Effect of claustrum stimulation on neurons of the contralateral medial oculomotor area, in the cat

In chloralose-anaesthetized cats, the extracellular spontaneous unitary activity was recorded from 157 neurons, located in the medial oculomotor area. 98 units were identified as projecting onto the superior colliculus. Electrical stimulations of the contralateral claustrum provoked, on 13 of these cells, an excitatory effect, lasting 10-35 ms and appearing with a latency of 20-50 ms. Full length section of the corpus callosum totally abolished the contralateral claustrum effect. The results suggest that in the cat, the claustrum may have a role in the bilateral control of the visuo-motor performance.

Neomyogenesis in 3D Dynamic Responsive Prosthesis for Inguinal Hernia Repair

Despite undisputed improvements, prosthetics hernia repair continues to be affected by unacceptable rates of complications. Postoperative adverse events such as discomfort and chronic pain represent a subject of increasing concern among the surgical community. Poor quality biologic response, stiff scar plates, and mesh shrinkage, a typical effect of conventional static meshes and plugs, are all indicated as the main reasons for many of the complications related to inguinal hernia repair. Even the conventional concept of treatment based upon a supposed reinforcement of the groin consequent to the fibrotic incorporation of meshes, would appear to be inadequate in the light of the latest scien…

Acute appendicitis and situs viscerum inversus: radiological and surgical approach—a systematic review

Abstract Introduction Acute appendicitis is one of the most frequent intra-abdominal diseases requiring emergency surgical consult and treatment. The diagnosis of this condition is based on clinical features and radiologic findings. One-third of patients with acute appendicitis present unusual symptoms. There are several circumstances that may cause misdiagnosis and unclear prognostic prediction. Among these, situs viscerum inversus totalis and midgut malrotation can be challenging scenarios, leading to a delay in treatment, especially when these conditions are unknown. We decided to carry on a systematic review of published cases of acute appendicitis in the context of anatomical anomalies…

Fixation free inguinal hernia repair with the 3D dynamic responsive prosthesis ProFlor: Features, procedural steps and long-term results

Abstract Background Static and fixated meshes to repair mobile structures like the groin may seem a procedural incongruence. Inguinal hernia is described as a degenerative disease. Therefore, the objective of disease treatment should be the regeneration of wasted tissue. The fibrotic scar plate, a typical biologic response of conventional static meshes, does not represent tissue regeneration but rather a foreign body reaction. These contrasting aspects seem to be related to high complication rates of inguinal herniorrhaphy. Recent studies concerning the pathophysiology of the groin have led to the development of new concepts for repairing inguinal protrusions. A proprietary designed 3D dyna…

Antibiotic Prophylaxis for Thyroid and Parathyroid Surgery: A Systematic Review and Meta-analysis

Objective: Although thyroid and parathyroid surgery is considered a clean procedure with a low incidence of surgical site infections (SSIs), a great number of endocrine surgeons use antibiotic prophylaxis (AP). The aim of this study was to assess whether AP is significantly effective in reducing the incidence of SSIs in this kind of surgery. Data Sources: A systematic literature search was performed with PubMed, Scopus, and ISI–Web of Science. Studies addressing the efficacy of AP in reducing the incidence of SSIs in thyroid and parathyroid surgery were included in the systematic review and meta-analysis. Review Methods: The random effects model was assumed to account for different sources …

Lipoma of the fossa femoralis mimicking a femoral hernia. Report of 2 cases

Highlights • Femoral lipoma can be mistaken with femoral hernia. • Differential diagnosis between femoral lipoma and femoral hernia can result challenging. • The occurrence of femoral pain can lead to misinterpretation of the symptoms.

Influence of ventral tegmental area (A10 region) on flight behaviour elicited by hypothalamic stimulation in the cat.

The influence of the ventral tegmental area (VTA) (dopaminergic A10 group neurons) on flight behaviour, induced by hypothalamic stimulation, was studied in the cat. Co-stimulation of hypothalamus and VTA (ipsi- or contralateral) induced an increase of the flight latency. Slow-motion analysis of flight behaviour showed that this increase was due to the augmentation of the fixation latency (FL) whereas the upright latency (UL) was not modified. Sulpiride injection (50 mg/kg i.p.) provoked the disappearance of VTA effect without affecting the basal behavioural sequence. The results show that DA A10 group neurons increase the attentive component of the flight reaction, suggesting a possible inf…

The Septum Inguinalis: A Clue to Hernia Genesis?

Purpose: Double ipsilateral inguinal ("pantaloon") hernias and also the more advanced "combined" inguinal hernia involve disruption of the inguinal floor. In the case of pantaloon hernias, the medial boundary of the internal ring remains intact but in combined hernias this is fully disrupted, producing a single hernial protrusion. Deepening the pathophysiology of these hernias may be helpful in addressing hernia genesis, thus improving strategies for the treatment of this disease. Materials and Methods: A cohort of 22 patients who underwent inguinal hernia repair showed double ipsilateral (pantaloon) hernia, comprising distinct direct and indirect protrusions separated by a tissue septum. I…

Muscle degeneration in inguinal hernia specimens.

