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The Lichtenstein hernioplasty has become a popular method in inguinal hernia repair. This study compared two methods of mesh fixation and wound closure. Forty-six men with unilateral inguinal hernia were randomized into two groups. In the control group polypropylene mesh was anchored with 3/0 Dexon sutures, fascia and skin were closed with sutures 3/0 Dexon and 3/0 Monosof. In the study group, the mesh was secured with butyl-2-cyanoacrylate adhesive and the fascia and skin were also glued with the adhesive. The costs of materials, duration of the operation, amount of postoperative analgesic doses, pain score after the first and the 7th postoperative day and return to daily activity were recorded. No recurrences during the mean follow-up of 4.7 months were observed and the cosmetic effect was very good. In the study group with tissue adhesive the patients had significantly lower pain score after the first postoperative day and had a tendency to require less analgetic doses and to return earlier to their daily activity. Duration of the operation was similar in both groups. The cost of sutures and tissue adhesive used in both procedures was comparable. The use of tissue adhesive in mesh fixation and wound closure seems to be a promising technique in Lichtenstein hernia repair., (2004 S. Karger AG, Basel.)

A new released cecal ligation (RCL) technique of septic shock induction in rats is presented. It is relatively not complicated, fast, not expensive, and it mimics the human pathology. Presented procedure seems to be a useful alternative for the cecal ligation alone or cecal ligation and puncture to induce experimental septic shock in small laboratory animals.

Aim: Microcirculatory disturbances are important early pathophysiological events in various organs during acute pancreatitis. The aim of the study was to evaluate changes in microperfusion of the pancreas, liver, kidney, stomach, colon, skeletal muscle, and to investigate the influence of heparin on the organ microcirculation in caerulein-induced experimental acute pancreatitis., Methods: Acute pancreatitis was induced by 4 intraperitoneal injections of caerulein (Cn) (15 microg/kg). The organ microcirculation was measured by laser Doppler flowmetry. Serum interleukin 6 and hematocrit levels were analysed., Results: Acute pancreatitis resulted in a significant drop of microperfusion in all examined organs. Heparin administration (2 x 2.5 mg/kg) improved the microcirculation in pancreas (36.9 +/- 4% vs 75.9 +/- 10%), liver (56.6 +/- 6% vs 75.2 +/- 16%), kidney (45.1 +/- 6% vs 79.3 +/- 5%), stomach (65.2 +/- 8% vs 78.1 +/- 19%), colon (69.8 +/- 6% vs 102.5 +/- 19%), and skeletal muscle (59.2 +/- 6% vs 77.9 +/- 13%). Heparin treatment lowered IL-6 (359.0 +/- 66 U/mL vs 288.5 +/- 58 U/mL) and hematocrit level (53 +/- 4% vs 46 +/- 3%)., Conclusion: Heparin administration has a positive influence on organ microcirculatory disturbances accompanying experimental Cn-induced acute pancreatitis., (Copyright 2004 The WJG Press ISSN)

The aim of the study was to investigate the impact of L-arginine (nitric oxide donor), L-NNA (NO synthase inhibitor), heparin and procaine on the pancreas' microcirculation, serum interleukin 6 (IL-6) level, and microscopic alterations of the pancreatic gland in acute pancreatitis (AP) in rats. AP was induced by 4 i.p. injections of cerulein (15 micrograms/kg/h). Microcirculatory values of the pancreas were measured by means of laser Doppler flowmetry 5 h after the first cerulein injection. Remarkable morphologic changes in the pancreas, including parenchymal necrosis, an elevation of serum IL-6 activity, and significant drop of pancreatic capillary perfusion was observed in rats with NO synthase inhibition. L-arginine improved the pancreatic microcirculation but worsened the microscopic alterations within the pancreas. Heparin had a beneficial effect on the microcirculatory values, serum IL-6 activity, and morphologic changes. Procaine had no effect on the course of AP. Authors conclude that heparin, improving the pancreatic capillary blood perfusion, may be considered as a promising therapeutic agent in acute pancreatitis.

