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Background: The endoscopic totally extraperitoneal (TEP) mesh repair is nowadays a well-established tension-free method for inguinal hernia repair. Mainly based on animal studies and case reports, a concern about the risk of postoperative infertility was expressed. This clinical study aimed to evaluate the risk of infertility due to obstructive azoospermia in men of fertile age who underwent a bilateral hernia repair. Methods: Over 3 years (2005-2008) 59 male patients, 18-60 years of age, underwent a bilateral TEP repair. Twenty-one of them were prospectively ('light mesh') and 38 retrospectively ('heavy mesh') evaluated for testicular volume and perfusion, serum levels of sexual hormones, ejaculate volume, and number of spermatic cells. Those parameters were determined preoperatively (prospective group) and not earlier than 3 months postoperatively (both groups). Results: No significant difference between pre- and postoperative values was detected in the prospectively studied group. All postoperative parameters were within the normal range in the retrospective group. There was no evidence of impaired fertility in any patient due to the operation. Conclusion: The standardized TEP technique for simultaneous bilateral inguinal hernia repair in male patients was not associated with a higher risk for postoperative infertility after mesh implantation. The use of heavy-weight meshes had no negative effect on fertility. [ABSTRACT FROM AUTHOR]

This article focuses on a study related to the treatment of microcirculatory disorders in acute liver failure by an endothelin- a receptor antagonist. Hepatocellular damage in acute liver failure (ALF) results both as a direct consequence of the initiating agent and indirect from the release of proinflammatory and cytotoxic mediators from activated, non-parenchymal sinusoidal-lining cells. Microcirculatory disorders are closely correlated to dysfunction of the liver during ALF. The treatment with selective antagonists of the endothelin-A-Receptor is a promising therapeutic approach of ALF by reducing microcirculatory lesions and their consequences affecting sinusoidal endothelium and hepatocytes.

Cytoprotective proteins are highly involved in cellular injury and regeneration, apoptosis and inflammation in the setting of solid organ transplantation. In renal transplants, expression of protective proteins is demonstrable in the early ischemia/reperfusion phase. The aim of the study was to investigate the effects of the cytoprotective protein heme oxygenase-1 (HO-1) induced by the substance hemin in the setting of isogeneic renal transplantation. Thirty-five isogeneic male Lewis rats (200-250 g) were divided into three groups. In group I and II researchers performed total nephrectomy following orthotopic kidney transplantation.

Researchers studied a selective endothelin-A receptor antagonist for its potential influence on the microcirculation in the setting of partial liver transplantation. Ninetyeight isogeneic Lewis rats were divided into 4 groups: (I) partial liver transplantation, (II) partial liver transplantation treated with the Darusentan immediately before reperfusion, (III) full-size liver transplantation, (IV) sham operation. Subsequently, the liver microcirculation was evaluated by intravital microscopy, and survival, liver function, and morphology were followed up to the 14th day. Compared with full-size transplanted animals, rats subjected to partial liver transplantation without Darusentan, group (I), showed a lower survival rate. These animals displayed severe microcirculatory lesions characterized by a significantly decreased perfusion rate, increased leukocyte velocity, and increased leukocyte adhesion. Disintegration of endothelium and increased recruitment of Kupffer cells were a frequent morphologic finding. The Darusentan-treated group (II) showed improved survival as well as improved parameters of microcirculatory function and morphology.