Incarcerated lumbar hernia in the Petit´s triangle as a cause of large bowel obstruction.

Petits hernia is a rare defect in the abdominal wall located in the lower lumbar triangle. The herniation in the Petiti trigonum is complicated by bowel incarceration in about 9% of cases, most often of the large bowel. We present a case report of a 73-year-old patient with clinical manifestations of large bowel obstrution. The patient was admitted and indicated for urgent surgery. Incarcerated left lumbar hernia in the Petits triangle with herniation of sigmoid colon that showed no signs of ischemia was found. Reposition of the sigmoid colon and hernioplasty of the lumbar hernia was performed. There were no postoperative complications and the patient was discharged on postoperative day 9. The presented case report shows that the lumbar hernia (Petit) may result in bowel obstruction and thus may cause a life-threatening condition that requires urgent surgical intervention.

Skin wound healing in obese and lean male adolescent rats submitted to pre-weaning litter size manipulation.

We investigated whether early postnatal over-nutrition affects normal course of skin wound healing. To induce over-nutrition the litter size was adjusted on the first day after birth to four pups/nest (small litters). In parallel, as a control, normal nests of 10 pups/nest (normal litters) were used. For the wound healing experiment 30 male Sprague-Dawley rats, 15 from normal nests and 15 from small nests, were used. Two parallel full-thickness skin incisions and two full-thickness excisions were performed on the back of each rat. Samples for histological examination (excisions) and wound tensile strength measurement (incisions) were collected on days 2, 6, and 14 after surgery. Our study demonstrates that rats from the small nests had enhanced plasma levels of insulin and enhanced body weight/fat parameters. Furthermore, in small nests, rats that expressed the above-mentioned symptoms displayed slight improvement of epidermis regeneration, accelerated demarcation line formation, and increased wound tensile strength. From this point of view the small nest model used in the present experiment is helpful for exploration whether these acquired changes might be considered as a sufficient essential factor involved in the regulation of metabolic homeostasis and wound repair in juvenile obese male rats. Nevertheless, further studies need to be performed to verify the present findings also on other animal models and humans and to describe the exact underlying mechanism.

[SILS appendectomy for acute appendicitis - two-year experience]. / SILS apendektómia pre akútnu apendicitídu - dvojrocné skúsenosti.

INTRODUCTION: The study aims to present our two-year experience with SILS (Single Incision Laparoscopic Surgery) appendectomy in patients operated on for acute appendicitis symptoms. The results obtained were analysed and then compared with patients operated by standard laparoscopy, as well as with data available from the published literature with emphasis on safety and advantages of a new operating technique. MATERIAL AND METHODS: A retrospective analysis of patients operated on at the Third Department of Surgery, Slovak Medical University, the Kosice-Saca Hospital, a.s., in the past two years was performed. Age, sex, BMI, length of operation, post-operative hospitalization period, occurrence of pre- and post-operative complications were evaluated. RESULTS: In the period from 1 November 2009 to 31 October 2011, 116 patients were operated on by the authors, 47 of them by the SILS technique. The group included 26 males and 21 females with average age of 37.13 years (18-80) and average BMI 26.3 kg/m2 (18-47.1). Average length of the operation was 54.81 minutes (30-100). The length of post-operative hospital stay was 3.83 days (2-6). An abscess in the surgical wound was found in three patients. One patient had to be reoperated due to a pericaecal abscessed hematoma. Incisional hernia was not observed in our group. CONCLUSION: Our results are comparable with the data from international published literature and confirm that the SILS appendectomy is a safe method and represents an appropriate alternative to the standard laparoscopic technique. It is suitable for surgeons with advanced experience in laparoscopy. Apart from the excellent cosmetic effect, other advantages or disadvantages in comparison with standard laparoscopy will require confirmation by prospective randomized studies.

Atropa belladonna L. water extract: modulator of extracellular matrix formation in vitro and in vivo.

Previously, we found that treatment of cutaneous wounds with Atropa belladonna L. (AB) revealed shortened process of acute inflammation as well as increased tensile strength and collagen deposition in healing skin wounds (Gál et al. 2009). To better understand AB effect on skin wound healing male Sprague-Dawley rats were submitted to one round full thickness skin wound on the back. In two experimental groups two different concentrations of AB extract were daily applied whereas the control group remained untreated. For histological evaluation samples were removed on day 21 after surgery and stained for wide spectrum cytokeratin, collagen III, fibronectin, galectin-1, and vimentin. In addition, in the in vitro study different concentration of AB extract were used to evaluate differences in HaCaT keratinocytes proliferation and differentiation by detection of Ki67 and keratin-19 expressions. Furthermore, to assess ECM formation of human dermal fibroblasts on the in vitro level fibronectin and galectin-1 were visualized. Our study showed that AB induces fibronectin and galectin-1 rich ECM formation in vitro and in vivo. In addition, the proliferation of keratinocytes was also increased. In conclusion, AB is an effective modulator of skin wound healing. Nevertheless, further research is needed to find optimal therapeutic concentration and exact underlying mechanism of action.

