Postoperative convalescence after inguinal hernia surgery: Prospective randomized multicenter study of laparoscopic versus Shouldice inguinal hernia repair in 1042 patients

Interest in inguinal hernia surgery has increased significantly with the introduction of new operating techniques during the past decade. This multicenter study compared short-term results in patients treated by the laparoscopic transabdominal preperitoneal patch technique (TAPP; n=518) and the Shouldice technique (n=524). We evaluated demographics, operative data, complications, hospital stay, postoperative pain, use of analgesics, functional status, sick leave, and complaints up to 3 months postoperatively. The median operating time was shorter in the Shouldice group (55 vs. 65 min), but there were no significant differences in complication rates, and major complications were rare. The hospital stay was 1 day or less in over 98% of cases in both groups, but more operations were performed on outpatient basis in the Shouldice group. In the TAPP group postoperative pain and analgesic consumption were less, postoperative functional status was better, and sick leave was shorter (10 vs. 14 days). These results show that the two methods are equally safe and have few major complications. The TAPP operation is associated with less postoperative pain, better postoperative functional status, and shorter sick leave, but at the price of a longer operating time. Electronic Publication     

Carcinogenicity of dextran sulfate sodium in relation to its molecular weight

The carcinogenicity of dextran and 3 kinds of dextran sulfate sodium with different molecular weights and almost the same sulfur content were compared in ACI rats. Dextran sulfate sodium of molecular weight 54,000 showed a strong carcinogenic activity when it was given orally as 2.5% diet, whereas dextran sulfate sodium of molecular weight 520,000 and 9500 and dextran showed no significant carcinogenicity, i.e. the peak of carcinogenic activity of dextran sulfate sodium appeared at molecular weight 54,000, and dextran sulfates with larger or smaller molecular weights had no carcinogenic activity.     

Studying the Composition of Salmus Preparation

Salmus is a product of Salvia sclarea technology that is widely used in balneary practice. It is established that the analytical characteristics of salmus substance, as stipulated in the temporal pharmacopoeial article VFS 42-1530-85, are not objective and should not be used for evaluating the quality of the ready-to-use preparation and for monitoring the process of its manufacturing. TLC data show that salmus contains all components of sage oil (Russian State Standard GOST 3171-76) except for linalyl acetate. Qualitative specific color reactions on Silufol TLC plates showed for the first time the presence of flavonoids such as kaempferol, quercetin, juglanin, quercitrin, and rungioside and revealed one previously unknown substance, probably, of a flavonoid nature. The TLC data also showed the presence of condensed tannins and chlorophylls. It is suggested to perform quantitative analysis and identification of biologically active substances in salmus using methods for determining the content of reducing sugars (carbohydrates) and oxidizable components. New procedures for determining the sum of essential oils and flavonoids using the total content of extractable components have been developed and verified. It is suggested that these substances are among the main therapeutic components of salmus. __________ Translated from Khimiko-Farmatsevticheskii Zhurnal, Vol. 39, No. 8, pp. 33 – 36, August, 2005.     

Tc-99m HMPAO SPECT imaging of the central nervous system in tuberous sclerosis

Tc-99m HMPAO was used to evaluate cerebral perfusion in a patient with tuberous sclerosis. The SPECT images demonstrated reduced HMPAO uptake in regions corresponding with MRI-confirmed locations of cortical tubers. These results indicate that the lesions are characterized by vascular perfusion deficits and support the hypothesis that cortical tubers result from developmental abnormalities of the embryonic central nervous system.     

Esophageal pH monitoring for gastroesophageal reflux: a United Kingdom study

Esophageal pH monitoring is the accepted standard for the investigation of gastroesophageal reflux (GER) in adults. A postal questionnaire was sent to 912 United Kingdom paediatric physicians & surgeons. Five hundred forty-seven (61%) replied, with 124 (22.7%) currently using the technique, mostly in conjunction with barium swallow and/or esophagoscopy. The use of pH monitoring to quantify GER was also accepted in principal as being the best determinant of reflux by a further 186 (34%), but as yet was unavailable in their hospitals. Pediatricians were also questioned as to their management of children with GER. The majority were treated medically with a variety of antireflux medication, with only 237 (42%) referring cases for surgery.     

Extracellular pH in the brain during ischemia: relationship to the severity of lactic acidosis

On the basis of data showing a bimodal distribution of values for extracellular pH (pHe), and a discontinuous delta PCO2/delta lactate relationship, Kraig et al. (1986) proposed that H+ is grossly compartmentalized between neurons and glia in the ischemic brain. We measured delta pHe during ischemia, varying ischemic lactate contents between 9 and 38 mmol kg-1. No bimodal distribution was found, but delta pHe varied linearly with lactate content. Because we have also failed to record a discontinuous delta PCO2/delta lactate relationship, we conclude that major compartmentation of H+ does not occur during ischemia.