a viable alternative to conventional repair. Numerous minimally invasive techniques for addressing PIH have mushroomed in the past two decades. These techniques vary considerably in their approaches to the internal ring (intraperitoneal, extraperitoneal), use of ports (three, two, one), endoscopic instruments (two, one, or none), sutures (absorbable, nonabsorbable), and techniques of knotting (intracorporeal, extracorporeal). In addition to the surgeons' experience and the merits/limitations of individual techniques, it is the nature of the defect that should govern the choice of technique. The emerging techniques show a trend toward increasing use of extracorporeal knotting and diminishing use of working ports and endoscopic instruments. These favor wider adoption of minimal access surgery in addressing PIH by surgeons, irrespective of their laparoscopic skills and experience. Growing experience, wider adoption, decreasing complications, and increasing advantages favor emergence of minimal access surgery as the gold standard for the treatment of PIH in the future. This article comprehensively reviews the laparoscopic techniques of addressing PIH.

Feasibility study of natural orifice transluminal endoscopic surgery inguinal hernia repair.

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Sherwinter, Danny A; Eckstein, Jeremy G

2009-07-01

A potentially less-invasive technique, transluminal surgery, may reduce or eliminate pain and decrease time to full return of activities after abdominal operations. Inguinal hernia repair is perfectly suited to the transgastric endoscopic approach and has not been previously reported. Our purpose was to evaluate the feasibility of transgastric bilateral inguinal herniorrhaphy (BIH). Feasibility study with a nonsurvival canine model. Under general anesthesia, male mongrel dogs weighing 20 to 30 kg had a dual-channel endoscope introduced into the peritoneal cavity over a percutaneously placed guidewire. An overtube with an insufflation channel was used. Peritoneoscopy was performed, and bilateral deep and superficial inguinal rings were identified. The endoscope was removed, premounted with a 4 x 6 cm acellular human dermal implant and then readvanced intraperitoneally through the overtube. The implant was then deployed across the entire myopectineal orifice and draped over the cord structures. Bioglue was then applied endoscopically, and the implant was attached to the peritoneum. After completion of bilateral repairs, the animals were killed and necropsy performed. Five dogs underwent pure natural orifice transluminal endoscopic surgery (NOTES) intraperitoneal onlay mesh (IPOM) BIH. Accurate placement and adequate myopectineal coverage was accomplished in all subjects. At necropsy no injuries to the major structures were noted but Bioglue misapplication with contamination of unintended sites did occur. Our study involved only a small number of subjects in nonsurvival experiments, and no gastric closure was used. Many of the characteristics of inguinal hernia repair are especially well suited to the transgastric approach. The repair is in line with the transgastric endoscope vector, bilateral defects are adjacent, and the IPOM technique does not require significant manipulation or novel instrumentation.

Abdominal blockage of iliohypogastric and ilio-inguinal nerves for ...

African Journals Online (AJOL)

South African Journal of Obstetrics and Gynaecology ... The aim of this study was to compare pain relief after caesarean section achieved by an ... and ilio-inguinal (IHII) nerve block with levobupivacaine with that in patients given a placebo.

Halotolerant streptomycetes isolated from soil at Taif region ...

African Journals Online (AJOL)

This study focuses on isolation and purification of some halotolerant streptomycetes from soil and sea water of western region, KSA as a source of salt tolerance gene(s). A few numbers (32) of streptomycetes-like colonies (SLC) were isolated and purified from two regions. From Jeddah, a number of 22 out of the 32 SLC ...

Pooled-DNA sequencing identifies genomic regions of selection in Nigerian isolates of Plasmodium falciparum.