[SILS cholecystectomy--analysis of the first 100 patients]. / SILS cholecystektómia - analýza süboru prvých 100 pacientov.

AIM: The purpose of the study is to evaluate the results of the group of patients underwent SILS cholecystectomy and compare them with the literature evidence. MATERIAL AND METHODS: The retrospective analysis of the first 100 patients underwent cholecystectomy through single SILS port was performed. The operation was carried out with standard laparoscopic instruments. The average age, sex, BMI, mean operative time and the length of postoperative hospitalization were recorded. RESULTS: The sex ratio was approximately 3:1 for women. The mean age in the group was 49 years, BMI 26.8 kg/m2, operative time 63 minutes and the length of postoperative hospitalization was 2.2 days. Two intraoperative complications were observed - cystis artery bleeding and leasion of common hepatic duct. Four patients required conversion to a conventional laparoscopic cholecystectomy and one to open procedure. Three wound complications during the postoperative period was observed. CONCLUSION: The results of analysis show the SILS cholecystectomy to be a good and comparable alternative to multiport cholecystectomy in the rate of complications, the length of hospitalization and postoperative recovery. The ideal candidates for the procedure are younger patients with lower BMI without the signs of acute inflammation. The further advantages, except excellent cosmetis result, is needed to confirm in randomized studies.

Intradermal running suture versus 3M™ Vetbond™ tissue adhesive for wound closure in rodents: a biomechanical and histological study.

BACKGROUND: Although tissue adhesives and traditional sutures were compared in numerous studies during the early stages of healing, it has to be clarified, from the histological and biomechanical point of view, how the differences develop during the later phases. METHODS: Twenty-four male Sprague-Dawley rats were used and divided into 2 groups: the IRS (intradermal running suture) and G (glue) groups. Two parallel full-thickness skin incisions were made on the back of each rat. Wounds in the IRS group were closed by an IRS, whereas wounds in the G group were closed using tissue adhesive (n-butylcyanoacrylate). Rats were sacrificed 7 and 22 days after surgery. RESULTS: Similar wound tensile strengths of glued and sutured wounds were measured on days 7 (IRS = 10.3 ± 1.7 g/mm(2) vs. G = 12.9 ± 4.0 g/mm(2), p = 0.9612) and 22 (IRS = 95.6 ± 15.7 g/mm(2) vs. G = 85.6 ± 16.4 g/mm(2), p = 0.2502) after surgery. Histology revealed a significantly increased amount of granulation tissue formation in glued wounds on day 7. The difference in granulation tissue formation was reduced until day 22. CONCLUSIONS: Tissue adhesive based on n-butylcyanoacrylate presents a fair alternative to traditional suture wound closure techniques.

[Regularities of resumption and metabolic maintenance of estrus cycles in domestic ruminants].

The review summarizes information from literature and results of author's own investigation concerning regularities of estrus cycles resumption and conditions of metabolic maintenances of estrus cyclicity in cows. It discusses problems of lenghtening of the anoestrus interval, alteration of cyclicity rhythm and normal estrus cycles resumption in domestic ruminant during first months of lactating period.

[Effect of motor activity of different intensity upon the blood composition and respiratory function in domestic animals during their first months of life].

Responses of the blood content, breathing function and gaseous metabolism to changes of motional activity level in calves in the first 30 days of a postnatal period were investigated. Keeping of calves in conditions natural for mature animals at different motor activity levels as compared with the locomotion limitation leads to a lesser reduction of hemoglobin content, haematocrit ratio, red cells and reticulocytes count in blood of calves during first 30 days of life. In comparison with calves with additional motor activity, 10-day old calves with natural motor activity and locomotion limitation showed an increase of the protein level and reduction of glucose and cholesterol in the blood. Locomotion limitation of calves during the first 30 days of postnatal period caused reduction of the blood oxygen carrying capacity (erythrocytes and reticulocytes count) with simultaneous decrease of breathing function and gaseous metabolism efficiency (breathing output, minute ventilation, carbon dioxide output and oxygen uptake).

