Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the surgical treatment of the hypertrophy of the prostata we use few operative methods. Some of them are older than 80 years. Mainly we use modify Harris--Hryntschak technics. Still 1889 Bassini made known operative method for onquinoscrotal hernia which has been with some modifications used up to this day. Bacause of the very low mortality and a pour local complication in last 5 years, if there is in the same time hypertrophy of the prostata and hernia, we combined open transvesical prostatectomy with a plastic of onquinoscrotal hernia. The authors give own operative technic, its advantage and the review on own casuistic.
 ...
PMID:[Simultaneous transvesical prostatectomy and reconstructive surgery of inguinoscrotal hernia]. 6 32

Fifty-three neonates and seven pediatric patients were treated with extracorporeal membrane oxygenation from September 1983 until April 1986. Venoarterial bypass was achieved by cannulating the right atrium via the right internal jugular vein and the aortic arch via the right common carotid artery. In the neonatal group, 40 infants with acute respiratory failure were treated, and 36 (90%) survived. Five infants with congenital heart disease were treated and three (60%) survived. Among the eight patients with congenital diaphragmatic hernia, there were three (38%) survivors. In the pediatric group, four patients were treated for ventricular failure after cardiac operations. Two were weaned from bypass, with one long-term survivor. Three patients with acute respiratory failure were treated, with one survivor. salvaging high-risk neonates with minimal morbidity and mortality. It has also been useful in the support of infants with congenital heart disease and congenital diaphragmatic hernia. In pediatric patients one cannot expect to get results that are comparable to those found in neonates. Still, this modality can be useful in salvaging some moribund patients with pulmonary or cardiac failure, or both.
 ...
PMID:Extracorporeal membrane oxygenation for respiratory and cardiac failure in infants and children. 380 95

The embryology and surgical anatomy of the inguinal area is presented with emphasis on embryologic and anatomic entities related to surgery. We have presented the factors, such as patent processus vaginalis and defective posterior wall of the inguinal canal, that may be responsible for the genesis of congenital inguinofemoral herniation. These, together with impaired collagen synthesis and trauma, are responsible for the formation of the acquired inguinofemoral hernia. Still, we do not have all the answers for an ideal repair. Despite the latest successes in repair, we, to paraphrase Ritsos, are awaiting the triumphant return of Theseus.
 ...
PMID:Embryologic and anatomic basis of inguinal herniorrhaphy. 837 22

Understanding the complex multisystem dysfunction in the infant with a congenital hernia of the posterolateral diaphragm is still evolving and has changed radically during the last decade. The reduction in lung mass, in conjunction with surfactant deficiency and diminished compliance, leads to initial deficiencies in oxygenation and carbon dioxide (CO2) removal. This may then be potentiated by an extremely reactive hypoplastic pulmonary arterial system. Treatment no longer is focused on the operative repair but rather on the components of the pathophysiological process that are potentially reversible. Thus, extracorporeal membrane oxygenation and delay of repair until resolution of pulmonary artery hypertension have become mainstays of therapy and are probably responsible for increasing the survival rate in the patient who presents early with respiratory distress from 50% to 65%. Still far from acceptable, these results are giving impetus to new approaches to therapy including drugs such as nitric oxide, fetal intervention including open repair, and lung transplantation.
 ...
PMID:Congenital diaphragmatic hernia: an overview. 893 50

Prosthetic materials proved to be a real success for incisional hernia repair, still there is a strong debate regarding the best mesh and procedure to be used. Most surgeons avoid full-thickness replacement with intraperitoneal mesh because, occasionally, an intense inflammatory response may lead to severe adhesions or enterocutaneous fistula. Still, interposition of the omentum between the abdominal contents and the mesh is a safe and natural method of visceral protection. Since July 1998, we used this technique in 33 cases treated for antero-lateral abdominal defects, operations that were followed by only 15% early and 3% late complications. Monofilament polypropylene meshes (Bard, Davol Inc.) were used in most cases. Although our results need further evaluation, may be considered favourable on short and medium term comparing to Romanian experience, which is based mainly on extraperitoneal placement of the mesh. The study is a good opportunity to review the literature regarding this issue.
 ...
PMID:[Incisional hernia repair using full-thickness intraperitoneal mesh]. 1514 11