BACKGROUND: There are few articles in the literature reporting the histological changes of groin structures affected by inguinal hernia. A deeper knowledge of this matter could represent an important step forward in the identification of the causes of hernia protrusion. This study aimed to recognise the pathological modifications of muscular structures in autopsy specimens excised from tissues surrounding the hernia orifice. METHODS: Inguinal hernia was identified in 30 autopsied cadavers, which presented different varieties of hernia, including indirect, direct and mixed. Tissue specimens were resected for histological study from structures of the inguinal area surrounding the hernia openi…

Inguinal Hernia: Defect Obliteration with the 3D Dynamic Regenerative Scaffold Proflor™.

Prosthetic inguinal hernia repair presents significant challenges. Some of these, such as mesh fixation and quality of the biologic response, are still debated among surgeons. For example, there is no strong consensus regarding a specific condition that characterizes the surgical procedure during herniorrhaphy. This issue concerns management of the hernia defect, which in conventional hernia repair with flat meshes remains patent. However, a critical analysis of typical postoperative complications after inguinal hernia repair reveals that some of these adverse events are related to patency of the hernial opening. Postoperative discomfort, pain with specific movements and even hernia recurre…

Airway cell composition at rest and after an all-out test in competitive rowers

Med Sci Sports Exerc. 2004 Oct;36(10):1723-9. Airway cell composition at rest and after an all-out test in competitive rowers. Morici G, Bonsignore MR, Zangla D, Riccobono L, Profita M, Bonanno A, Paternò A, Di Giorgi R, Mirabella F, Chimenti L, Benigno A, Vignola AM, Bellia V, Amato G, Bonsignore G. SourceDepartment of Experimental Medicine Italian National Research Council (CNR), Palermo, Italy. Abstract PURPOSES: This study was designed to assess: a) whether rowing affects airway cell composition, and b) the possible relationship between the degree of ventilation during exercise and airway cells. SUBJECTS AND METHODS: In nine young, nonasthmatic competitive rowers (mean age +/- SD: 16.2 …

Vacuum inversion and securing of distal colonic pseudodiverticula with novel spiked O-rings

Background Diverticular disease is increasingly prevalent in Western societies and is associated with significant morbidity. Objective Two-stage endoscopic device development for inversion and secured ligation of colonic diverticula; first, human cadaver studies were performed to measure forces required for diverticular inversion; second, a novel set of devices (elastic spiked O-ring with delivery system) was tested in animals. Design Prospective, observational study of human cadavers and prospective, interventional study of a porcine model. Setting University hospital pathology laboratory and animal facility. Intervention Full-thickness inversion of the colonic wall with a pipelike deliver…

Biologic Response of Inguinal Hernia Prosthetics: A Comparative Study of Conventional Static Meshes Versus 3D Dynamic Implants

Despite improvements in prosthetics and surgi- cal techniques, the rate of complications following inguinal hernia repair remains high. Among these, discomfort and chronic pain have become a source of increasing concern among surgeons. Poor quality of tissue ingrowth, such as thin scar plates or shrinking scars—typical results with con- ventional static implants and plugs—may contribute to these adverse events. Recently, a new type of 3D dynami- cally responsive implant was introduced to the market. This device, designed to be placed fixation-free, seems to induce ingrowth of viable and structured tissue instead of regressive fibrotic scarring. To elucidate the differences in biologic respo…

The role of the substantia nigra on the rage reaction elicited by hypothalamic stimulation, in the cat.

The effects of substantia nigra stimulation on the rage reaction evoked by hypothalamic activation were studied. The reference value of the rage reaction was the latency of the hissing, which was constant in all animals when hypothalamic stimulation was performed with the same parameters. Simultaneous activation of substantia nigra and hypothalamus determined a significant decrease in hissing latency. The influence of the substantia nigra on the affective components of the aggressive behavior is underlined.

Long-Term Results of Fixation-Free Incisional Hernia Repair Using a Tentacle-Shaped Implant

INTRODUCTION: The fixation and the overlap of the mesh represent an open issue in incisional hernia repair. An exclusively designed prosthesis has been developed to assure a suture-free repair and a broader coverage of the abdominal wall. This study describes the long-term results of incisional hernia procedures carried out positioning a tentacle-shaped implant through a specifically developed surgical technique. MATERIALS AND METHODS: A proprietary symmetrically-shaped flat mesh constituted by a large central body with integrated radiating arms was used to repair incisional hernias in 68 patients. The prosthesis was placed in preperitoneal/retromuscular sublay. The friction of the straps p…

Colorectal infiltrating deep endometriosis: Laparoscopic treatment. A case report

Endometriosis is a disease affecting approximately 10% of women of fertile age. A particular presentation is deep infiltrating endometriosis of the rectosigmoid colon with symptoms that can mimic an intestinal obstruction or neoplasm. We report the case of a 39-year-old woman with pelvic pain during the menstrual cycle and significant anemia who presented an ectopic endometrial tissue in correspondence of the rectum. Because of the thickness of the lesion the patient underwent a segmental laparoscopic colorectal resection with end-to-end anastomosis.

