Magnetic resonance visualization of iron-loaded meshes in patients with pain after inguinal hernia repair.

PURPOSE: Chronic post-operative inguinal pain (CPIP) is defined as pain lasting more than 3 months and the incidence is less than 4% after laparoscopic hernia repair. CPIP can have several causes. In this study, we aimed to show that 3D-iron loaded mesh preparations are useful in radiological evaluation of post-operative complications, especially patients with chronic pain and the mesh status of operated inguinal hernia cases. METHODS: A total of 450 cases who had been operated for inguinal hernia with 3D-iron loaded mesh and who had ongoing pain at the post-operative period were included in this study. MRI (Magnetic Resonance Imaging) was performed at the post-operative 90th day of the seven symptomatic (groin pain, limitation of movement) cases which were operated using a 3D-iron loaded mesh, 10 × 15 cm in size, (DynaMeshEndolap visible with 25% MRI-visible filaments, FEG TextiltechnikmbH, Aachen, Germany) for inguinal hernia repair to evaluate mesh status, localization, and local complications. Gradient echo sequences in the sagittal, axial, and coronal sections on MRI were discussed by two radiologists. Mesh localizations, their relationship with surrounding structures and their complications related with mesh were evaluated by two radiologists (D.Y, D.E.T.S). RESULTS: No significant radiological findings related to defined anatomical structures were found in the MRI images of the study group. The dimensions measured on the sagittal, axial and coronal images were correlated with original mesh sizes and no significant shrinkage was detected. CONCLUSION: Mesh position and deformation as shrinkage can be the mesh-related cause of pain. The incidence of CPIP in our patients is less than 2%. 3D-iron loaded meshes were monitored with MRI in CPIP patients and there was no mesh-related changes found in our study. The use of MRI-visible meshes will most likely help us to monitor mesh preparations and show potential time-dependent changes in mesh characteristics and consequent complications. In case of doubtful clinical postoperative hernia recurrence or chronic groin pain, mesh position can be identified by MRI and unnecessary surgical intervention can be avoided.

Different kinds of reactive oxygen and nitrogen species were detected in colon and breast tumors.

Several studies have shown the involvement of reactive oxygen species (ROS; O2*-, hypochlorite, hydroxyl radical, hydrogen peroxide) in carcinogenesis. With certain pathologies, nitric oxide (NO) is formed and can interact with superoxide radical (O2*-) resulting in the propagation of the highly reactive species, peroxynitrite. In order to study the molecular mechanisms underlying the ability of reactive oxygen and nitrogen species (RONS) to mediate carcinogenesis, we have measured ROS, NO, and peroxynitrite content of cancerous tissues obtained from colon and breast carcinoma cases by chemiluminescence technique. All ROS were significantly increased in cancerous colon tissues with hypochlorite making the most important contribution and suggesting the role of inflammatory cells. NO was also increased and the peroxynitrite concentration was higher in cancerous samples. For breast carcinoma cases, only O2*- was significantly increased. Hypochlorite was not detected excluding the contribution of inflammatory cells. NO concentrations were not significantly different, therefore, ROS might originate by change in the redox state of the tissue.

Estrogens ameliorate remote organ inflammation induced by burn injury in rats.

OBJECTIVE AND DESIGN: The present study was designed to investigate the role of sex steroids in burn-induced remote organ injury. MATERIAL OR SUBJECTS: Male Wistar albino rats were given burn trauma (n=39), and underwent castration or sham operation at 2 h following the burn injury. TREATMENT: Rats were injected sc with either 17beta estradiol benzoate (E2, 10 mg/kg) or an androgen receptor blocker cyproterone acetate (CPA, 25 mg/kg) or vehicle, immediately after burn and at 12 h. METHODS: At 24 h of burn insult, rats were decapitated. Blood samples for RIA of testosterone, estradiol and tumor necrosis factor (TNF)-alpha and the tissue samples for myeloperoxidase activitiy (MPO) were taken. ANOVA student's t test was used for statistical analysis. RESULTS: Castration, antiandrogen and E2 treatments increased plasma estradiol levels and depressed burn-induced elevation in serum TNF-alpha levels. In the liver and lung, burn-induced increase in MPO was reduced by E2 and castration, while CPA was effective in reducing neutrophil infiltration only in the liver. CONCLUSION: We propose that treatment with estrogens or antiandrogens might be applicable in clinical situations to ameliorate systemic inflammation induced by burn.

The effect of hyperthermic preconditioning on the immune system in rat peritonitis.

OBJECTIVE: To assess whether hyperthermic (HT) preconditioning prevents the lethal effects of peritonitis by acting on the immune system. DESIGN: Prospective, controlled, experimental study. SETTING: Laboratory and animal facility of the university. MATERIALS: Adult male Sprague-Dawley rats. INTERVENTIONS: In the HT groups animals were subjected to hyperthermia (42 degrees C, 15 min) and 8 h later peritonitis (P) (n = 14) was induced. In the normothermic (NT) groups, animals were subjected to normothermia (38 degrees C, 15 min) and 8 h later peritonitis (n = 14) was induced. Each group had a corresponding sham laparotomy group (n = 14). Six rats from each group were allowed to live 7 days for survival. In the control group (n = 4), rats were not anesthetized or heat treated. MEASUREMENTS AND RESULTS: Sixteen hours after peritonitis and laparotomy, rats were killed. Blood was taken to measure the percentage of CD(4)(+), CD(8)(+), CD(4)(+)CD(56)(+), CD(8)(+) CD(11 b)(+), NK(+), B cells and the level of tumor necrosis factor. Grading of peritonitis and the measurement of free oxygen radicals in the peritoneal fluid were undertaken. All rats in the HT + P and sham laparotomy groups survived for 7 days, while in the NT + P group two rats died in 7 days. HT decreased the severity of peritonitis and increased the free oxygen radicals in the peritoneal fluid; however, the difference did not reach statistical significance. HT prevented the decrease in CD(4)(+) and B cells and the increase in CD(11 b)(+). CONCLUSIONS: HT may have a protective role in sepsis by reducing the severity of peritonitis. A causal relation between hyperthermia and an improved immune system seems possible.