Mesh inguinal herniorrhaphy: a ten-year review

Inguinal herniorrhaphy remains one of the most common surgical operations, with approximately 10 to 20 per cent performed for recurrence. Reviews by specialized hernia centers show mesh repair has a recurrence rate of 0.2 per cent. Detractors of this repair include increased cost, technical difficulty, and risk for infection. The purpose of this study was to compare mesh versus nonmesh inguinal herniorrhaphy at a large teaching institution. From 1985 to 1994, 892 patients underwent primary repair for inguinal hernia at the Veterans Administration Hospital at Memphis, TN. Patients were stratified by repair [Lichtenstein (Mesh), open anterior (Bassini, Marcy, McVay, and Shouldice), laparoscopic (Lap), and preperitoneal (Post)]. Operative time for Mesh repair (111 +/- 2 minutes) was longer than for Bassini or McVay (91 +/- 2 and 98 +/- 2 minutes; P < 0.05), and Lap repairs were longer than all others (192 +/- 16 minutes; P < 0.05). Hospital stay averaged 2.2 +/- 0.1 days for Mesh versus 2.6 +/- 0.1 days for all repairs combined (P = not significant). Mesh patients developed four wound infections (1.0%), none requiring mesh removal, versus nine infections (1.8%) in other groups (P = not significant). One Mesh patient (0.3%) developed recurrence, compared with 16 (3.5%) with open anterior repair (P < 0.01). Inguinal herniorrhaphy using an open mesh repair technique provides superior recurrence rates without increasing risk for infection, length of stay, or technical difficulty.     

A myosin III from Limulus eyes is a clock-regulated phosphoprotein

The lateral eyes of the horseshoe crab Limulus polyphemus undergo dramatic daily changes in structure and function that lead to enhanced retinal sensitivity and responsiveness to light at night. These changes are controlled by a circadian neural input that alters photoreceptor and pigment cell shape, pigment migration, and phototransduction. Clock input to the eyes also regulates photomechanical movements within photoreceptors, including membrane shedding. The biochemical mechanisms underlying these diverse effects of the clock on the retina are unknown, but a major biochemical consequence of activating clock input to the eyes is a rise in the concentration of cAMP in photoreceptors and the phosphorylation of a 122 kDa visual system-specific protein. We have cloned and sequenced cDNA encoding the clock-regulated 122 kDa phosphoprotein and show here that it is a new member of the myosin III family. We report that Limulus myosin III is similar to other unconventional myosins in that it binds to calmodulin in the absence of Ca2+; it is novel in that it is phosphorylated within its myosin globular head, probably by cAMP-dependent protein kinase. The protein is present throughout the photoreceptor, including the region occupied by the photosensitive rhabdom. We propose that the phosphorylation of Limulus myosin III is involved in one or more of the structural and functional changes that occur in Limulus eyes in response to clock input.     

A prospective study of short- and long-term neuropsychological outcomes after traumatic brain injury in children.

Longitudinal neuropsychological outcomes of traumatic brain injury (TBI) were investigated in 53 children with severe TBI, 56 children with moderate TBI, and 80 children with orthopedic injuries only. Neuropsychological functioning was assessed at baseline, at 6- and 12-month follow-ups, and at an extended follow-up (a mean of 4 years postinjury). Mixed model analyses revealed persistent neuropsychological sequelae of TBI that generally did not vary as a function of time postinjury. Some recovery occurred during the first year postinjury, but recovery reached a plateau after that time, and deficits were still apparent at the extended follow-up. Further recovery was uncommon after the first year postinjury. Family factors did not moderate neuropsychological outcomes, despite their demonstrated influence on behavior and academic achievement after childhood TBI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of CYP2D1 inhibition on the behavioural effects of d-amphetamine