Nerve degeneration in inguinal hernia specimens

BACKGROUND: The histological study of the herniated inguinal area is rare in the literature. This report is focused on the detection of structural changes of the nerves within tissues bordering the inguinal hernia of cadavers. Their physiopathological consequences are hypothesized. MATERIALS AND METHODS: Primary inguinal hernia was diagnosed in 30 fresh cadavers. Tissue specimens from the inguinal region close to and around the hernia opening were excised for histological examination. A control of the data was achieved through tissue samples excised from equivalent sites of the inguinal region in 15 cadavers without hernia. RESULTS: The detected nerves in the inguinal area demonstrated path…

Fixation-free incisional hernia repair in the elderly: our experience with a tentacle-shaped implant.

Background: Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in carrying out the repair. Aims: In order to assure broader coverage of the abdominal wall and a tension- and fixation-free repair, a specifically designed prosthesis was developed for the surgical treatment of incisional hernias. The results of a fixation-free incisional hernia repair carried out in elderly patients using a tentacle-shaped implant are reported herewith. Methods: A tentacle-shaped flat mesh with a large central body and integra…

Effects of Intraaccumbens Microinjections of Quinpirole on Head Turning and Circling Movement in the Rat

This study was designed to evaluate whether nucleus accumbens dopamine D2 receptors are involved in the initiation of the movement, as distinguished from its execution. For this purpose, the effects of the quinpirole-induced increase of nucleus accumbens dopamine D2 receptor activity were observed on specific parameters of the circling behavior and of its first stage, the head-turning (HT) movement. The experiments were performed on rats with unilateral 6-hydroxydopamine (6-OHDA) lesion of the pars compacta of the substantia nigra and d-amphetamine i.p. (3 mg/kg). Bilateral intraaccumbens microinjections of quinpirole (1, 5, and 10 microg/0.5 microl), an agonist of the D2 receptor family, w…

Histological findings in direct inguinal hernia

Abstract BACKGROUND: The study is focused on recognizing the histological changes of the structures close to and around the hernia opening in patients having direct inguinal hernia. METHODS: In 15 patients with primary bilateral direct inguinal hernia who underwent a Stoppa open posterior inguinal hernia repair, tissue specimens from the abdominal wall surrounding a direct hernia border were excised for histological examination. These findings in patients with direct inguinal hernia were compared with tissue specimens excised from the fossa inguinalis media of cadavers without hernia. RESULTS: Significant degenerative modifications such as fibrohyaline degeneration and fatty substitution of…

Effects of sulpiride on the orienting movement evoked By acoustic stimulation in the Rat.

Abstract Drugs that selectively block D 2 receptors are known to provoke a rapid cell firing increase followed by A9 and A10 dopaminergic (DA) neuron inactivation (depolarization block). In this study, possible relationships between cell firing rapid increase and specific behavioral effects, linked to sensorimotor integration, were investigated in the rat. To this purpose, with the aid of a video camera apparatus and a frame-by-frame analysis, effects of sulpiride-induced blockade of DA D 2 receptors were analyzed on the orienting movement of the head induced by acoustic stimulation. In a control group of rats, during trials lasting 20 min, latency and duration of head turning (HT) were 186…

A New Prosthetic Implant for Inguinal Hernia Repair: Its Features in a Porcine Experimental Model

Even after more than 100 years of inguinal hernia repair, the rate of complications and recurrence remains unacceptably high. In the last decades, few effective advances in surgical technique and materials have been made. The authors see them as minor adjustments in the shape and materials of the prosthetic implants. Still, the underlying genesis of inguinal hernia remains undefined. Based upon this, it seems the surgical repair of inguinal protrusions cannot be based upon the pathogenesis because the etiology to date has not been addressed. Most hernia repairs are performed with some degree of point fixation (sutures/tacks) to stop the mesh from migrating and creating high recurrence rates…

Neurotrophic effects of central nicotinic receptor activation

A growing number of data have shown that compounds interacting with neuronal nicotinic acetylcholine receptors (nAChRs) have, both in vivo and in vitro, the potential to be neuroprotective and that treatment with nAChR agonists elicit long-lasting improvement of cognitive performance in a variety of behavioural tests in rats, monkeys and humans. Epidemiological and clinical studies suggested also a potential neuroprotective/trophic role of (-)-nicotine in neurodegenerative disease, such as Alzheimer's disease and Parkinson's disease. This neuroprotective/trophic role of nAChR activation has been mainly mediated by alpha7 and alpha4beta2 nAChR subtypes, as evidenced using selective nAChR ant…

The role of the substantia nigra in the control of amygdaloid paroxysmal activity.

AbstractBoth in acute and chronic cats, focal paroxysmal activity evoked in the ventro-basal complex of the amygdala has been inhibited by substantia nigra conditioning stimulation, to a greater extent, than by caudate nucleus activation. Injection of kainic acid into substantia nigra resulted in the disappearance of the caudate inhibition. It is suggested that the final control, exerted by the striatum on the amygdaloid seizures, occurs by means of the substantia nigra.

