Use of a Marlex fan in the repair of direct and indirect hernias by laparoscopy.

Sixty-seven laparoscopic hernia repairs are described with the use of Marlex mesh in a new fan configuration in 56 cases. This fan is easily constructed and manipulated endoscopically. It offers more surface area of Marlex to the surrounding tissues and occupies more potential space, being conformable to the space left by a hernia sac. In 67 repairs we have had one recurrence at a maximum of 10 months follow-up. One patient had contralateral lower extremity deep venous thrombosis (DVT), one had a palpable inguinal mass, and two patients suffered temporary orchialgia.     

Activity of some enzymes of carbohydrate metabolism in human subcutaneous adipose tissue in newborns, infants and adults. I. Activity of pyruvate kinase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase and phosphogluconate dehydrogenase.

The activity of glucose-6-phosphate dehydrogenase, phosphogluconate dehydrogenase, pyruvate kinase (PK) and lactate dehydrogenase (LDH) was measured in human adipose tissue (AT) of newborns aged 0-2 and 2-48 h, of 3- to 5-month-old infants and of adults. AT was sampled by means of a special needle from the gluteal region without anesthesia. We observed significantly higher activity of the two pentose phosphate shunt enzymes when calculated on protein content and wet weight basis in newborns as compared to infants and adults. There were no differences for PK and LDH between newborns and adults when the values were calculated for the soluble protein. The protein concentration of the AT decreased significantly during the development.     

The action of isoproterenol on the chick embryo heart

The action of isoproterenol on the heart of chick embryos has been observed. The drug was injected into the amniotic sac (2 × 80 mg/kg/48 h) from the 5th day of embryonic life up to the time of hatching. The mortality of isoproterenol-treated animals up to day 16 was higher than control animals. Total body oedema (8 to 10 days) and haemorrhagic oedema of the occipital region (10 to 17 days) were observed. From the 5th to the 7th embryonic day malformations of great vessels occurred. From the 7th to the 14th embryonic day a blockade of development of coronary vascularization was regularly observed, particularly in the ventral wall of the right ventricle. This effect was always associated with persistence of intertrabecular spaces in the non-vascularized area, and with a higher water content in the heart. From the 10th to 12th embryonic day, degenerative changes in the cardiac muscle were observed. The lesions were characterized by typical myolysis. Capillaries in the affected area were dilated and blocked with packed erythrocytes. Necrotic changes were localized only in those parts of the ventricular walls in which the vascular bed and myoarchitecture were normally developed. In comparison with similar changes in adults, there was no inflammatory cellular proliferation.It follows from these results that administration of necrogenic doses of isoproterenol to chick embryo causes different types of change at different developmental periods. Each change has a specific, relatively sharply defined and limited critical period.     

Polyunsaturated fatty acids, phytosterols and cholesterol metabolism in the Mediterranean diet

The objective of this work was to review nutritional components of the Mediterranean diet. The Mediterranean diet is not a specific diet plan or diet program but a collection of eating habits that are traditionally followed by the people of the Mediterranean region. There are at least 16 countries bordering the Mediterranean Sea and food habits vary between these countries according to culture, ethnic background and religion. The Mediterranean diet, containing olive oil, fish, fruits and vegetable is associated with a low rate of cardivascular and cancer diseases. This diet is rich in phytosterols, squalene, dietary fibre, antioxidants, phenolic substances and polyunsaturated acids.     

Moustache reconstruction in patients with cleft lip: (final aesthetic touches in clefts-part ii)

Men with clefts often have limited or even missing moustache growth in scar areas or in the upper lip prolabium. However the histological testing showed the absence or at least the inactive form of androgenic receptor in hair follicle of cleft site, transplantation of autologous grafts harvested from hair was successful in all six cases either into scars or the prolabium. A more natural effect was achieved by using micrografts. The positive reaction of patients proved there is a need for detailed treatment in highly outgoing individuals.     

Guided tissue regeneration, barrier membranes and reconstruction of the cleft maxillary alveolus

The use of barrier membranes for bone regeneration is especially beneficial in the case of severely affected soft tissue. One useful indication may be the formation of an effective shell for bone grafts in maxilla cleft defect reconstruction. When selecting a proper material for clinical use, one must consider the safety record, the resorption time and route of elimination, the time of the maintained barrier function, the necessary time of mechanical strength, and costs. Two resorbable collagen membranes, one of single-layer and one of double-layer material, were tested in vitro and in vivo. The tested single-layer membrane is less expensive, but it is also less handling than the double-layer membrane. In vitro, samples were incubated in simulated surgical wound. A complete unambiguous picture of disintegration was not proved histologically in either material in six investigation terms (1-6 weeks). In vivo the effect of the assessed membranes was verified on a group of patients (N = 45) with a cleft. Materials were applied in the reconstruction of the alveolar defect by cancellous bone grafts. The influence on the course of healing was not stated as statistically significant. However, with respect to the costs of double layer membrane, this material was used in the most severe cases.     

Eye complications of cetuximab therapy

Skin toxicity is the most important side effect of cetuximab administration, but little is known about the eye toxicity, including periorbital skin. We present here four cases of patients with metastatic colorectal carcinoma treated with the combination of cetuximab, irinotecan, 5-fluorouracil and leucovorin who had manifestation of complications in the eye or periorbital skin. These manifestations consisted of erythematous eruptions in the periorbital skin with blepharitis and conjunctivitis in three patients and trichomegaly in one patient. The symptoms were controlled with local therapy including corticosteroids and antibiotics. The skin toxicity in the periorbital region is more important than in other skin areas because of the impact on the social activity of the patient and the vision. The manifestations of eye toxicity of cetuximab may be controlled by local therapy, and the management of these patients requires the collaboration of medical oncologist and ophthalmologist.