A role for the collagen I/III and MMP-1/-13 genes in primary inguinal hernia?
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Abnormal collagen metabolism is thought to play an important role in the development of primary inguinal hernia. This is underlined by detection of altered collagen metabolism and structural changes of the tissue in patients with primary inguinal hernia. However, it is still unknown whether these alterations reflect a basic dysfunction of the collagen synthesis, or of collagen degradation. In the present study, we analysed type I and type III procollagen messenger ribonucleic acid (mRNA) and MMP-1 and MMP-13 mRNA in cultured fibroblasts from the skin of patients with primary inguinal hernia, and from patients without hernia (controls) by reverse transcription polymerase chain reaction (RT-PCR) and Northern Blot. The results indicated that the ratio of type I to type III procollagen mRNA was decreased in patients with primary hernia, showing significant differences as compared to controls (p = 0.01). This decrease was mainly due to the increase of type III procollagen mRNA. Furthermore, RT-PCR analysis revealed that the expression of MMP-1 mRNA in patients with primary hernia is equivalent to that of controls (p > 0.05). In addition, MMP-13 mRNA is expressed neither in patients with primary hernia nor in controls. We concluded that abnormal change of type I and type III collagen mRNAs contribute to the development of primary inguinal hernia, whereas the expressions of MMP-1 and MMP-13 mRNA appears not to be involved in the development of primary inguinal hernia. Thus, the knowledge on the transcriptional regulation of collagen in patients with primary inguinal hernia may help to understand the pathogenesis of primary inguinal hernia, and implies new therapeutic strategies for this disease.Keywords:
Procollagen peptidase
Northern blot
To study the dynamic changes of alpha 1 (I), alpha 1 (III) and alpha I (IV) procollagen mRNA and collagen-producing cells during CCl4 induced SD rat liver fibrogenesis (20 weeks).The investigations were performed using Northern blot analysis, in situ hybridization and immunohistochemical techniques.The increased expression of alpha 1 (III) procollagen mRNA during fibrogenesis by Northern blot analysis was the most predominant among the three mRNAs studied. However, the increase of alpha 1 (IV) procollagen mRNA expression occurred earlier, while the expression of alpha 1 (I) mRNA did not increase until the middle stage of the experiment. Desmin positive and/or smooth muscle actin positive Ito cells and myofibroblasts (MFs) in and around the necrotic areas expressed alpha 1 (I), alpha 1 (III) and alpha 1 (IV) procollagen mRNA signals detected by in situ hybridization during the early stage of the experiment. All the three procollagen mRNAs were mostly localized in fibroblasts (Fbs) and MFs in the septa during the mid and late stages of fibrosis.Fbs and MFs were considered as important Col I, Col III and Col IV producing cells in liver fibrosis. Sinusoid endothelia were involved in Col IV synthesis in the fibrotic liver.
Procollagen peptidase
Northern blot
Myofibroblast
Alpha (finance)
Hepatic stellate cell
Desmin
CCL4
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Abstract Background Pediatric inguinal hernia (PIH) is a common disease in children. Laparoscopic hernia repair (LHR) has developed rapidly in recent years, but there are still different opinions compared with traditional open hernia repair (OHR). The purpose of this study was to compare the advantages and disadvantages of LHR and OHR in the treatment of pediatric inguinal hernia. Methods We performed a retrospective review of all children (< 14 years) who underwent repair of inguinal hernia in the pediatric surgery center of the Affiliated Hospital of Qingdao University from January 2015 to December 2015. We collected the medical records of all the children and analyzed the clinical characteristics, operation-related information and follow-up. Results In the OHR group, 202 cases underwent unilateral inguinal hernia repair, and 43 cases underwent bilateral inguinal hernia repair. In the LHR group, 168 cases underwent unilateral inguinal hernia repair, and 136 cases underwent bilateral inguinal hernia repair. There was a significant difference in the operation time between the two groups, but there were no significant differences in postoperative hospitalization time and incidence of ipsilateral recurrent hernia between the two groups. The incidence rates of metachronous contralateral hernia (MCH) and surgical site infection in LHR group were significantly lower than those in the OHR group. Conclusion Our study shows that compared with OHR, LHR has the advantages of concealed incision, minimal invasiveness, reduced operation time, detection of contralateral patent processus vaginalis, and reduced incidence of MCH. In conclusion, LHR is safe and effective in the treatment of pediatric indirect inguinal hernia.