Modifications of head turning and circling movement following sulpiride microinjections into nucleus accumbens in the rat

The aim of this study was to determine whether a relationship exists between nucleus accumbens D2 receptors, circling behavior, and its first stage, the head turning. Rats were unilaterally lesioned in the substantia nigra with 6-hydroxydopamine and afterward treated with d-amphetamine IP following bilateral intraaccumbens microinjections (1, 5, 10 micrograms/0.5 microliters) of sulpiride, a D2 receptor antagonist. Computer-assisted video analysis allowed the study of some parameters (number of turns, type of turn, head turning duration, degree and speed) characterizing rotatory activity. Sulpiride microinfusion resulted in a dose-dependent decrease of the number of turns and head rotation …

Small bowel volvulus due to a large intestinal lipoma: A rare case report

Highlights • These are rare, benign, slow-growing mesenchymal tumors originating from adipose tissue in the bowel wall. Lipomas of mesentery, mesocolon, and antimesenteric side of intestine are extremely rare. • We describe a case of small bowel obstruction secondary to volvulus due to an antimesenteric ileal lipoma. • Mesenteric lipomas are rare clinical entity, with less than 50 cases described in English language literature. CT scan is the gold standard imaging modality for diagnosis of mesenteric lipoma and other lipomatous abdominal masses. • It shows homogenous tumor of adipose tissue, gives information about features of the small bowel and if there is evidence of ischemia and can dem…

The control of amygdaloid seizures by the globus pallidus.

Both in acute and chronic cats entopeduncular stimulation inhibits, to a greater extent than caudate activation, focal paroxysmal activity in the ventro-basal complex of the amygdala. Lesion of entopeduncular neurons, by means of kainic acid injection, induces a decrease of the caudate inhibitory effect. It is suggested that neostriatal control of the amygdaloid seizures occurs partly through the globus pallidus.

Modifications of the spontaneous bioelectric activity and of the after discharge evoked in the amygdala after pallidal injection of kainic acid in the cat.

Publisher Summary This chapter explains the modifications of the spontaneous bioelectric activity and of the after discharge (AD) evoked in the amygdala after pallidal injection of kainic acid (KA) in the cat. An experiment was conducted in which injection of KA, a neurotoxic drug analog of glutamate, was made into the entopeduncolar nucleus (EN), the equivalent of the medial globus pallidus of primates, to observe the modifications produced on the spontaneous amygdaloid bioelectric activity and on the evoked AD. An AD was evoked in the amygdala by stimulation of the ipsilateral pyriform cortex. The duration of the amygdaloid AD was related to the stimulus parameters. In the same animal, th…

Laparoscopic cholecystectomy in a patient with Steinert myotonic dystrophy. Case report.

Myotonic dystrophy (MD) is a serious multi-systemic autosomal dominant disease. The estimated incidence is 1 in every 8000 births, with an estimated prevalence of between 2.1 and 14.3 cases per 100,000 inhabitants. Signs and symptoms vary from a severe form of congenital myopathy, present from birth and often fatal, to a classic form and a delayed form, which generally presents after the age of 50 and in which the only sign is a cataract and life expectancy is completely normal. We describe the clinical case of a 40-year-old woman with Steinert myotonic dystrophy who underwent laparoscopic cholecystectomy (under general anesthesia) for symptomatic gallbladder stones. The conduct of anesthes…

External hernia of the supravesical fossa: Rare or simply misidentified?

Abstract Background External hernias of the supravesical fossa are considered rare, perhaps wrongly. Highlighting clinical and anatomical features could be useful for correct, preoperative diagnosis, thus avoiding the risk of complications such as incarceration. The study aims to demonstrate that the incidence of external protrusions of the supravesical fossa is higher that supposed. Probably, being mistaken for direct hernias, these hernia types are misidentified and not included in current classifications. This issue deserves attention due to the elevated risk of incarceration related to its distinctive structure. Material and methods 249 consecutive open anterior inguinal hernia procedur…

Neo-nervegenesis in 3D dynamic responsive implant for inguinal hernia repair. Qualitative study.

Abstract Background Prosthetic repair of inguinal hernias is one of the most performed surgical procedures. Nevertheless, high rates of complications affect the surgical treatment. Implant fixation, poor-quality tissue ingrowth and mesh shrinkage seem to be involved in postoperative complications, discomfort and chronic pain following inguinal hernia repair. To address these issues a multilamellar shaped 3D dynamic responsive prosthesis has been developed. This new implant, positioned fixation-free to obliterate the hernia opening, thanks its inherent dynamic compliance during inguinal movements, has demonstrated to induce an enhanced biological response. The ingrowth of newly formed muscle…

Terminal or truncal ligation of the inferior thyroid artery during thyroidectomy? A prospective randomized trial.

Abstract Introduction Thyroidectomy is a common procedure in general and endocrine surgery. The technique of ligation of inferior thyroid artery (ITA) has been invoked as a possible cause of appearance of postoperative hypocalcemia. Methods We performed a prospective randomized study involving 184 patients undergoing total thyroidectomy to evaluate the differences of truncal ligation versus distal ligation of ITA in terms of postoperative hypocalcemia, vocal fold palsy, voice and swallowing impairment. The patients were divided into group A (trunk ligation of ITA) and group B (terminal branches ligation of ITA). Results We evaluated postoperative PTH and calcemia (immediate, 6 and 12 months…

Laparoscopic drainage of liver abscess: case report and literature review.

