Impact of Mesh and Fixation on Chronic Inguinal Pain in Lichtenstein Hernia Repair : 5-Year Outcomes from the Finn Mesh Study

Objective To find out the mesh fixation technique that minimises chronic pain in Lichtenstein hernioplasty. Summary background data Mesh fixation may affect chronic pain and recurrence after inguinal hernia surgery, but long-term results of comparative trials are lacking. Methods Lichtenstein hernioplasty was performed under local anaesthesia on 625 patients in day care units. The patients were randomised to receive either a cyanoacrylate glue (n = 216), self-gripping mesh (n = 202) or non-absorbable 3-0 polypropylene sutures (n = 216) for the fixation of mesh. A standardised telephone interview or postal questionnaire was conducted 5 years after the index operation. The patients with complaints suggesting recurrence or chronic pain (visual analogue scale >= 3, 0-10) were examined clinically. The rate of occasional pain, chronic severe pain, recurrence, re-operations, daily use of analgesics, overall patient satisfaction and sensation of a foreign object were recorded. Results A total of 82% of patients (n = 514) completed the 5-year audit including 177, 167 and 170 patients in the glue, self-fixation and suture groups, respectively. There were no significant differences in the incidence of pain (7-8%), operated recurrences (2-4%), overall re-operations (4-5%), need for analgesics (1-2%), patient's satisfaction (93-97%) or in the feeling of a foreign object (11-18%) between the study groups. Conclusion The choice of the mesh or fixation method had no effect on the overall long-term outcome, pain or recurrence of hernia. Less penetrating fixation (glue or self-gripping mesh) is a safe option for the fixation of mesh in Lichtenstein hernia repair.Peer reviewe

Remote Sensing methods for power line corridor surveys

AbstractTo secure uninterrupted distribution of electricity, effective monitoring and maintenance of power lines are needed. This literature review article aims to give a wide overview of the possibilities provided by modern remote sensing sensors in power line corridor surveys and to discuss the potential and limitations of different approaches. Monitoring of both power line components and vegetation around them is included. Remotely sensed data sources discussed in the review include synthetic aperture radar (SAR) images, optical satellite and aerial images, thermal images, airborne laser scanner (ALS) data, land-based mobile mapping data, and unmanned aerial vehicle (UAV) data. The review shows that most previous studies have concentrated on the mapping and analysis of network components. In particular, automated extraction of power line conductors has achieved much attention, and promising results have been reported. For example, accuracy levels above 90% have been presented for the extraction of conductors from ALS data or aerial images. However, in many studies datasets have been small and numerical quality analyses have been omitted. Mapping of vegetation near power lines has been a less common research topic than mapping of the components, but several studies have also been carried out in this field, especially using optical aerial and satellite images. Based on the review we conclude that in future research more attention should be given to an integrated use of various data sources to benefit from the various techniques in an optimal way. Knowledge in related fields, such as vegetation monitoring from ALS, SAR and optical image data should be better exploited to develop useful monitoring approaches. Special attention should be given to rapidly developing remote sensing techniques such as UAVs and laser scanning from airborne and land-based platforms. To demonstrate and verify the capabilities of automated monitoring approaches, large tests in various environments and practical monitoring conditions are needed. These should include careful quality analyses and comparisons between different data sources, methods and individual algorithms

A missense substitution A49T in the steroid 5-alpha-reductase gene (SRD5A2) is not associated with prostate cancer in Finland

Prostatic steroid 5-alpha-reductase gene (SRD5A2) encodes a critical enzyme involved in the conversion of testosterone to dihydrotestosterone. A germline mis-sense substitution (A49T) leads to a variant SRD5A2 protein, which has a 5-fold higher in vitro V max than the wild-type protein (Ross et al, 1998; Makridakis et al, 1999). The A49T variant was recently associated with 2.5 to 3.28-fold increased risk of prostate cancer (PC) in African-American and Hispanic men (Makridakis et al, 1999). Also, Jaffe et al (2000) reported an association between A49T and more aggressive disease among Caucasian patients. Here, we report that the prevalence of the A49T variant in 449 Finnish PC patients was 6.0%, not significantly different from 6.3% observed in 223 patients with benign prostatic hyperplasia or 5.8% in 588 population-based controls (odds ratio for PC 1.04, 95% C.I. 0.62–1.76 P = 0.89). There was no association between A49T and the family history of the patients nor with tumour stage or grade. Our results argue against a prominent role of the A49T variant as a genetic risk factor for prostate cancer development and progression in the Finnish population. © 2001 Cancer Research Campaign www.bjcancer.co

Factors predicting chronic pain after open inguinal hernia repair : a regression analysis of randomized trial comparing three different meshes with three fixation methods (FinnMesh Study)

