Tissue adhesives for repairing inguinal hernia: a preliminary study

AIM: To investigate the efficacy of tissue adhesives for closing the orifice of the inguinal hernia sac (IHS) as an alternative method for treating inguinal hernia. METHODS: Five-week-old male Lewis rats (n=4) were used, because Lewis rats have a large patent IHS. The rats were divided into 9 groups (n=6 in each) according to the type of tissue adhesive used: G1, fibrin glue (Beriplast); G1b, Beriplast plus blood; G2, microfibrillar collagen hemostat (Avitene); G2b, Avitene plus blood; G3, fibrinogen-based sealant (TachoComb); G3b, TachoComb plus blood; G4, synthetic absorbable sealant (Advaseal); G5, bilateral single port laparoscopic injection of octylcyanoacrylate (Dermabond); and G6, sham operation (control group). In G1-G4, surgery was performed through a midline lower abdominal incision. In G5, a 5-mm laparoscope was inserted in the epigastrium, a fine catheter was passed through the side port of the laparoscope into the right HIS, and 0.2 mL Dermabond was injected. The left IHS was treated in the same way. All rats were sacrificed 3 months after treatment, and IHS patency was examined macroscopically. All rats in G5 and G6 were mated 50 days after treatment to check fertility. RESULTS: All rats survived until sacrifice. At sacrifice, all IHS were patent in G6. All IHS were also patent in G1-G4, but all IHS were closed at the internal ring in G5. In G5 there were no adhesions between the orifice of the closed sac and the small bowel in 5/6, and only minor adhesions in 1/6. G5 fertility (5/6: 83%) was the same as for the control group (G6). CONCLUSION: Our results suggest that laparoscopic injection of Db into the IHS is simple, safe, reliable, virtually scarless, and may be a reasonable alternative to standard open surgical inguinal hernia repair.     

The use of a Parker Flex-Tip tube in a case of large laryngeal polyps

A 58-year-old man was scheduled for laryngomicrosurgery for treatment of large laryngeal polyps. Although awake induction was initially attempted to prevent airway obstruction, his vocal cords could not be visualized. We therefore tried intubation with a Parker Flex-Tip (PFT) tube under the guidance of a bronchial fiberscope (BF). After inserting the BF, his trachea was intubated easily. The operation was performed without any complications. We conclude that a PFT tube is useful for endotracheal intubation in a patient with large laryngeal polyps.     

Elevated erythropoietin in vitreous with ischemic retinal diseases

The aim of the current study was to measure the concentrations of erythropoietin in the vitreous fluid and analyze its association with vascular endothelial growth factor (VEGF) in ischemic vitreoretinal diseases. Vitreous fluid samples were collected from patients with proliferative diabetic retinopathy, branch retinal vein occlusion and idiopathic macular hole. Concentrations of erythropoietin and VEGF in vitreous fluid were significantly elevated in patients with proliferative diabetic retinopathy and branch retinal vein occlusion as compared to patients with macular hole. There were no differences in serum concentrations of erythropoietin and VEGF among patient groups. There was significant correlation between erythropoietin and VEGF concentrations in vitreous fluid. Erythropoietin was up-regulated in ischemic disorders and may act as an endogenous neuroprotective factor against ischemic retinal disorders.     

Photographic face recognition of cooperators vs. defectors

Results of three experiments, in which a total of 167 students participated, consistently indicated that participants performed recognition tasks better for face photographs of defectors than those of cooperators. The face photographs used in the experiments were those of participants taken during prisoner's dilemma (PD) experiments a few years prior to the present study. In Experiments 1 and 2, photographs of cooperators and defectors in a one-shot PD experiment, taken after they had filled out a lengthy post-experimental questionnaire, were used. In Experiment 3, the photographs were those of high and low cooperators, taken at the moment of a cooperation or defection choice, respectively. Recognition was better for photographs that were judged unattractive than attractive. At the same time, it was better for photographs of less cooperative participants in the PD studies than those of more cooperative participants. Implications of the findings for Cosmides & Tooby's (1992) 'cheater-detection' module for social exchange domain were discussed.     

Cyclin D1 amplification and p16(MTS1/CDK4I) deletion correlate with poor prognosis in head and neck tumors

OBJECTIVES/HYPOTHESIS: Cyclin D1, a cell cycle regulator localized to chromosome 11q13, is amplified in several human tumors including head and neck squamous cell carcinoma (HNSCC). Amplification and/or overexpression of cyclin D1 have been correlated to a poor prognosis. Deletion of the p16 gene, localized to 9p21, has also been observed in a significant proportion of HNSCC. The p16 gene regulates cyclin D1-CDK4 activity and prevents retinoblastoma tumor suppressor gene phosphorylation, thereby downregulating cellular proliferation. Detection of cyclin D1 amplification and p16 deletion using a simple and sensitive method will be valuable for the development of effective treatment modalities for head and neck cancer. STUDY DESIGN: We have used fluorescence in situ hybridization (FISH) to study cyclin D1 amplification and p16 gene deletion in head and neck tumors. Both single- and dual-color FISH were performed. METHODS: Paraffin-embedded tissues from 103 patients with HNSCC were analyzed using genomic DNA probes for cyclin D1 and p16. Dual-color FISH was performed with chromosome 11 or 9 centromeric probes as a control. Twenty-eight of these samples were analyzed for p16 expression by immunohistochemistry. RESULTS: Cyclin D1 amplification was observed in 30% (31/103) of patients, and p16 deletion in 52% (54/103). Lack of p16 expression was observed in 64% (18/28) of patients. There was a good correlation between the deletion of p16 sequences and the loss of p16 expression (P = .008). Amplification of cyclin D1 had a statistically significant association with recurrence, distant metastasis, and survival at 36 months. There was a significant association between p16 deletion and the development of distant metastases. Cyclin D1 amplification and p16 deletion together correlated with recurrence, distant metastasis, and survival. CONCLUSIONS: We demonstrate that FISH is a simple and sensitive method for detecting cyclin D1 amplification and p16 deletion in head and neck cancer. Our results suggest that these two genetic aberrations together portend a poorer outcome than either of the abnormalities alone in head and neck cancer.     

The effect of repeated sevoflurane anesthesia on hepatic function and immunological system

BACKGROUND: Sevoflurane is known as a useful and safe anesthetic because of its properties of fast uptake and elimination at the lungs and of no effects on hepatic function. In this study we examined the effect of repeated sevoflurane anesthesia on hepatic function and immunological system. METHODS: Eight patients (ASA, PS 2 or 3) received sevoflurane anesthesia three times in 6 months. Six patients had emergency operation for injuries. Aspirate transaminase (AST), alanine transaminase (ALT) and complements (CH50, C3, C4) were measured prior to anesthesia, and 1, 7 and 14 days after anesthesia. RESULTS: The values of AST and ALT were high prior to anesthesia at the first anesthesia. However, these were of no significant changes. CH50, C3, C4 increased significantly after the first anesthesia. However, there were no significant changes of these complements after the second and the third anesthesia. CONCLUSIONS: Our results suggest that sevoflurane is not likely to provide adverse effects on the liver and to suppress the production of complements accompanied by the surgical stress.