Aim To evaluate the safety and efficacy of the minimally invasive surgical approach (laparoscopic drainage) of liver abscesses in selected cases. Case report Male, 58 years old, from a rural area, presented with epigastric abdominal pain, fever, weight loss, loss of appetite, a palpable mass in the epigastrium and neutrophilic leukocytosis. CT revealed a complex multiloculated liver abscess in segments 2-3. Systemic antibiotic therapy alone was ineffective; percutaneous drainage was excluded due to the characteristics of the lesion. Result Given the complexity of the lesion, a laparoscopic approach was chosen involving complete drainage of the abscess, debridement and irrigation; the cavity…

First-in-man permanent laparoscopic fixation free obliteration of inguinal hernia defect with the 3D dynamic responsive implant ProFlor-E®. Case report

Abstract Introduction In the case of inguinal hernia recurrence after primary anterior repair, international guidelines strongly suggest a posterior laparoscopic approach. The 3D dynamic-responsive prosthesis for inguinal hernia repair ProFlor-E® has recently been introduced to the market. The present report describes the results of the first-in-man laparoscopic inguinal hernia repair carried out with ProFlor-E®. Presentation of case A 71-year-old male Caucasian presented with recurrent inguinal hernia after primary anterior repair. A fixation free TAPP procedure with ProFlor-E® was planned. Implant delivery and placement to obliterate the defect was quick and safe. Postoperatively, startin…

Uterine Involvement in Klippel–Trenaunay Syndrome: A Rare But Relevant Event. Review of the Literature

IntroductionKlippel–Trenaunay syndrome (KTS) is a rare vascular congenital disorder characterized by the classical triad of port-wine stains, abnormal growth of soft tissues and bones, and vascular malformations. The involvement of the genitourinary tract and of the uterus in particular is extremely infrequent but relevant for possible consequences.MethodsWe performed an extensive review of the literature using the Pubmed, Scopus and ISI web of knowledge database to identify all cases of KTS with uterine involvement. The search was done using the MeSH term “Klippel–Trenaunay syndrome” AND “uterine” OR “uterus.” We considered publications only in the English language with no limits of time. …

A regenerative 3D scaffold for inguinal hernia repair. MR imaging and histological cross evidence. Qualitative study

Abstract Background Inguinal hernia is a degenerative disease occurring in a high motile surround. Stopping degeneration and promoting tissue regeneration should be the treatment goal. Groin hernias are conventionally managed with static flat meshes, mostly fixated to the delicate inguinal environment. Far from a regenerative effect, the biologic response of conventional hernia meshes is characterized by a foreign body reaction leading to a stiff/shrunken scar plate, which is often the source of unpleasant complications. Recently, a newly engineered 3D device for inguinal hernia repair – ProFlor-has been developed to produce a regenerative biological response. Unlike conventional hernia mes…

Fixation free femoral hernia repair with a 3D dynamic responsive implant. A case series report

Abstract Background To date, no gold standard for the surgical treatment of femoral hernia exists. Pure tissue repair as well as mesh/plug implantation, open or laparoscopic, are the most performed methods. Nevertheless, all these techniques need sutures or mesh fixation. This implies the risk of damaging sensitive structures of the femoral area, along with complications related to tissue tear and postoperative discomfort consequent to poor quality mesh incorporation. The present retrospective multicenter case series highlights the results of femoral hernia repair procedures performed with a 3D dynamic responsive implant in a cohort of 32 patients during a mean follow up of 27 months. Mater…

Terminal ligature of inferior thyroid arterhy branches during total thyroidectomy for multinodular goiter is associated with higher postoperative calcium and PTH levels

Purpose: To evaluate the impact of truncal versus terminal branch ligature of the inferior thyroid artery (ITA) on postoperative calcium and PTH plasma levels in patients undergoing total thyroidectomy for multinodular goiter. Methods: A prospective randomized study was performed comparing a group of patients that underwent either truncal ligature of the ITA (group 1) or terminal ligature of ITA branches (group 2). Results: A series of 126 consecutive patients with non-toxic euthyroid multinodular goiter underwent total thyroidectomy. Truncal ligature of the ITA was performed in 63 patients (group 1) and terminal branch ITA ligature in 63 patients (group 2). Postoperative ionized serum calc…

Inhibitory effect of A10 dopaminergic neurons of the ventral tegmental area on the orienting response evoked by acoustic stimulation in the cat.

Abstract The effect of bilateral electric stimulation of A10 dopaminergic neurons of the ventral tegmental area (80–300 μA, 20–50 Hz, 0.1–0.5 ms, 2 s duration) on latency and duration of the orienting response, evoked by acoustic stimuli (4500–8000 Hz, 2 s), was studied in the cat. A10 neuron stimulation, simultaneous with the acoustic one, was performed with threshold parameters inducing minimal behavioral signs (head searching movement, sniffing, increase in alertness). By means of a videoanalysis system, a statistically significant increase, both of latency and duration of the response, was observed. The possible role of dopamine was studied administrating sulpiride (20 mg/kg IP), a dopa…

Fixation-free inguinal hernia repair using a dynamic self-retaining implant.

