Components separation technique for large abdominal wall defect / 대한외과학회지

Repairing large incisional hernia with abdominal wall reconstruction is a technically challenging problem for surgeons. We report our experience of large midline incisional hernia which was repaired successfully with components separation technique. A patient with incisional hernia, 35 x 20 cm in size, underwent operation following standard components separation technique. The aponeurosis of the external abdominal oblique muscle was longitudinally transected from the rectus sheath, and the external abdominal oblique muscle was separated from the internal abdominal oblique muscle. With further separation of the posterior rectus sheath from the rectus abdominis muscle, closure of the abdominal wall was attained without tension. The post-operative course was uneventful with minor wound seroma. The patient discharged safely, and no further complication in terms of recurrence and wound problem has occurred. Components separation technique could be a possible and effective treatment option for repair of large abdominal wall defect.

Cadaver as an experimental model to study abdominal wall tension

The use of cadaver as an experimental model to evaluate tension of the abdominal wall after aponeurotic incisions and muscular undermining is described on this article. The tension required to pull the anterior and the posterior rectus sheaths towards the midline was studied in fresh cadavers at two levels: 3 cm above and 2 cm below the umbilicus. Traction measurement was assessed with a dynamometer attached to suture loops on the anterior and posterior recti sheaths, close to the midline, above and below the umbilicus. The quotient of the force used to mobilize the aponeurotic site to the midline and its resulting displacement was called the traction index. These indices were compared in three situations: 1) prior to any aponeurotic undermining; 2) after the incision of the anterior rectus sheath and the undermining of the rectus muscle from its posterior sheath; and 3) after additionally releasing and undermining of the external oblique muscle. The experimental model described showed to be feasible to demonstrate the effects on tension of the abdominal wall after incisions and undermining of its muscles and aponeurosis.

O uso de cadáver como modelo experimental para a avaliação da tensão da parede abdominal após incisões aponeuróticas e descolamentos musculares é descrito neste artigo. A tensão necessária para levar a aponeurose anterior e posterior do músculo reto até a linha média foi estudada em cadáveres frescos em dois níveis: 3 cm superior e 2 cm inferiormente à cicatriz umbilical. As medidas de tração foram realizadas com o uso de um dinamômetro aclopado às alças realizadas com fio de sutura na aponeurose anterior e posterior dos retos, próximas à linha média, nos níveis supra e infra-umbilicais. A tração utilizada para mobilizar os pontos aponeuróticos até a linha média e seu deslocamento resultante foram denominados coeficiente de tração. Estes índices foram comparados em três situações: 1) anteriormente a qualquer descolamento; 2) após a incisão da aponeurose anterior do reto e o descolamento do músculo reto de sua aponeurose posterior; e 3) após, além da manobra anterior, a liberação e descolamento do músculo oblíquo externo. O modelo experimental descrito mostrou-se factível na avaliação da alteração da tensão na parede abdominal após incisões e descolamentos destes músculos e aponeuroses.

Research on Separation Characteristics of the Extracellular Algae-lysing Components from Three Algae-lysing Bacteria / 微生物学通报

Three algae-lysing bacteria (L7、L8、L18) have been isolated. We used starch medium,which has no passive effect on growth of the Anabaena flos-aquae as cutivate medium. After being cultivated for 4d on a reciprocal shaker at 30℃ and a speed of 100 r/min,the cultivate broth were centrifugated at a speed of 4000 r/min for 20min、filtrated with 0.22 ?m membrane,and condensed by vacuum rotary evaporator at 65℃. The sterile condensed bacteria-free filtrate obtained are dialysed,sedimentated by ethanol,extracted by organic solvents,absorbed by activated carbon. The molecular weight of the extracellular algae-lysing components of L7 are less than 3.5 kD,while the molecular weight of extracellular algae-lysing components of L8 and L18 are between 3.5 kD～7 kD; ethanol can not separate extracellular algae-lysing components from other componets efficiently; carbon tetrachloride can separate the extracellular algae-lysing components of L7 into water-layer efficiently,while petroleum ether can separate the extracellular algae-lysing components of L8 and L18 into water-layer efficiently,the ex-tracellular algae-lysing