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Oyebola, Kolapo M; Idowu, Emmanuel T; Olukosi, Yetunde A; Awolola, Taiwo S; Amambua-Ngwa, Alfred

2017-06-29

The burden of falciparum malaria is especially high in sub-Saharan Africa. Differences in pressure from host immunity and antimalarial drugs lead to adaptive changes responsible for high level of genetic variations within and between the parasite populations. Population-specific genetic studies to survey for genes under positive or balancing selection resulting from drug pressure or host immunity will allow for refinement of interventions. We performed a pooled sequencing (pool-seq) of the genomes of 100 Plasmodium falciparum isolates from Nigeria. We explored allele-frequency based neutrality test (Tajima's D) and integrated haplotype score (iHS) to identify genes under selection. Fourteen shared iHS regions that had at least 2 SNPs with a score > 2.5 were identified. These regions code for genes that were likely to have been under strong directional selection. Two of these genes were the chloroquine resistance transporter (CRT) on chromosome 7 and the multidrug resistance 1 (MDR1) on chromosome 5. There was a weak signature of selection in the dihydrofolate reductase (DHFR) gene on chromosome 4 and MDR5 genes on chromosome 13, with only 2 and 3 SNPs respectively identified within the iHS window. We observed strong selection pressure attributable to continued chloroquine and sulfadoxine-pyrimethamine use despite their official proscription for the treatment of uncomplicated malaria. There was also a major selective sweep on chromosome 6 which had 32 SNPs within the shared iHS region. Tajima's D of circumsporozoite protein (CSP), erythrocyte-binding antigen (EBA-175), merozoite surface proteins - MSP3 and MSP7, merozoite surface protein duffy binding-like (MSPDBL2) and serine repeat antigen (SERA-5) were 1.38, 1.29, 0.73, 0.84 and 0.21, respectively. We have demonstrated the use of pool-seq to understand genomic patterns of selection and variability in P. falciparum from Nigeria, which bears the highest burden of infections. This investigation identified known

[Study of collagen and elastic fibers of connective tissue in patients with and without primary inguinal hernia].

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Bórquez, Pablo; Garrido, Luis; Manterola, Carlos; Peña, Patricio; Schlageter, Carol; Orellana, Juan José; Ulloa, Hugo; Peña, Juan Luis

2003-11-01

There are few studies looking for collagen matrix defects in patients with inguinal bernia. To study the skin connective tissue in patients with and without inguinal bernia. Skin from the surgical wound was obtained from 23 patients with and 23 patients without inguinal bernia. The samples were processed for conventional light microscopy. Collagen fibers were stained with Van Giesson and elastic fibers with Weigert stain. Patients without hernia had compact collagen tracts homogeneously distributed towards the deep dermis. In contrast, patients with hernia had zones in the dermis with thinner and disaggregated collagen tracts. Connective tissue had a lax aspect in these patients. Collagen fiber density was 52% lower in patients with hernia, compared to subjects without hernia. No differences in elastic fiber density or distribution was observed between groups. Patients with inguinal bernia have alterations in skin collagen fiber quality and density.

Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study

DEFF Research Database (Denmark)

Bischoff, Joakim Mutahi; Linderoth, Gitte; Aasvang, Eske Kvanner

2012-01-01

or genitals during sexual activity was reported by 88 patients (10.9%), and 19 patients (2.4%) reported that the pain had impaired their sexual activity to a moderate or severe degree. Older patients and patients with longer follow-up had lower prevalence of pain during sexual activity. CONCLUSIONS......BACKGROUND: Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual...... activity after laparoscopic inguinal herniorrhaphy on a nationwide basis. METHODS: The study population comprised all men aged 18-50 years registered in the Danish Hernia Database (n = 1,671) who underwent primary laparoscopic herniorrhaphy between January 1, 1998 and November 30, 2009. Questionnaires...

Low level of sequence diversity at merozoite surface protein-1 locus of Plasmodium ovale curtisi and P. ovale wallikeri from Thai isolates.