Inguinal hernia repair remains controversial, despite advances in technique and materials. Conventional implants are typically static (passive) and do not move in concert with the groin's motility. Inguinal hernia repair with mesh fixation on dynamic groin structures are not tension free, and are associated with tissue tearing, bleeding, hematoma, and nerve entrapment--all which might contribute to mesh dislocation. The poor quality of tissue ingrowth within static meshes/plugs embodies another crucial issue in prosthetic hernia repair. Because the prosthetics used for inguinal hernia repair are incorporated by rigid fibrotic tissue (hence the term "scar plate"), the regressive tissue leads…

Totally laparoscopic treatment of intestinal tuberculosis complicated with bowel perforation: The first case report in worldwide literature with a brief review

IntroductionBowel perforation is a relatively rare presentation of abdominal tuberculosis, whose diagnosis is challenging but fundamental to minimize morbidity and mortality. Laparoscopy is considered an effective modality for diagnosis, but its role in surgical treatment is still not established. We reported the first worldwide case of totally laparoscopic treatment of intestinal tuberculosis complicated with bowel perforation.Case presentationA 30-year-old man with a history of weight loss, preceded by 2 years of nonproductive cough, was admitted to the Infectious Disease Department with a presumed diagnosis of tuberculosis. A microbiological culture test confirmed the diagnosis, and the …

New mesh shape and improved implantation procedure to simplify and standardize open ventral hernia repair: a preliminary report.

Introduction Issues in ventral hernia repair are represented by the need for mesh fixation and how to assure a sufficient mesh overlap of the defect. Aiming to resolve these problems, this study describes a modified technique for ventral and incisional hernia repair based upon a newly developed mesh with a special design. This new type of implant allows broader coverage of the abdominal wall and results in tension- and fixation-free repair. Materials and methods A unique geometrically shaped mesh consisting of a large central body and radiating arms was used to repair ventral or incisional hernia. The mesh was intended not to be point-fixated. The friction of the straps passing through the …

Connexin-30 mRNA Is Up-Regulated in Astrocytes and Expressed in Apoptotic Neuronal Cells of Rat Brain Following Kainate-Induced Seizures

Glial connexins (Cxs) make an extensively interconnected functional syncytium created by a network of gap junctions between astrocytes and oligodendrocytes. Among Cxs expressed in the brain, Cx30 is expressed in grey matter astrocytes, as shown at the protein level by immunoistochemistry. In the present study we aimed to perform a detailed study of the regional distribution of Cx30 mRNA in the adult and postnatal developing rat brain, analyzing its expression by in situ hybridization, and determining its cell type localization by double labeling. Recently, it has been suggested that neuronal activity may control the level of intercellular communication between astrocytes through gap junctio…

Expression of connexin36 in the adult and developing rat brain.

The distribution of connexin36 (Cx36) in the adult rat brain and retina has been analysed at the protein (immunofluorescence) and mRNA (in situ hybridization) level. Cx36 immunoreactivity, consisting primarily of round or elongated puncta, is highly enriched in specific brain regions (inferior olive and the olfactory bulb), in the retina, in the anterior pituitary and in the pineal gland, in agreement with the high levels of Cx36 mRNA in the same regions. A lower density of immunoreactive puncta can be observed in several brain regions, where only scattered subpopulations of cells express Cx36 mRNA. By combining in situ hybridization for Cx36 mRNA with immunohistochemistry for a general neu…

Transcription factor gene expression profiling after acute intermittent nicotine treatment in the rat cerebral cortex

Several studies in different in vitro and in vivo models have demonstrated neuroprotective effects of nicotinic receptor agonists and indirect trophic actions of nicotine on brain are suggested from observations describing nicotine as a cognitive enhancer by increasing vigilance and improving learning and memory. While an increasing number of studies have given evidence of neuroprotective and neurotrophic effects of nicotine treatment, the molecular mechanism mediating the neurotrophic effects of nicotine are not fully understood. Previously in an analysis of several neurotrophic factors as possible mediators of nicotine-induced neuroprotection and/or neurotrophic effects we could reveal th…

Enhanced angiogenesis in the 3D dynamic responsive implant for inguinal hernia repair ProFlor

Biologic response to hernia prostheses represents a continuous source of debate. Conventional hernia meshes, in their typical static, passive configuration have been used for decades to reinforce the herniated abdominal wall. These flat implants, mainly fixated with sutures or tacks, induce poor quality fibrotic ingrowth that shrinks the mesh. In groin hernia repair, flat meshes are applied in the delicate inguinal surrounding where uncontrolled development of a scar plate can impair movement and may incorporate the sensitive nerves crossing this area. Complications deriving from mesh fixation and nerve entrapment are frequent and unpleasant for patients. To remedy these problems, a multila…

Dynamic Responsive Inguinal Scaffold Activates Myogenic Growth Factors Finalizing the Regeneration of the Herniated Groin

Background: Postoperative chronic pain caused by fixation and/or fibrotic incorporation of hernia meshes are the main concerns in inguinal herniorrhaphy. As inguinal hernia is a degenerative disease, logically the treatment should aim at stopping degeneration and activating regeneration. Unfortunately, in conventional prosthetic herniorrhaphy no relationship exists between pathogenesis and treatment. To overcome these incongruences, a 3D dynamic responsive multilamellar scaffold has been developed for fixation-free inguinal hernia repair. Made of polypropylene like conventional flat meshes, the dynamic behavior of the scaffold allows for the regeneration of all typical inguinal components: …

Feasibility and Safety of Laparoscopic Complete Mesocolic Excision (CME) for Right-sided Colon Cancer