Congenital hypothyroidism (CH) is the commonest treatable cause of mental retardation. The prevelance is 1/3000 - 1/4000 live births worldwide. The importance of CH is that, the longer the diagnosis of CH is delayed, the higher the risk of mental retardation and neurologic sequale; such as poor motor coordination, ataxia, spastic diplegia, muscular hypotonia, strabismus, learning disability and diminished attention span. The most common cause of permenant CH is thyroid dysgenesis (85-90%) in which the transcription factors TTF1,TTF2 and PAX8 would appear to be obvious candidate genes in the aetiology. Especially cardiac defects and some other birth defects are described in patients with CH. Inborn errors of thyroid hormonogenesis are responsible for 10-15% of CH cases and usually have autosomal recessive inheritance, consistent with a single gene mutation. Transient CH is very common in prematures with an estimate of 10% of CH babies identified on newborn screening, or 1 in 40,000 neonates. CH neonates are usually symptom-free and the most encountered symptoms are prolonged jaundice, large fontanelles and umbilical hernia. In general, the extent of clinical findings depends on the cause, severity and duration of hypothyroidism. An elevated TSH>20 microm Iu/L and a decreased concentration of T4 confirms the diagnosis of CH. Infants with permanant abnormalities of thyroid function mostly have a serum TSH concentration > 50 microm Iu/L. Ultrasonography, thyroid scintigraphy, bone x ray of the knee and serum thyroglobulin concentration are the other essentials after diagnosis to clarify the status of the thyroid and the severity of hypothyroidism. The higher doses of 10- 15 microm g/kg/day and the commencement of treatment before 2 weeks gave rise to better long term outcome of CH patients. In the follow up of the patients noncompliance is the most important problem and serum freeT4 or T4 and TSH should be obtained at each visit to adjust the doses of L-thyroxine. Still a small number of patients with severe hypothyroidism in utero or reflected by clinical signs and symptoms extremely low T4 levels and delayed bone age may have intellectual deficits despite normal intelligence.
 ...
PMID:Congenital hypothyroidism clinical aspects and late consequences. 1644 57

Pulmonary hypoplasia is the principal cause of morbidity and mortality in infants with congenital diaphragmatic hernia (CDH). Still, relatively little is known about the mechanisms causing lung hypoplasia associated with CDH. The differentiation from alveolar epithelial cells type II (AECs-II) into alveolar epithelial cells type I (AECs-I) is one of the key processes in lung development in late gestation. It is well known that increased lung expansion promotes differentiation into AECs-I phenotype, whereas reduced lung expansion promotes AECs-II phenotype. The recent availability of cell-specific molecule markers for AECs-I and AECs-II has provided an opportunity to study the various characteristics of these two cell types. To test the hypothesis that the differentiation of AECs-II to AECs-I is impaired in the CDH hypoplastic lung, we investigated molecular markers for AECs-I [ICAM-1, T1alpha, aquaporin 5 (AQP5)] and molecular markers for AECs-II [thyroid transcription factor-1 (Ttf-1), surfactant protein (SP)-B and C] in the nitrofen-induced CDH lung. Fetal rat lungs of normal (n = 7) and nitrofen-treated (n = 14) dams were harvested on embryonic day 21. The expression of the ICAM1, T1alpha, AQP5, SP-B, C and Ttf-1 was analyzed in each lung by real-time reverse transcription polymerase chain reaction. Immunohistochemical studies were performed to evaluate the protein expression level of ICAM1 and Ttf1. Expression levels of ICAM-1, T1alpha and AQP5 were significantly reduced (P < 0.05) in the lungs from nitrofen-treated CDH animals compared to normal controls. ICAM-1 and AQP5 immunohistochemistry showed a diffuse pattern of expression in the alveolar cells in normal lungs. By contrast, the ICAM-1 and AQP5 positive cells were markedly reduced in hypoplastic lungs with CDH. On the other hand, the expression levels of Ttf-1, SP-B and C were significantly (P < 0.05) increased in the lungs from nitrofen-treated CDH animals compared to normal controls. The population of Ttf-1 positive cells was slightly increased in the lungs from nitrofen-treated animals in immunohistochemical study. Our results demonstrate that there is significant reduction in the proportion of AECs-I and increase in the proportion of AECs-II in the hypoplastic lung in the nitrofen-induced CDH. This data provides the first evidence to support the hypothesis that AEC differentiation is impaired in CDH hypoplastic lung.
 ...
PMID:Impaired alveolar epithelial cell differentiation in the hypoplastic lung in nitrofen-induced congenital diaphragmatic hernia. 1724 93