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Putaporntip, Chaturong; Hughes, Austin L; Jongwutiwes, Somchai

2013-01-01

The merozoite surface protein-1 (MSP-1) is a candidate target for the development of blood stage vaccines against malaria. Polymorphism in MSP-1 can be useful as a genetic marker for strain differentiation in malarial parasites. Although sequence diversity in the MSP-1 locus has been extensively analyzed in field isolates of Plasmodium falciparum and P. vivax, the extent of variation in its homologues in P. ovale curtisi and P. ovale wallikeri, remains unknown. Analysis of the mitochondrial cytochrome b sequences of 10 P. ovale isolates from symptomatic malaria patients from diverse endemic areas of Thailand revealed co-existence of P. ovale curtisi (n = 5) and P. ovale wallikeri (n = 5). Direct sequencing of the PCR-amplified products encompassing the entire coding region of MSP-1 of P. ovale curtisi (PocMSP-1) and P. ovale wallikeri (PowMSP-1) has identified 3 imperfect repeated segments in the former and one in the latter. Most amino acid differences between these proteins were located in the interspecies variable domains of malarial MSP-1. Synonymous nucleotide diversity (πS) exceeded nonsynonymous nucleotide diversity (πN) for both PocMSP-1 and PowMSP-1, albeit at a non-significant level. However, when MSP-1 of both these species was considered together, πS was significantly greater than πN (pdiversity at this locus prior to speciation. Phylogenetic analysis based on conserved domains has placed PocMSP-1 and PowMSP-1 in a distinct bifurcating branch that probably diverged from each other around 4.5 million years ago. The MSP-1 sequences support that P. ovale curtisi and P. ovale wallikeri are distinct species. Both species are sympatric in Thailand. The low level of sequence diversity in PocMSP-1 and PowMSP-1 among Thai isolates could stem from persistent low prevalence of these species, limiting the chance of outcrossing at this locus.

[Hidradenocarcinoma of the heel associated with inguinal metastases].

Science.gov (United States)

Labbardi, W; Hali, F; Marnissi, F; Cribier, B; Chiheb, S

Hidradenocarcinoma is a rare malignant tumour involving the sweat glands. It classically arises de novo, only rarely resulting from pre-existing hidradenoma. The literature contains few reports of lymph node metastasis in this tumour. We report a case of a patient with hidradenocarcinoma of the heel associated with inguinal node metastases. We report the case of a 64-year-old patient with a history of chronic smoking, who in the last two years developed a painless nodule in his right heel, with no prior injury, and which gradually increased in size to become an ulcerated tumour. Physical examination revealed a rounded tumour mass, ulcerated in the centre, and associated with multiple inguinal adenopathies. Histological and immunohistochemical examination was suggestive of hidradenocarcinoma. The patient had undergone extensive local excision with inguinal lymphadenectomy. Histological examination showed infiltration of lymph nodes by the tumour with capsular rupture. Radiotherapy was subsequently given. The outcome was good without recurrence after 34 months of follow-up. Hidradenocarcinoma is a rare malignant tumour. Diagnosis is based on histological and immunohistochemical examination. However, hidradenocarcinoma may on occasion be difficult to differentiate from hidradenoma, a benign tumour, hence the interest of complete surgical resection with safety margins even in the absence of cytological malignancy. Local recurrences are common. The occurrence of lymph node metastasis during hidradenocarcinoma has been described only rarely in the literature. Such metastases usually occur after tumour resection. The specific features of our case are the rarity of lymph node metastases in hidradenocarcinoma coupled with the fact that these metastases were discovered upon diagnosis of the primary tumour. Copyright © 2017. Published by Elsevier Masson SAS.

Syntheses, structures, and physicochemical properties of diruthenium compounds of tetrachlorocatecholate with metal-metal bonded Ru(3+)(mu-OR)(2)Ru(3+) and Ru(3.5+)(mu-OR)(2)Ru(3.5+) cores (R = CH(3) and C(2)H(5)).