OBJECTIVE The aim of this prospective clinical study is to compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group). SUMMARY BACKGROUND DATA Although CME with central vascular ligation in laparoscopic right hemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancer-related 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controversy surrounding its use. METHODS In this randomized controlled trial, several prim…

Regulation of NT Receptors after Chronic Treatment with Typical and Atypical Neuroleptic Drugs

Neurotensin is a tridecapeptide, which produces central effects such as hypotension, hypothermia, muscle relaxation, analgesia, antinociception, and reduces locomotor activity (Nemeroff et al., 1977). In the recent years, several lines of evidences indicated the great importance of the dopamine (DA)- neurotensin (NT) interaction taking place mostly in the mesolimbocortical areas, both at cell bodies (A10 DA-ergic group located in the ventral tegmental area -VTA-) and nerve terminal level (cerebral cortex, n. accumbens, olfactory tubercle, ventral n. caudato-putamen) (Quirion, 1983; Nemeroff, et al., 1984; Nemeroff, 1986). Immunocytochemical data indicated the presence of NT-like immunoreact…

Histological findings of the internal inguinal ring in patients having indirect inguinal hernia

BACKGROUND: Aiming to deepen the understanding of the factors involved in the genesis of groin hernia, this study is focused on identifying the histological changes within the muscle fibers of the internal inguinal ring in patients having indirect inguinal hernia. METHODS: In eight patients with primary or recurrent bilateral indirect inguinal hernia who underwent a Stoppa open posterior inguinal hernia repair, a tissue specimen from the edge of the internal inguinal ring was biopsied and histologically examined. RESULTS: In all of the tissue samples, remarkable degenerative changes such as fibrohyaline degeneration of the muscle fibers, vascular congestion, and phlogistic infiltration thro…

Successful laparoscopic management of congenital diaphragmatic relaxation: A case report

Highlights • We describe a case report of congenital Diaphragmatic relaxation treated with totally laparoscopic plication of the left hemidiaphragm with nonresorbable sutures. • In our case report the diaphragmatic relaxation seemed to be congenital and the laparoscopic approach resulted the most appropriate technique to obtain the repositioning of abdominal organs and diaphragmatic placation. • A brief review of literature was performed to identify outcomes and potentially surgical advantages of laparoscopic approach for diaphragmatic relaxation. Laparoscopic approach can only be practiced in selected cases.

Combined inguinal hernia in the elderly. Portraying the progression of hernia disease

Abstract Introduction Identification of a combined hernia is a common occurrence in the course of inguinal hernia repair. This type of protrusion disease seems to affect the elderly, in particular. Very few investigations have been carried out to ascertain the structural changes that occur in the groin affected by this clinical condition. Method Analysis of intraoperative findings of combined inguinal hernias evidenced in the elderly, from the most recent 100 groin hernia repair procedures carried out by a single operator, represents the basis of the article. Protrusions that presumably represent the forerunner of this type of hernia were also analyzed: double ipsilateral inguinal hernias c…

Modified fixation free plug technique using a new 3D multilamellar implant for inguinal hernia repair: a retrospective study of a single operator case series.

Aim: Implant fixation, mesh shrinkage and poor quality of tissue ingrowth are unresolved issues in modern hernia repair. Many complications reported in the literature such as bleeding, nerve entrapment, hematoma, pain, discomfort, and testicular complications, are considered to be a direct results of implant fixation. This article describes the outcomes of a procedure carried out using a handcrafted implant that addresses the issues consequent to point fixation. Methods: This was a retrospective study on the short, medium and long-term results of placing a-modified, fixation free three-dimensional polypropylene implant in 61 patients who underwent inguinal hernia repair using a novel delive…

Effect of sertraline treatment on benzodiazepine receptors in the rat brain.

In this paper we describe the modification of benzodiazepine (BDZ) binding sites in the rat brain after different times of treatment with the 5-hydroxytryptamine-(5HT) uptake blocker sertraline. We investigated the effect of 8, 15 and 30 days sertraline treatment (10 mg/kg/day, i.p.) on 3 H-flunitrazepam binding sites. In order to describe the anatomical site of action of the drug, the experiment has been carried out by means of quantitative receptor autoradiography. After 8 days of sertraline treatment, an increase of BDZ receptor density is found in the olfactory tubercle. This effect is reversed at 15 and 30 days. At 15 days of treatment, an increase is found in the anterior cingulate co…

Damage to the vascular structures in inguinal hernia specimens.

BACKGROUND: Few scientific reports to date describe the histological modification of structures outlining a hernia opening. This article is focused on the identification of the pathological changes in vascular structures in tissues excised from cadavers with inguinal hernia. A deeper comprehension of this topic could lead to essential improvements in the detection of hernia genesis. MATERIALS AND METHODS: Different kinds of hernia, including indirect, direct and mixed, were identified in 30 autopsied subjects. Tissue samples were resected for histological study from abdominal wall structures close to the hernia opening. Histological examination focused on the detection of structural changes…

Sphincter-like motion following machanical dilation of the internal inguinal ring during indirect inguinal hernia procedure

INTRODUCTION: Even today, there is still great speculation as to the underlying pathogenesis of inguinal hernia. As a result, it could be extrapolated that the vast majority of repairs are based upon conjecture. Most current repairs are founded upon the principle of "closing the defect" in the anatomy, either by suturing closed under tension, covering with a mesh or obliterating the defect with a plug. Many variants of each method are refined to achieve better clinical outcomes. Yet few, if any, strive to understand a fundamental question: "What has gone wrong with the normal physiological and anatomical mechanisms that prevent abdominal structures protruding through the abdominal wall?" We…

The role of the claustrum in the bilateral control of frontal oculomotor neurons in the cat.