In rats, amphetamine (AMP) conversion to 4-OH-AMP is metabolized by CYP2D1, the rat equivalent of the human enzyme CYP2D6. To determine the impact of impaired AMP metabolism on its behavioural effects, AMP-induced hyperactivity, AMP discrimination and AMP self-administration were examined in male Wistar rats with or without pretreatment with the CYP2D1 inhibitors quinine and budipine. In vivo, quinine (20 mg/kg) and budipine (10 mg/kg) increased the plasma area under the curve of AMP 4-fold and 3.6-fold respectively, and decreased the plasma levels of 4-OH-AMP, 3-fold and 8.6-fold, confirming that the doses used suppressed CYP2D1 activity. Both inhibitors prolonged AMP-induced hyperactivity (0.3 mg/kg) and prolonged the duration of AMP-appropriate responding for periods of up to 90 min post-AMP administration in a drug discrimination procedure. In rats given a preload dose of AMP (0.8 mg/kg) 3 h prior to the self-administration test session, CYP2D1 inhibition resulted in fewer AMP infusions being taken compared with rats receiving the AMP preload dose alone. These studies indicate that AMP is responsible for the behavioural effects seen in rats and that a rat phenocopy model of the human CYP2D6 deficiency state can be produced by CYP2D1 inhibitors.     

Legal perceptions of science and expert knowledge.

In the past half century, expert testimony has played an increasingly important role in American litigation. As the volume of expert testimony has grown, so have issues surrounding its admissibility into evidence. In the past decade, a trilogy of U.S. Supreme Court cases redefined the rules governing admissibility. This article reviews these cases and examines some of the assumptions about expert knowledge implicit in the opinions. It argues that the opinions ask judges to assume the role of scientific methodologists. Together, the 3 opinions reflect what Steven Cole calls a realist-constructivist view of science. Science is socially constructed both in the laboratory and in the wider community, but the construction is constrained by input from the empirical world. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic and drug use determinants of smoking status in an urban adult population of Black African descent

We examined the influence of socioeconomics and drug use on current smokers (N = 137) and nonsmokers (N = 143) from an urban adult population of Black African descent. Median participant age was 33 years (range = 20-59). Smokers consumed a median of eight cigarettes/day (range = 0-35). Interestingly, 86% smoked fewer than 15 cigarettes/day and only 8% smoked menthol cigarettes. Socioeconomic and drug use variables significantly associated with smoking status in univariate analyses were included in a multiple logistic regression model that controlled for gender and age. Compared with nonsmokers, smokers were less likely to be university educated, more likely to be divorced, separated, or widowed, more likely to be current alcohol users, and more likely to be current marijuana users. Unexpectedly, household income and employment status were not associated with smoking status. Among current alcohol users, smokers consumed three times the number of drinks per month that nonsmokers consumed (p<.001). Among current marijuana users, smokers consumed more than five times the number of joints per month that nonsmokers consumed (p<.001). Overall, lower education levels, divorce, and alcohol and marijuana use were significantly associated with increased likelihood of smoking among this population.     

Effects of the antimigraine compound zolmitriptan (''Zomig'') on psychomotor performance alone and in combination with diazepam in healthy volunteers

Posterior lenticonus is a protrusion of the posterior capsule and cortex into the vitreous. The etiology is widely debated because of the rare nature of the condition. Lenticonus can present with concurrent ocular conditions, which can disrupt normal visual development. Currently, the only treatment option for posterior lenticonus is lensectomy, which may still have a reduced chance of visual success secondary to the associated disease. Although strabismus and amblyopia are commonly associated, keratoconus has not previously been reported with unilateral posterior lenticonus. Considering treatment of the associated condition may allow the patient to delay or forego surgical intervention.     

Introduction to the Special Section on Health and Cognitive Function.

Numerous factors related to health and diseases have been studied in relation to cognitive function. It has been shown that across the life span, systemic medical diseases can negatively impact cognitive function. Factors that influence the development of medical diseases, such as poor health habits, biological risk factors, hormones, genetic factors, exposure to environmental toxins, and certain treatments for disease, can also have an adverse effect on cognitive function. Conversely, factors such as high levels of education, good health habits, and some treatments for disease can be protective. Included in this special section are 6 empirical articles that examine the relation of health or disease to cognitive function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multi-angle Imaging SpectroRadiometer (MISR) instrument descriptionand experiment overview

The Multi-angle Imaging SpectroRadiometer (MISR) instrument is scheduled for launch aboard the first of the Earth Observing System (EOS) spacecraft, EOS-AM1. MISR will provide global, radiometrically calibrated, georectified, and spatially coregistered imagery at nine discrete viewing angles and four visible/near-infrared spectral bands. Algorithms specifically developed to capitalize on this measurement strategy will be used to retrieve geophysical products for studies of clouds, aerosols, and surface radiation. This paper provides an overview of the as-built instrument characteristics and the application of MISR to remote sensing of the Earth