Science.gov (United States)

Miyasaka, H; Chang, H C; Mochizuki, K; Kitagawa, S

2001-07-02

Metal-metal bonded Ru(3+)(mu-OR)(2)Ru(3+) and Ru(3.5+)(mu-OR)(2)Ru(3.5+) (R = CH(3) and CH(3)CH(2)) compounds with tetrachlorocatecholate (Cl(4)Cat) have been synthesized in the corresponding alcohol, MeOH and EtOH, from a nonbridged Ru(2+)-Ru(3+) compound, Na(3)[Ru(2)(Cl(4)Cat)(4)(THF)].3H(2)O.7THF (1). In alcohol solvents, compound 1 is continuously oxidized by oxygen to form Ru(3+)(mu-OR)(2)Ru(3+) and Ru(3.5+)(mu-OR)(2)Ru(3.5+) species. The presence of a characteristic countercation leads to selective isolation of either Ru(3+)(mu-OR)(2)Ru(3+) or Ru(3.5+)(mu-OR)(2)Ru(3.5+) as a stable adduct species. In methanol, Ph(4)PCl and dibenzo-18-crown-6-ether afford Ru(3+)(mu-OMe)(2)Ru(3+) species, [A](2)[Ru(2)(Cl(4)Cat)(4)(mu-OMe)(2)Na(2)(MeOH)(6)] ([A](+) = Ph(4)P(+) (2), [Na(dibenzo-18-crown-6)(H(2)O)(MeOH)](+) (3)), while benzo-15-crown-5-ether provides a Ru(3.5+)(mu-OMe)(2)Ru(3.5+) species, [Na(benzo-15-crown-5)(2)][Ru(2)(Cl(4)Cat)(4)(mu-OMe)(2)Na(2)(MeOH)(6)] (4). The air oxidation of 1 in a MeOH/EtOH mixed solvent (1:1 v/v) containing benzo-15-crown-5-ether provides a Ru(3.5+)(mu-OMe)(2)Ru(3.5+) species, [Na(benzo-15-crown-5)(H(2)O)][Ru(2)(Cl(4)Cat)(2)(mu-OMe)(2)Na(2)(EtOH)(2)(H(2)O)(2)(MeOH)(2)].(benzo-15-crown-5) (5). Similarly, the oxidation of 1 in ethanol with Ph(4)PCl provides a Ru(3.5+)(mu-OEt)(2)Ru(3.5+) species, (Ph(4)P)[Ru(2)(Cl(4)Cat)(4)(mu-OEt)(2)Na(2)(EtOH)(6)] (7). A selective formation of a Ru(3+)(mu-OEt)(2)Ru(3+) species, (Ph(4)P)(2)[Ru(2)(Cl(4)Cat)(4)(mu-OEt)(2)Na(2)(EtOH)(2)(H(2)O)(2)] (6), is found in the presence of pyrazine or 2,5-dimethylpyrazine. The crystal structures of these compounds, except 2 and 7, have been determined by X-ray crystallography, and all compounds have been characterized by several spectroscopic and magnetic investigations. The longer Ru-Ru bonds are found in the Ru(3+)(mu-OR)(2)Ru(3+) species (2.606(1) and 2.628(2) A for 3 and 6, respectively) compared with those of Ru(3.5+)(mu-OMe)(2)Ru(3.5+) species (2.5260(6) A and 2

Association of sequence variants on chromosomes 20, 11, and 5 (20q13.33, 11q23.3, and 5p15.33) with glioma susceptibility in a Chinese population.