The aim of this study was to investigate the impact of L-arginine (nitric oxide synthase substrate), L-NG-nitro-L-arginine (nitric oxide synthase inhibitor), and heparin on the pancreas microcirculation, serum IL-6 level and microscopic alterations of the pancreas in acute pancreatitis in rats. Acute pancreatitis was induced by 4 i.p. injections of cerulein (15mg/kg). Microcirculatory values were measured by means of laser Doppler flowmetry 5 h after the first cerulein injection. Remarkable histopathological changes in the pancreas, including parenchymal necrosis, an elevation of serum IL-6 level, and a significant drop of pancreatic capillary perfusion was observed in rats with nitric oxide synthase inhibition. L-arginine improved the pancreatic microcirculation but worsened the microscopic alterations within the pancreas. Heparin had a beneficial effect on the microcirculatory values, serum IL-6 concentration, and morphologic changes. Authors conclude that inhibition of nitric oxide synthase aggravates acute pancreatitis. L-arginine treatment improves pancreatic perfusion but potentiates morphological alterations. Heparin, improving the microcirculation and inflammatory changes within the pancreatic gland, may be considered as a promising therapeutic agent in acute pancreatitis.

Local microcirculatory dysfunction within the pancreatic gland might be an important factor in the conversion of oedematous to necrotizing pancreatitis. Therapeutic agents, improving the pancreatic blood flow, might be valuable in acute pancreatitis treatment. An influence of nitric oxide, heparin and procaine treatment on microcirculatory values in acute pancreatitis (AP) in rats was investigated. Acute pancreatitis was induced by i.p. injection of cerulein in four doses of 15 microg kg-1 each at 1-h intervals. The rats with pancreatitis were divided into five groups, 12 animals each. One group remained without treatment, four groups were treated i.p. either with NO synthase inhibitor L-NNA (2x25 mg kg-1 or heparin 2x2.5 mg kg-1 or L-arginine 2x100 mg kg-1 or procaine 2x25 mg kg-1. Five control groups, ten animals each, received saline, L-NNA, heparin, L-arginine or procaine only. Five hours after the first ceruleine injection microcirculatory values within the pancreas were measured by means of laser Doppler flowmetry. Acute pancreatitis caused a significant drop of microcirculatory value to 37% of the basal value. The L-NNA administration resulted in a further insignificant reduction of the pancreatic blood flow to 34%. An improvement of microcirculation was observed in rats with pancreatitis receiving heparin (76%) and L-arginine (72%). Procaine had no effect on microcirculatory disturbances within the pancreas in rats with pancreatitis. Cn-induced acute pancreatitis (AP) causes microcirculatory deterioration within the pancreas. Heparin and nitric oxide donor, L-arginine, might be considered as therapeutic agents, improving the diminished pancreatic tissue perfusion observed in acute pancreatitis. Procaine does not improve the pancreatic blood flow in acute pancreatitis., (Copyright 1997 The Italian Pharmacological Society.)

Unlabelled: Microcirculatory disturbance may play an important role in the development of severe pancreatitis, leading the edematous form of the disease to the necrosis. The aim of this study was to investigate the impact of L-arginine (nitric oxide donor), L-NN (NO synthase inhibitor), and heparin on the pancreas microcirculation, serum interleukin-6 level and microscopic alterations of the pancreas in acute pancreatitis in rats., Methods: Acute pancreatitis was induced in 72 rats by four intraperitoneal injections of cerulein (CN) (15 micrograms/kg body weight). Microcirculatory values was measured by means of laser Doppler flowmetry five hours after the first cerulein injection. The animals were divided into the following groups (12 rats each), according to the kind of treatment: Group 1 (CN), Group 2 (CN + L-NNA), Group 3 (CN + L-arginine), Group 4 (CN + Heparin), Group 5 (Control), Group 6 (L-NNA), Group 7 (L-arginine), Group 8 (Heparin)., Results: Remarkable morphologic changes in the pancreas including parenchymal necrosis, an elevation of serum IL-6 level, and significant drop of pancreatic capillary perfusion was observed in rats with NO synthase inhibition. L-arginine improved the pancreatic microcirculatory but worsened the microscopic alteration within the pancreas. Heparin had a beneficial effect on the microcirculatory values, serum IL-6 concentration, and morphologic changes., Conclusions: Acute pancreatitis causes microcirculatory disturbance within the pancreatic gland. The inhibition of NO synthase aggravates AP. L-arginine treatment improves pancreatic perfusion but potentiates morphologic alterations. Heparin has beneficial impact on AP, it improves the microcirculation and inflammatory changes within the pancreatic gland.