[Comparative study of electric excitability and metabolism in the assessment of vitality of the ischemized muscles of the amputated limb before replantation]. / Sravnitel'noe izuchenie élektrovozbudimosti i metabolizma v otsenke zhiznesposobnosti ishemizirovannykh myshts amputirovannoi konechnosti pered replantatsiei.

The authors have studied the dynamic changes of metabolic processes and the functional and the structural preservation of the muscles under the influence of heat ischemia (18-21 degrees C) on 29 amputated posterior extremities of 21 adult dogs of the both sexes. It has been shown that direct muscle excitability disappears 5 hours after the influence of heat ischemia, although after 6 hours of observation the values of the metabolic processes in the muscles made 35-40% of the basic level. The character of the changes in the muscle excitability gives an idea of the duration of action of heat ischemia and the preservation of vitality of the amputated extremity only up to the moment of its complete disappearance. The final irreversible ultrastructural lesions of the overwhelming majority of the myocytes appear during the period of 6 to 8 hours of action of heat ischemia.

[Dependence of Na, K-ATPase enzyme activity on the surface properties and charge of the substances interacting with the cell membrane]. / Zavisimost' fermentativnoi aktivnosti Na, K-ATFazy ot poverkhnostnykh svoistv i zariada vzaimodeistvuiushchikh s kletochnoi membranoi veshchestv.

The surface activity and effect of histone, sodium deoxycholate and Triton X-100 on N+,K+-ATPase have been compared. It has been found that the coefficient of surface tightness on the borderline of suspension of ATPase containing membranes/air decreases with the increase in concentrations of these agents. The enzyme activity undergoes biphasic modification increasing with lower and decreasing with higher concentrations of the agents. The effectiveness of the agents depends on the charge of their molecules. The mechanism of interaction between Na+,K+-ATPase and the above modifiers is discussed.

[Effect of the A-factor on the adenylate level in Streptomyces griseus]. / Vliianie A-faktora na uroven' adenilatov u Streptomyces griseus.

The adenylate content of various strains of Streptomyces griseus was measured. With respect to the ATP and ADP content the strains capable of spore formation, streptomycin synthesis and A-factor (2-isocapryloyl-3-hydroxymethyl-4-hydroxybutyrolactone) synthesis differed from the A-factor deficient mutants. The addition of the A-factor to the recipient strains decreased the intracellular content of ATP and the ATP/ADP ratio. The strain which is not an A-factor recipient did not modify the ATP content when the A-factor was added to the medium.

[Effect of pH on ATPase activity and 18-O metabolism catalyzed by membrane preparations of Na,K-ATPase from guinea pig kidneys]. / Vliianie pH na ATFaznuiu aktivnost' i 180-obmen, kataliziruemye membrannymi preparatami na,K-ATPazy iz pochek morskoi svinki.

The effect of pH in the incubation medium on ATPase activity and the direct 18O-exchange, catalyzed by initial and treated by surface active agents membrane preparations of Na, K-ATPase has been studied. The pH dependence of the ratio between the direct 18O exchange and Na,K-ATPase activity was detected; this ratio being equal to 4,5 +/- +/- 0.6, 1.5 +/- 0.1 and 0.4 +/- 0.1 at the pH values of 6.1, 7.5 and 9.0, respectively. The pretreatment of preparations by DOC or histone H2a, used in both activatory and inhibitory-amounts, abolished the effect of acid pH and made the ratio practically the same at 6.1 and 7.5 pH values. Both agents did not affect the action of the alcaline pH value equal to 9.0. Triton X-100 was not able to change the pH dependence of the ratio.

[Effect of surface-active agents on Na, K-ATPase from guinea pig kidneys]. / Vliianie poverkhnostno-aktivnykh veshchestv na Na, K-ATFazu iz pochek morskoi svinki.

The effect of surface active agents on the activity of Na, K-ATPase and on the direct medium 18O exchange in the membrane preparations of the guinea pig kidney has been studied. The medium 18O exchange was considered as a character of the K+-dependent stage in ATPase reaction. Low concentration of all the surface active agents were shown to stimulate, and high concentrations -- to inhibit both ATPase and medium 18O exchange. The relation between medium 18O exchange and Na,K-ATPase activity was found to be equal to 1.5 +/- 0.1. The treatment of preparations by activating amounts of the surface active agents resulted in lowering this relation up to 1.0 +/- 0.09 and 1.3 +/- 0.04 for DOC and triton X-100, correspondently, due to a stronger stimulation of ATPase activity than of medium 18O exchange. With the inhibiting amounts of triton X-100 and histone H2a, this relation did not change, but it decreased in the presence of equal amounts of DOC.