Effects of enoxaparin on the healing of abdominal wall in rats: study on breaking strength and histopathology. (57/300)

PURPOSE: To evaluate the influence of enoxaparin on the abdominal wall healing. METHODS: Sixty Wistar male rats were randomly distributed into two experimental groups. Group E: consisted of 30 rats, submitted to abdominal suture and treated with enoxaparin in a dose of 1 mg/kg of body weight, subcutaneously administered from immediate postoperative until the 7th day; Group C: consisted of 30 rats submitted to abdominal suture and treated with the equivalent dose per volume of NaCl 0.9%. The animals were submitted to median laparotomy and were operated again at the 3rd, 7th or 14th postoperative day for the resection of the anterior abdominal wall. The tissue's stretching resistance was tested and a histopathological evaluation was performed. Through Mann-Whitney's U test, a statistical analysis was conducted considering significant values for p <0.05. RESULTS: The tensile breaking strength presented a median of 0.64N for group C and 0.41N for group E (p=0.60) at the 3rd postoperative day; of 2.27N for group C and of 4.32N for group E (p=0.01) at the 7th POD; of 5.72N for group C and of 6.62N for group E (p=0.97) at the 14th POD. In relation to the histopathological study, the results did not show significant statistical differences, except for the amount of collagen at the 7th POD, which medians were 2 on group C and 1 on group E (p=0.007). CONCLUSION: Considering the conditions in which this study was conducted, the administration of enoxaparin led to an strengthening of the tissue's breaking resistance at the 7th POD; on the histopathological exam, a significant difference was observed at the 7th POD, with a better collagen disposition on group C.  (+info)

Comparison of RCAS1 and metallothionein expression and the presence and activity of immune cells in human ovarian and abdominal wall endometriomas. (58/300)

BACKGROUND: The coexistence of endometrial and immune cells during decidualization is preserved by the ability of endometrial cells to regulate the cytotoxic immune activity and their capability to be resistant to immune-mediated apoptosis. These phenomena enable the survival of endometrial ectopic cells. RCAS1 is responsible for regulation of cytotoxic activity. Metallothionein expression seems to protect endometrial cells against apoptosis. The aim of the present study was to evaluate RCAS1 and metallothionein expression in human ovarian and scar endometriomas in relation to the presence of immune cells and their activity. METHODS: Metallothionein, RCAS1, CD25, CD69, CD56, CD16, CD68 antigen expression was assessed by immunohistochemistry in ovarian and scar endometriomas tissue samples which were obtained from 33 patients. The secretory endometrium was used as a control group (15 patients). RESULTS: The lowest metallothionein expression was revealed in ovarian endometriomas in comparison to scar endometriomas and to the control group. RCAS1 expression was at the highest level in the secretory endometrium and it was at comparable levels in ovarian and scar endometriomas. Similarly, the number of CD56-positive cells was lower in scar and ovarian endometriomas than in the secretory endometrium. The highest number of macrophages was found in ovarian endometriomas. RCAS1-positive macrophages were observed only in ovarian endometriomas. CD25 and CD69 antigen expression was higher in scar and ovarian endometriomas than in the control group. CONCLUSION: The expression of RCAS1 and metallothionein by endometrial cells may favor the persistence of these cells in ectopic localization both in scar following cesarean section and in ovarian endometriosis.  (+info)

Sonography in identification of abdominal wall lesions presenting as palpable masses. (59/300)

OBJECTIVE: Abdominal wall lesions often present as palpable masses. The purpose of this presentation is to provide an overview of the sonographic appearances of different abdominal wall lesions. METHODS: Patients were scanned with high-frequency (5- to 12-MHz) linear transducers. Extended or panoramic views were recorded often to show the lesion in perspective to adjacent structures in the abdominal wall. RESULTS: The different layers of the abdominal wall could be clearly shown on high-frequency sonography, and the abdominal wall abnormalities were recognized in all the patients. CONCLUSIONS: Hernias are the most common abdominal wall lesions. Herniated bowel loops have variable appearances depending on their air-fluid content and degree of obstruction. Localized fluid collections in the abdominal wall (seromas, liquefying hematomas, and abscesses) can be well visualized. More infrequently, tumors or vascular lesions can be identified in the abdominal wall.  (+info)

Cardiac axis in fetuses with abdominal wall defects. (60/300)

