Initial experience with application of single layer modified Kugel mesh for inguinal hernia repair: Case series of 72 consecutive patients.

OBJECTIVE: This is an initial review of the safety and efficacy of anterior preperitoneal modified Kugel (MK) mesh herniorrhaphy application without using optional onlay mesh. METHODS: We retrospectively reviewed patients who underwent herniorrhaphy by a single surgeon from July 1st, 2009 to December 31st, 2010. During these 18 months, a total of 72 patients underwent single-layer MK mesh herniorrhaphy. Anterior preperitoneal approach was used to place the mesh. If the patient's inguinal hernia defect did not exceed the memory ring of MK mesh, the onlay mesh was omitted. Postoperative results (wound infection, recurrence, and chronic pain/discomfort) were recorded and analyzed. RESULTS: A total of 72 patients underwent anterior preperitoneal single layer MK mesh herniorrhaphy. One patient had recurrent hernia after 1 year and was treated with a laparoscopic transabdominal preperitoneal operation. The most common postoperative complaint was mild soreness which was self-resolving after 1 month. Mean total operative time (skin to skin) was 73 minutes. The average hospital stay was 2 days. Most of the postoperative complications including soreness (14%), pain for > 3 months (1.4%), and scrotal hematoma (1.4%) were self-resolving. One patient experienced wound infection, which was treated with oral antibiotics. One patient had recurrence 1 year after the operation. CONCLUSION: The postoperative complication and recurrence rates of single-layer MK mesh herniorrhaphy was comparable with previously reported tension-free repair. Single-layer application is safe and feasible. A longer follow-up period and larger study group with a control group are needed to verify our method.

Antiproliferation effect and mechanism of prostate cancer cell lines as affected by isoflavones from soybean cake.

The objectives of this study were to determine the antiproliferation effect of prostate cancer cell lines LNCaP and PC-3 as affected by 4 isoflavone fractions prepared from soybean cake and isoflavone standards genistein and daidzein. With the MTT test, most treatments were effective in inhibiting prostate cancer cell growth at a low dose of 5 and 10 mug/mL. In cell cycle analysis, the fractions of aglycon, a mixture of acetylglucoside and aglycon, as well as genistein and a combination of genistein and daidzein standards exhibited a high G2/M ratio for LNCaP, as did the acetylglucoside, genistein and a combination of genistein and daidzein standards for PC-3. Results of Western blotting revealed an increase in p53 protein expression of LNCaP following treatments of the aglycon fraction, genistein and a combination of genistein and daidzein standards. However, all the treatments did not affect Bcl-2 protein expression significantly in both LNCaP and PC-3 cells. A decline in cyclin B1 expression of LNCaP was observed for all the treatments, with the mixture of acetylglucoside and aglycon possessing the most pronounced effect. But for PC-3, a decrease in cyclin B1 expression was shown for all the isoflavones, with the exception of malonylglucoside, glucoside and acetylglucoside fractions. The outcome of this study may provide a basis for possible production of functional food in the future with soybean cake as raw material.