Correction: Volume: 22 Issue: 5 Pages: 819-819 DOI: 10.1007/s10029-018-1788-y WOS:000446065400016Chronic pain after inguinal hernioplasty is the foremost side-effect up to 10-30% of patients. Mesh fixation may influence on the incidence of chronic pain after open anterior mesh repairs. Some 625 patients who underwent open anterior mesh repairs were randomized to receive one of the three meshes and fixations: cyanoacrylate glue with low-weight polypropylene mesh (n = 216), non-absorbable sutures with partially absorbable mesh (n = 207) or self-gripping polyesther mesh (n = 202). Factors related to chronic pain (visual analogue scores; VAS ae 30, range 0-100) at 1 year postoperatively were analyzed using logistic regression method. A second analysis using telephone interview and patient records was performed 2 years after the index surgery. At index operation, all patient characteristics were similar in the three study groups. After 1 year, chronic inguinal pain was found in 52 patients and after 2 years in only 16 patients with no difference between the study groups. During 2 years' follow-up, three (0.48%) patients with recurrences and five (0.8%) patients with chronic pain were re-operated. Multivariate regression analysis indicated that only new recurrent hernias and high pain scores at day 7 were predictive factors for longstanding groin pain (p = 0.001). Type of mesh or fixation, gender, pre-operative VAS, age, body mass index or duration of operation did not predict chronic pain. Only the presence of recurrent hernia and early severe pain after index operation seemed to predict longstanding inguinal pain.Peer reviewe

Meaningful learning with mobile devices: pre-service class teachers’ experiences of mobile learning in the outdoors

The authors consider the use of mobile learning environment ActionTrack in teacher education. Pre-service class teachers’ (N = 277) experiences of the mobile learning environment were measured with a 7-point Likert-scale questionnaire based on seven attributes of meaningful learning. Students’ ratings for different attributes were analysed quantitatively. The authors conclude that, based on this analysis, it is possible to create meaningful learning experiences using ActionTrack. All the measured attributes of meaningful learning obtained positive values. In the mobile learning events of this study, three attributes arose as the essential features: mobile learning in the outdoors was primarily considered collaborative, active and contextual.</p

Sliding and abrasive wear behaviour of HVOF- and HVAF-sprayed Cr3C2-NiCr hardmetal coatings

This paper provides a comprehensive characterisation of HVOF- and HVAF-sprayed Cr3C2-25 wt.% NiCr hardmetal coatings. One commercial powder composition with two different particle size distributions was processed using five HVOF and HVAF thermal spray systems. All coatings contain less Cr3C2 than the feedstock powder, possibly due to the rebound of some Cr3C2-rich particles during high-velocity impact onto the substrate. Dry sand-rubber wheel abrasive wear testing causes both grooving and pull-out of splat fragments. Mass losses depend on inter- and intra-lamellar cohesion, being higher (≥70 mg after a wear distance of 5904 m) for the coatings deposited with the coarser feedstock powder or with one type of HVAF torch. Sliding wear at room temperature against alumina involves shallower abrasive grooving, small-scale delamination and carbide pull-outs, and it is controlled by intra-lamellar cohesion. The coatings obtained from the fine feedstock powder exhibit the lowest wear rates (≈5×10-6 mm3/(Nm)). At 400 °C, abrasive grooving dominates the sliding wear behaviour; wear rates increase by one order of magnitude but friction coefficients decrease from ≈0.7 to ≈0.5. The thermal expansion coefficient of the coatings (11.08×10-6 °C-1 in the 30-400 °C range) is sufficiently close to that of the steel substrate (14.23×10-6 °C-1) to avoid macro-cracking

Tribology of HVOF- and HVAF-sprayed WC-10Co4Cr hardmetal coatings: A comparative assessment