Hernia Repair
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Background: Worldwide, inguinal hernia repair is the commonest surgical procedure in general surgery, but the optimal repair technique for inguinal hernia has not been defined and accepted in most parts of Africa and other developing nations. The aim of this study was to determine the epidemiology of inguinal hernias and feasibility of mesh implants in our centre.
Methodology: This was a descriptive cross-sectional study of consecutive adult patients with uncomplicated inguinal hernias who received polypropylene mesh for repair of their inguinal hernias. Selection criteria included inguinoscrotal/inguinolabial hernia, recurrent or bilateral hernia or bubunoceles with wide defects. Descriptive statistics and tests of significance were done.
Results: Inguinal hernia represented 77.3% of all abdominal wall hernias encountered during the study. However, only 27.8% (100 patients) of the 360 patients that satisfied the inclusion criteria received mesh implants. Of the 100 patients studied, 31% had recurrent hernias, 48% harbored complete inguinoscrotal/inguinolabial hernia while 13% had incomplete inguinoscrotal hernia. Majority (86%) had unilateral hernia.The annual repair rates using mesh implants increased progressively from 4% in 2013 to 40% in 2017. A quarter (25%) had comorbidities. Majority (60%) of repairs were under general anesthesia. The overall postoperative complication rate was 14%. Wound infection rate was 3.5%. There was statistically significant difference in the rates of wound-related events between recurrent and primary inguinal hernias (p=0.000). There was no mortality or recurrence recorded in this study.
Conclusion: The uptake of mesh implants for inguinal hernia repair in our environment is low, though the trend is changing with higher proportions of patients accepting mesh implants in recent time. Elective inguinal hernia surgery with polypropylene mesh is feasible, safe, effective and reproducible in our setting.
Hernia Repair
Abdominal Hernia
Inguinal canal
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Hypertrophic scars
Procollagen peptidase
Northern blot
BETA (programming language)
Alpha (finance)
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Previous studies have suggested that procollagen types I and III are the major collagenous gene products of cultured human skin fibroblasts. In this study the expression of 10 different genes, encoding the subunit polypeptides for collagen types I-VI, by human skin fibroblasts in culture was analyzed by molecular hybridizations. Northern transfer analysis demonstrated the presence of specific mRNA transcripts for collagen types I, III, IV, V, and VI, but not for type II collagen. Quantitation of the abundance of these mRNAs by slot blot hybridizations revealed that type I, III, and VI procollagens were the major collagenous gene products of skin fibroblasts in culture. The mRNAs for type IV and V collagens represented only a small percentage of the total collagenous mRNA transcripts. Further analysis by in situ hybridization demonstrated that the majority of the cultured cells coexpressed the genes for type I, III, and VI procollagen pro-alpha chains. Further in situ hybridization analyses revealed the expression of type VI collagen genes in normal human skin. These data demonstrate that human skin fibroblast cultures can be used to study the transcriptional regulation of at least nine genetically distinct procollagen genes. The data further suggest that type VI collagen, in addition to types I and III, may be a major collagenous component of human skin.
Procollagen peptidase
Northern blot
Human skin
Type I collagen
Dermal fibroblast
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Procollagen peptidase
Northern blot
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Human skin fibroblasts were cultivated in confluent monolayers, retracting collagen lattices, retracting fibrin lattices and non‐retracting fibrin lattices and the expression of messenger RNA specific for the α 1 chain of type I procollagen comparatively studied by Northern blot and dot blot hybridization. Two factors contribute to the lower level of procollagen messenger RNA in collagen lattices the retraction and the nature of the fibrillar protein that constitutes the lattices. Fibrin lattices, when they do not retract, make as much collagen and procollagen mRNA as monolayer confluent cells.
