Sublay or onlay incisional hernia repair along with abdominoplasty: which is better? Long-term results.

PURPOSE: Estimation and comparison of results after incisional hernia repair (IHR) modo onlay or sublay with abdominoplasty in patients who lost the weight following Roux-en-Y Gastric Bypass (RYGB). Analysis and comparison of changes in quality of life (QL) of these patients prior to RYGB, before and after simultaneous IHR and abdominoplasty. METHODS: Clinical analysis involved 40 patients with abdominal disfigurement (following RYGB and massive weight loss) after one-time IHR sublay method with abdominoplasty-group 1 or IHR onlay method with abdominoplasty-group 2. We evaluated postoperative results and long-term QL changes (DAS24, SF-36 scales). RESULTS: We noted abnormal wound healing (2), pneumonia (3) and dysesthesia (3) in patients from group 1, and abnormal wound healing (2), seroma (2), pneumonia (2), and dysesthesia (4) in group 2. Quality of life was improved in the functional, esthetic and psychological aspects. CONCLUSIONS: One stage incisional hernia repair by onlay as well as sublay method with abdominoplasty are safe surgical methods improving the functioning of patients after major weight loss following RYGB. Sublay hernia repair and abdominoplasty was connected with longer time of the: operation, drainage, analgesic agents use, time to mobilization and to full oral diet than the onlay method. Significant improvement of the quality of life was noted after every subsequent step of surgical treatment in both groups. Reduction of the risk of BMI re-growth after bariatric surgery is related to the need for constant, specialized care for these patients at every stage of follow-up after bariatric surgery.

Adeno-associated virus vectors show variable dependence on divalent cations for thermostability: implications for purification and handling.

Recombinant adeno-associated virus (rAAV) shows significant promise as a vector for gene transfer in pre-clinical models of human disease, and is currently being evaluated in human clinical trials. As a consequence, increasing attention is being turned to the important tasks of optimizing rAAV titer, purity, and stability. We have observed dramatic variation in divalent cation dependence for thermostability of different rAAV vectors. To further investigate this observation, the thermostability of eight different vector constructs ranging in size from 73 to 107% of wild-type genome size (4.68 kilobases) was determined in the presence and absence of divalent cations. Virions containing smaller genomes (i.e., <85% wild type) were relatively divalent cation independent for thermostability. In contrast, virions containing recombinant genomes close to, or exceeding, wild-type size (i.e., >95% wild type) were dependent on divalent cations for thermostability. Genome sequence also appeared to be a factor in the thermostability of the larger rAAV vectors. These observations are of both practical and theoretical significance. Divalent cations should be included in all buffer solutions used during rAAV purification and storage, and unnecessary heat exposure avoided. These data also demonstrate that different recombinants of a particular virus should not be assumed to possess the same thermostability profile.

Transactivation of the p53 oncogene by E1a gene products.

Infection of quiescent rat kidney cells with human adenovirus is shown to transcriptionally stimulate (transactivate) the p53 oncogene. The increased transcription results in an accumulation of p53-specific mRNA in parallel with an increase in p53 protein levels, although there is a considerable delay between transcriptional activation and the detection of stable p53 mRNA and protein. The induction of p53 is detectable with two monoclonal antibodies recognizing different epitopes. The induction of p53 by adenovirus is delayed compared to induction by serum, and it occurs after the onset of adenovirus-induced cellular DNA replication. Thus, adenovirus-induced DNA replication bypasses a G0/G1 control point. Experiments with hydroxyurea show that p53 activation does not require continued cell cycling and thus is likely to be a direct consequence of viral gene expression. Finally, the induction of p53 is shown to be dependent on expression of the 289-residue product encoded by the viral E1a gene.

Mouse fetal thymus lobes cultured in IL-2 generate CD3+, TCR-gamma delta-expressing CD4-/CD8+ and CD4-/CD8- cells.

Whole, undisrupted, 14-day fetal mouse thymus lobes were liquid-cultured in medium supplemented with 10 U/ml rIL-2. The cells that emerged from these fetal thymus lobes grew in an IL-2-dependent manner and showed non-MHC-restricted cytolytic activity. By two-color flow microfluorimetric analysis they could be subdivided into CD4-/CD8+ and CD4-/CD8- subpopulations, both of which contained CD3+ cells. Northern analysis of total cellular RNA revealed full-length transcripts of gamma- and delta-message, predominantly the truncated (1.0 kb) beta- and no detectable alpha-message. Taken together, these results show that by culturing 14-day fetal thymus lobes in IL-2, in the absence of deliberate mitogen stimulation, CD3+, TcR-gamma delta-expressing CD4-/CD8+ and CD4-/CD8- T cells are obtained. Such cells may represent the precursors of similar cells found outside the thymus in adult mice.

Molecular basis of X-ray-induced mutation at the HPRT locus in human lymphocytes.

Human lymphocytes lacking functional HPRT enzyme after a dose of 300 rad X-radiation were cloned and the monoclonal populations expanded so that sufficient genomic DNA was obtained for Southern analysis. A total of 33 mutant clones were analysed. Wild-type clones showed no evidence of changes to the HPRT gene resolvable by Southern banding patterns whereas 17 of 33 mutant clones showed changes. The alterations observed included total gene deletions (3 clones) and partial gene deletions with or without the appearance of novel bands (12 clones). Two clones showed the appearance of novel bands only. There were no changes observed in 16 of the 33 mutant clones. Three clones showed changes inconsistent with deletion of portions of the gene. In these clones inversion seems to have been the most likely cause of the mutation. The spectrum of gene alterations following ionizing radiation appears different to that previously observed for spontaneous mutations. Consequently, ionizing radiation or radiomimetic agents would appear to be aetiologic, at the most, for only a minor proportion of in vivo somatic mutations.