The effect of claustrum (CL) stimulation on the spontaneous unitary activity of ipsi and contralateral frontal oculomotor neurons, was studied in chloralose-anaesthetized cats. A total of 205 units was bilaterally recorded in the medial oculomotor area, homologous of the primate "frontal eye fields"; 127 neurons were identified as projecting to the superior colliculus; for 33 of these last units stimulation of the ipsilateral CL provoked an excitatory effect lasting 10-25 ms and appearing with a latency of 5-15 ms; on 8 units the excitatory effect was followed by an inhibition lasting 100-250 ms. Ninety-eight of the 127 neurons were also tested through activation of the contralateral CL: 13…

The use of a new kind of low profile retractor for arteriovenous fistula procedure simplifies and speeds up the intervention

Purpose The aim of this study was to demonstrate the effectiveness of a new kind of disposable surgical retractor in arteriovenous fistula (AVF) procedures in order to achieve an easier, faster and safer surgical intervention. Methods Between January and June 2008, 22 AVF procedures were performed using the 3PAWS ReeTrakttrade; (Insightra Inc. - Irvine, Ca., USA) a self-retaining, low profile retractor. An equivalent patient sample, in which an AVF was performed using conventional retraction devices, was considered for comparison of the intra- and post-operative results. Results In all of the 22 AVF procedures performed, the ReeTrakt™ system has simplified the performance of the surgical te…

Topic: Inguinal Hernia - Joined guidelines.

La ligature terminale des branches de l’artère thyroïdienne inférieure diminue la morbidité parathyroïdienne après thyroïdectomie totale pour goitre

Resume But de l’etude Le but de cette etude etait d’evaluer l’impact de la ligature proximale de l’artere thyroidienne inferieure sur le taux postoperatoire de calcium et de parathormone chez les patients operes d’une thyroidectomie totale pour goitre. Patients et methodes Une etude randomisee a compare un groupe de patients operes par ligature proximale tronculaire de l’artere thyroidienne inferieure (groupe 1) a un deuxieme groupe de patients operes par ligature distale des branches de l’artere thyroidienne inferieure au contact de la capsule thyroidienne. Cent vingt-six patients consecutifs operes d’une thyroidectomie totale pour goitre multiheteronodulaire euthyroidien ont ete inclus. S…

Effects of motor cortex removal on circling behaviour.

AbstractChemical stimulation of the dopaminergic nigro-striatal system induces circling behaviour also in animals in which an extensive telencephalic lesion has been performed. In order to avoid the effects linked to chemical stimulation, we have studied the circling behaviour means of electrical stimulation of the caudate nucleus in chronic cats with cortical lesions. The role of the motor cortex on the circling behaviour is emphasized.

Difficult laparoscopic cholecystectomy and preoperative predictive factors

AbstractLaparoscopic cholecystectomy (LC) is the standard technique for treatment of gallbladder disease. In case of acute cholecystitis we can identify preoperative factors associated with an increased risk of conversion and intraoperative complications. The aim of our study was to detect preoperative laboratory and radiological findings predictive of difficult LC with potential advantages for both the surgeons and patients in terms of options for management. We designed a retrospective case–control study to compare preoperative predictive factors of difficult LC in patients treated in emergency setting between January 2015 and December 2019. We included in the difficult LC group the surge…

Inguinal Hernia: Crossfire Between the Meshes.

Prosthetic strap system for simplified ventral hernia repair. Its results in a porcine experimental model.

Abstract: Introduction Aiming to achieve a simplified ventral hernia repair, a proprietary shaped mesh was experimentally tested in the porcine model. The mesh is structured with a large central body and radiating straps. The friction of the straps passing through the tissues are hypothesized to be adequate to maintain the mesh in place during tissue ingrowth, avoiding classic point fixation while ensuring a wide coverage of the abdomen. Methods The mesh, having 6 radial straps, was placed using a sublay preperitoneal technique in 4 pigs. All straps were passed laterally through the abdominal wall and exteriorized from the skin. The straps were trimmed at the level of the skin, allowing the…

Tentacle-shaped mesh for fixation-free repair of umbilical hernias

Purpose: Mesh fixation and broad overlap represent an open issue in umbilical hernia repair. A proprietary-designed implant with tentacle straps at its boundary has been developed to ensure a suture-free repair and a broader coverage of the abdominal wall. The study describes the results of umbilical hernia procedures carried out with the tentacle-shaped implant and the related surgical technique. Methods: A proprietary tentacle-shaped flat mesh having a central body with integrated radiating arms at its edge was used to repair large umbilical hernias in 62 patients. The implant was placed in preperitoneal sublay. The friction of the straps, crossing the abdominal wall thanks to a special n…