Science.gov (United States)

Chen, Hongyan; Chen, Yuanyuan; Zhao, Yao; Fan, Weiwei; Zhou, Keke; Liu, Yanhong; Zhou, Liangfu; Mao, Ying; Wei, Qingyi; Xu, Jianfeng; Lu, Daru

2011-04-15

Two genome-wide association studies of glioma in European populations identified 14 genetic variants strongly associated with risk of glioma, but it is unknown whether these variants are associated with glioma risk in Asian populations. The authors genotyped these 14 variants in 976 glioma patients and 1,057 control subjects to evaluate their associations with risk of glioma, particularly high-grade glioma (glioblastoma; n = 312), in a Chinese population (2004-2009). Overall, the authors identified 3 susceptibility loci for glioma risk at 20q13.33 (RTEL1 rs6010620 (P = 2.79 × 10(-6))), 11q23.3 (PHLDB1 rs498872 (P = 3.8 × 10(-6))), and 5p15.33 (TERT rs2736100 (P = 3.69 × 10(-4))) in this study population; these loci were also associated with glioblastoma risk (20q13.33: RTEL1 rs6010620 (P = 3.57 × 10(-7)); 11q23.3: PHLDB1 rs498872 (P = 7.24 × 10(-3)); 5p15.33: TERT rs2736100 and TERT rs2736098 (P = 1.21 × 10(-4) and P = 2.84 × 10(-4), respectively)). This study provides further evidence for 3 glioma susceptibility regions at 20q13.33, 11q23.3, and 5p15.33 in Chinese populations.

Evaluation of larvicidal activity of the methanolic extracts of Piper alatabaccum branches and P. tuberculatum leaves and compounds isolated against Anopheles darlingi

Directory of Open Access Journals (Sweden)

Frances T. T. Trindade

2012-10-01

Full Text Available Piper is a notable genus among Piperaceae due to their secondary metabolites such as lignans, amides, esters and long chain fatty acids used as anti-herbivore defenses with comparable effects of pyrethroids, that holds a promise in insect control, including malaria vectors such as Anopheles darlingi, the main vector in the North of Brazil. Methanolic extracts of Piper tuberculatum Jacq., Piperaceae, and P. alatabaccum Trel. & Yunck., Piperaceae, and some isolated compounds, i.e, 3,4,5-trimetoxy-dihydrocinamic acid, dihydropiplartine; piplartine, piplartine-dihydropiplartine and 5,5',7-trimetoxy-3',4'-metilenodioxiflavone were tested as larvicides against A. darlingi. The Lethal Concentrations (LC50 and LC90 of methanolic extracts were 194 and 333 ppm for P. tuberculatum and 235 and 401 ppm for P. alatabacum, respectively. Isolated compounds had lower LC values, e.g. the LC50 and LC90 of the piplartine-dihidropiplartine isolated from both plant species was 40 and 79 ppm, respectively.

Partial Sequence Analysis of Merozoite Surface Proteine-3α Gene in Plasmodium vivax Isolates from Malarious Areas of Iran

Directory of Open Access Journals (Sweden)

H Mirhendi

2008-12-01

Full Text Available Background: Approximately 85-90% of malaria infections in Iran are attributed to Plasmodium vivax, while little is known about the genetic of the parasite and its strain types in this region. This study was designed and performed for describing genetic characteristics of Plasmodium vivax population of Iran based on the merozoite surface protein-3α gene sequence. Methods: Through a descriptive study we analyzed partial P. vivax merozoite surface protein-3α gene sequences from 17 clinical P. vivax isolates collected from malarious areas of Iran. Genomic DNA was extracted by Q1Aamp® DNA blood mini kit, amplified through nested PCR for a partial nucleotide sequence of PvMSP-3 gene in P. vivax. PCR-amplified products were sequenced with an ABI Prism Perkin-Elmer 310 sequencer machine and the data were analyzed with clustal W software. Results: Analysis of PvMSP-3 gene sequences demonstrated extensive polymorphisms, but the sequence identity between isolates of same types was relatively high. We identified specific insertions and deletions for the types A, B and C variants of P. vivax in our isolates. In phylogenetic comparison of geographically separated isolates, there was not a significant geo­graphical branching of the parasite populations. Conclusion: The highly polymorphic nature of isolates suggests that more investigations of the PvMSP-3 gene are needed to explore its vaccine potential.