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. This should be a priority for our considerations, as fixating mesh puts it in stark contrast to the physiology and dynamics of the myotendineal structures of the groin. Following years of surgical practice, implant fixation, mesh shrinkage, and poor quality of tissue ingrowth still represent an unresolved issue in modern hernia repair. Conventional prosthetics used for inguinal hernia repair are static and passive. They do not move in harmony with the dynamic elements of the groin structure and, as a result, induce the ingrowth of thin scar plates or shrinking regressive tissue that colonizes the implants. The authors strongly believe that these characteristics may be a contributing factor for recurrences and patient discomfort. Other complications are reported in the literature to be a direct result of fixation of the implants, such as bleeding, nerve entrapment, hematoma, pain, discomfort, and testicular complications. To improve results by respecting the physiology and kinetics of the inguinal region, we felt that a new type of prosthesis should be designed that induces a more structured tissue ingrowth similar to the natural biologic components of the abdominal wall. This prosthetic device was specifically designed to be placed with no point fixation. This was achieved by using inherent radial recoil, vertical buffering, friction, and delivering the device in a constrained state. A secondary benefit of this "dynamic" design is that the implant moves in a three-dimensional way in unison with the movements of the myotendineal structures of the groin. The results appear to show that the three-dimensional structure not only acts as a suitable scaffold for a full thickness ingrowth of a tissue barrier but also seems to induce an ordered, supple, elastic tissue, which allows for neorevascularization and neoneural growth. The outcomes indicate a reduced impact of fibrotic shrinkage on the implant/scar tissue when compared with shrinkage of polypropylene meshes reported in the literature. This pilot study shows the features of such an implant in a porcine experimental model.
 ...
PMID:A new prosthetic implant for inguinal hernia repair: its features in a porcine experimental model. 2175 35

The results of laparoscopic treatment of rectal cancer have been evaluated in several randomized trials. Still, the validity of this approach remains controversial because of concerns regarding its oncological safety. In this review, oncological results of laparoscopic rectal resection were similar to those of laparotomy, with no observed survival difference. Conversion from laparoscopy to laparotomy seemed to be associated with worse oncological results and an increased post-operative morbidity including nervous sequelae. Intra-operative blood loss was significantly reduced with the laparoscopic approach, but post-operative morbidity was not different. Post-operative pain and length of hospital stay were decreased by the laparoscopic approach, and short-term quality of life was improved. There was no demonstration of significant reduction in late morbidity such as incisional hernia and bowel adhesions.
 ...
PMID:What is the established contribution of laparoscopy in the treatment of rectal cancer? 2314 1

Laparoscopic paraesophageal hernia repair is an operation that allows for relief of gastrointestinal and respiratory symptoms with a minimal recovery time and a high degree of satisfaction. It is a difficult and complex operation; however, if the important tenets are adhered to by surgeons with a lot of experience in laparoscopic PEH repair, the results are good. Patient selection is important. Older or frail patients who are asymptomatic should not have an operation, and some who are very symptomatic should probably consider just a reduction of their gastric volvulus and gastropexy. Still, most of the patients will be symptomatic and will be able to tolerate a laparoscopic definitive repair. The important aspects of repair include: complete resection of the hernia sac from the mediastinum, adequate esophageal mobilization, adequate closure of the hiatus, and fundoplication. The most troublesome aspect of the operation is the recurrence rate, which is up to 50% at 5 years of follow-up. Fortunately, most recurrences are asymptomatic and the vast majority of patients still have greatly improved quality of life.
...
PMID:Laparoscopic paraesophageal hernia repair. 2410 83


1 2 Next >>