This paper provides a comprehensive assessment of the sliding and abrasive wear behaviour of WC-10Co4Cr hardmetal coatings, representative of the existing state-of-the-art. A commercial feedstock powder with two different particle size distributions was sprayed onto carbon steel substrates using two HVOF and two HVAF spray processes. Mild wear rates of <10-7mm3/(Nm) and friction coefficients of 480.5 were obtained for all samples in ball-on-disk sliding wear tests at room temperature against Al2O3 counterparts. WC-10Co4Cr coatings definitely outperform a reference electrolytic hard chromium coating under these test conditions. Their wear mechanisms include extrusion and removal of the binder matrix, with the formation of a wavy surface morphology, and brittle cracking. The balance of such phenomena is closely related to intra-lamellar features, and rather independent of those properties (e.g. indentation fracture toughness, elastic modulus) which mainly reflect large-scale inter-lamellar cohesion, as quantitatively confirmed by a principal component analysis. Intra-lamellar dissolution of WC into the matrix indeed increases the incidence of brittle cracking, resulting in slightly higher wear rates. At 400\ub0C, some of the hardmetal coatings fail because of the superposition between tensile residual stresses and thermal expansion mismatch stresses (due to the difference between the thermal expansion coefficients of the steel substrate and of the hardmetal coating). Those which do not fail, on account of lower residual stresses, exhibit higher wear rates than at room temperature, due to oxidation of the WC grains.The resistance of the coatings against abrasive wear, assessed by dry sand-rubber wheel testing, is related to inter-lamellar cohesion, as proven by a principal component analysis of the collected dataset. Therefore, coatings deposited from coarse feedstock powders suffer higher wear loss than those obtained from fine powders, as brittle inter-lamellar detachment is caused by their weaker interparticle cohesion, witnessed by their systematically lower fracture toughness as well

Hemin and Cobalt Protoporphyrin Inhibit NLRP3 Inflammasome Activation by Enhancing Autophagy : A Novel Mechanism of Inflammasome Regulation

Inflammasomes are intracellular protein platforms, which, upon activation, produce the highly proinflammatory cytokines interleukin (IL)-1 beta and IL-18. Heme, hemin and their degradation products possess significant immunomodulatory functions. Here, we studied whether hemin regulates inflammasome function in macrophages. Both hemin and its derivative, cobalt protoporphyrin (CoPP), significantly reduced IL-1 beta secretion by cultured human primary macrophages, the human monocytic leukemia cell line and also mouse bone marrow-derived and peritoneal macrophages. Intraperitoneal administration of CoPP to mice prior to urate crystal-induced peritonitis alleviated IL-1 beta secretion to the peritoneal cavity. In cultured macrophages, hemin and CoPP inhibited NLRP3 inflammasome assembly by reducing the amount of intracellular apoptosis-associated speck-like protein containing a caspase-recruitment domain (ASC). The reduction of ASC was associated with enhanced autophagosome formation and autophagic flux. Inhibition of autophagy prevented the CoPP-induced depletion of ASC, implying that the depletion was caused by increased autophagy. Our data indicate that hemin functions as an endogenous negative regulator of the NLRP3 inflammasome. The inhibition is mediated via enhanced autophagy that results in increased degradation of ASC. This regulatory mechanism may provide a novel approach for the treatment of inflammasome-related diseases. (C) 2016 S. Karger AG, BaselPeer reviewe

Prostate MRI added to CAPRA, MSKCC and Partin cancer nomograms significantly enhances the prediction of adverse findings and biochemical recurrence after radical prostatectomy

Background To determine the added value of preoperative prostate multiparametric MRI (mpMRI) supplementary to clinical variables and their role in predicting post prostatectomy adverse findings and biochemically recurrent cancer (BCR). Methods All consecutive patients treated at HUS Helsinki University Hospital with robot assisted radical prostatectomy (RALP) between 2014 and 2015 were included in the analysis. The mpMRI data, clinical variables, histopathological characteristics, and follow-up information were collected. Study end-points were adverse RALP findings: extraprostatic extension, seminal vesicle invasion, lymph node involvement, and BCR. The Memorial Sloan Kettering Cancer Center (MSKCC) nomogram, Cancer of the Prostate Risk Assessment (CAPRA) score and the Partin score were combined with any adverse findings at mpMRI. Predictive accuracy for adverse RALP findings by the regression models was estimated before and after the addition of MRI results. Logistic regression, area under curve (AUC), decision curve analyses, Kaplan-Meier survival curves and Cox proportional hazard models were used. Results Preoperative mpMRI data from 387 patients were available for analysis. Clinical variables alone, MSKCC nomogram or Partin tables were outperformed by models with mpMRI for the prediction of any adverse finding at RP. AUC for clinical parameters versus clinical parameters and mpMRI variables were 0.77 versus 0.82 for any adverse finding. For MSKCC nomogram versus MSKCC nomogram and mpMRI variables the AUCs were 0.71 and 0.78 for any adverse finding. For Partin tables versus Partin tables and mpMRI variables the AUCs were 0.62 and 0.73 for any adverse finding. In survival analysis, mpMRI-projected adverse RP findings stratify CAPRA and MSKCC high-risk patients into groups with distinct probability for BCR. Conclusions Preoperative mpMRI improves the predictive value of commonly used clinical variables for pathological stage at RP and time to BCR. mpMRI is available for risk stratification prebiopsy, and should be considered as additional source of information to the standard predictive nomograms.Peer reviewe