OBJECTIVES: To investigate whether fetal cardiac axis is affected by the presence of an abdominal wall defect (AWD) independent of congenital heart disease (CHD). METHODS: Video ultrasound records from fetuses with AWDs identified from 1991-2004 were reviewed. Still images of the fetal cardiac four-chamber view were digitized and two independent examiners measured the cardiac axis. A cardiac axis of >65 degrees or <25 degrees was considered abnormal. Maternal charts were reviewed for fetal echocardiogram results and neonatal charts were reviewed for confirmation of CHD and type of AWD. RESULTS: Of 17 fetuses with omphalocele and 42 fetuses with gastroschisis, 16 (27%) fetuses had an abnormal cardiac axis, while only seven (12%) had CHD. Fifty-nine percent of fetuses with omphalocele had an abnormal cardiac axis and 35% had CHD. Fourteen percent of fetuses with gastroschisis had an abnormal cardiac axis and 2% had CHD. Of 43 fetuses with a normal cardiac axis, only one had CHD. CONCLUSIONS: Fetal cardiac axis is often affected by the presence of an AWD independent of CHD. A normal cardiac axis in fetuses with AWDs is an accurate predictor of the absence of CHD, the negative predictive value being 97.7%.  (+info)

Effect of umbilical ring constriction on Wharton's jelly. (61/300)

OBJECTIVE: The turgor of Wharton's jelly depends on osmotic and hydrostatic pressures. We tested the hypothesis that umbilical ring constriction has an impact on umbilical venous hemodynamics and thus on the volume of Wharton's jelly. METHODS: In a cross-sectional study of 237 low-risk singleton pregnancies, the cross-sectional area of the fetal end of the umbilical cord was determined using sonography at 20-41 weeks of gestation. The inner area of the two arteries and the vein was also measured and subtracted from the cord area to calculate the area of Wharton's jelly. Based on the Bernoulli equation, the degree of vein constriction at the umbilical ring was assessed using the blood velocity increment at the abdominal inlet. Regression analysis and SD-score statistics were used to construct mean values and to assess the effects. The dataset was also analyzed for gender-specific effects. RESULTS: The umbilical cord cross-sectional area increased with gestational age during the period 20-31 weeks, remaining essentially stable thereafter. The Wharton's jelly increased with gestational age from 20 until 31-32 weeks of gestation and remained at the same level for the rest of the pregnancy. At mid-gestation, on average 70% of the cord cross-sectional area was occupied by Wharton's jelly; at 31 weeks and later this value was 60%. Umbilical vein constriction was associated with reduced umbilical cord cross-sectional area and Wharton's jelly in female fetuses (P = 0.0007 and P = 0.003, respectively), but not in male fetuses. CONCLUSIONS: Under physiological conditions, umbilical ring constriction affects umbilical vein hemodynamics, with corresponding effects on the umbilical cord cross-sectional area and the amount of Wharton's jelly. Interestingly, the effects are gender-specific.  (+info)

Fungal abdominal wall abscess in a renal transplant recipient. (62/300)

The incidence of fungal infection is significantly higher in patients with endstage renal disease and renal transplant recipients than in normal individuals. Candidia Albicans is an uncommon cause of abdominal wall abscess. We describe a 37 year-old renal transplant recipient with such an infection. He presented with atypical clinical manifestations and an insidious course, but was successfully treated with antifungal therapy.  (+info)

The role of bovine preserved peritoneum in rats ventral hernia: a histological evaluation. (63/300)

PURPOSE: To assess the role of preserved bovine parietal peritoneum as a material for hernia repair in a rat ventral hernia model. METHODS: An abdominal wall defect (15mm x 25mm) was created in Wistar male rats (n=40). Control animals (n=20) had the polypropylene (PP) mesh sutured into the defect, whereas bovine preserved peritoneum (BPP) was used in experimental group (n=20). After 7 and 28 days, the abdominal wall was taken off and histological studies of the amount of collagen by Sirius Red stain and morphometric evaluation consisted in quantitative analysis of the collagen by using specific software (Imagelab). The Mann-Whitney, Kruskal-Wallis and ANOVA tests were applied for statistical analysis (pd"0.05). RESULTS: Histological examination revealed no difference between the BPP and PP groups (p = 0.55 NS). CONCLUSION: BPP is suitable for the closure of ventral hernias in rat model as shown by its morphological properties.  (+info)

Perforated carcinoma of the caecum presenting as necrotising fasciitis of the abdominal wall, the key to early diagnosis and management. (64/300)

BACKGROUND: Necrotising Fasciitis is a life threatening soft tissue infection which requires aggressive, early surgical management. CASE PRESENTATION: We present a rare case of a retroperitoneal perforation of a carcinoma of the caecum presenting as a necrotising fasciitis of the anterior abdominal wall. CONCLUSION: This case highlights the importance of early aggressive debridement to healthy tissue limits, the consideration of a rare underlying cause, and the scope for plastic surgical reconstruction in order that aggressive initial surgery can be adequately performed.  (+info)