Procollagen peptidase
Northern blot
Dot blot
Transcription
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To review the occurrence of contralateral inguinal hernia in infants and children who presented with unilateral inguinal hernia and underwent herniotomy in order to establish whether simultaneous contralateral exploration is a necessity in our environment.A retrospective study.Muhimbili National Hospital Paediatric surgical ward.Seven hundred and thirty two children.Twenty five infants and children developed an inguinal hernia on the contralateral side 2-76 months after herniotomy. Follow-up period was one to thirteen years. Six hundred and seventy one were boys and sixty one girls (M:F = 11:1). Right side presentation was seen in two-thirds of the children. Subsequent contralateral hernia occurrence was more common in girls (4.9%) and slightly higher in children above 12 months of age (3.5%) but these comparisons were not significant (p values were 0.45 and 0.89 and R.R. values were 0.97 and 0.67 respectively). Subsequent development of contra lateral hernia in children with left-sided hernia was high (6.7%) and this was statistically significant (p = 0.002, R.R. = 3.38).The risk of occurrence of contra-lateral inguinal hernia following unilateral inguinal herniotomy is not significantly excessive when compared by age or sex implying that routine exploration on the contralateral side in infants and children clinically presenting with unilateral inguinal hernia is not justified and we recommend herniotomy only when there is adequate clinical evidence of an inguinal hernia. Despite the significant risk of developing a contralateral hernia in children with left-sided hernia, the authors do not recommend routine right-sided exploration as the frequency is not high.
Presentation (obstetrics)
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Systematic review of the risk of developing a metachronous contralateral inguinal hernia in children
Abstract Background This study aims to establish the risk of developing a metachronous contralateral inguinal hernia (MCIH) following open repair of a unilateral inguinal hernia in children. Methods A systematic review was performed using a defined search strategy. Studies in which children undergoing open repair of a unilateral inguinal hernia without contralateral exploration and who were followed up for MCIH development were included. Results Of 5937 titles and abstracts screened, 154 full-text articles were identified for review; 49 papers were analysed with data on 22 846 children. The incidence of MCIH was 7·2 per cent overall, 6·9 per cent in boys and 7·3 per cent in girls (P = 0·381). Children with a left-sided inguinal hernia had a significantly higher risk of developing a MCIH than those with a right-sided hernia (10·2 versus 6·3 per cent respectively; P < 0·001). Conclusion Overall, in both boys and girls, 14 contralateral explorations are required to prevent one metachronous hernia. The risk of developing a MCIH appears unchanged in early childhood, with a slight reduction after 12 years of age. Children with a left-sided hernia have the greatest risk of developing a contralateral hernia, but ten explorations are still required to prevent one metachronous hernia. Most MCIHs occur in the first 5 years after unilateral inguinal hernia repair.
Hernia Repair
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ObjectiveTo analyze the proportion of incarcerated direct inguinal hernia(IDIH) to inguinal hernia and toshow the significance of herniography in diagnosis. MethodsOne case of bilateral IDIH was reported and the literatureswere reviewed to analyze the proportion of IDIH to incarcerated inguinal hernia, direct inguinal hernia and inguinal hernia.The herniography showed the significance in diagnosis of diverticular direct inguinal hernia(DDIH) , which was the mostcommon cause of IDIH.ResultsIn recent years, the proportion of IDIH to incarcerated inguinal hernia, direct inguinalhernia and inguinal hernia increased in elderly group in China. An evaluative herniography preoperative could demonstrate theDDIH and the ipsilateral multiple hernia.ConclusionsIts very important to confirm IDIH and DDIH. The proportion ofIDIH to inguinal hernia increases in elder. An evaluative herniography is of great value to the diagnosis of DDIH, which is themain cause of IDIH.
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