Comparison of the Plasma and Hernia Sac Tissue Copper Levels in Direct and Indirect Inguinal Hernia Patients

Abstract

Although the inguinal hernia is among the most commonly encountered and well-described health problems all over the world, the etiology is still controversial. The aim of this study was to compare the plasma and hernia sac tissue copper levels in direct and indirect inguinal hernia patients. Plasma and hernia sac tissue copper levels obtained from patients operated under spinal anesthesia with primary direct (group I, n = 55, 45 male, mean age = 45.68 yr) and indirect (group II, n = 55, 40 male, mean age = 38.57 yr) hernias were detected by atomic absorption spectrophotometer. Significantly lower plasma and hernia sac tissue copper levels were detected in group I in comparison to group II (p < 0.001). Both plasma and hernia sac tissue copper levels were significantly lower in males when we compare the patients according to their sex characteristics, including both direct and indirect hernia groups (p < 0.05 and p < 0.01, respectively). Age was not a significant factor. The plasma and hernia sac tissue copper levels were significantly lower in direct hernia patients in comparison to indirect hernia patients. Copper is a cofactor of lysyl oxidase, an important enzyme in collagen tissue metabolism, so there might be a defect in the collagen synthesis of direct hernia patients because of the decreased activity of the lysyl oxidase. Further investigations are necessary to clarify this concept.

Effect of operating room care combined with home care for the postoperative rehabilitation and prognosis of gastric cancer patients with low PTEN gene expression

“…Postoperative body temperature care reduces the effects of low temperature on patient rehabilitation and prognosis, excluding unfavorable factors and promoting patient recovery (18). Various postoperative indicators demonstrated that rehabilitation status of the observation group was significantly better than that of the control group (p<0.01), suggesting that OR care could effectively improve patient rehabilitation and prognosis, which was consistent with relevant studies (19). When comparing the overall quality of life between the observation and control groups, the scores of quality of life and family adaptability and cohesion in the observation group were significantly higher than those in the control group, demonstrating patient improvement in these areas after care was provided (p<0.01).…”

Inguinal hernia repair using a synthetic long-term resorbable mesh: results from a 3-year prospective safety and performance study

“…Bellon et al [28] demonstrated increased levels of factors that help degradation of collagen as matrix metalloproteinase 2 (MMP-2) and transforming growth factor B1 expression in fascia transversalis of MIH patients compared with patients with LIH or control patients. Abci et al [29] found lower expression of the inhibitor of MMP-2: tissue inhibitor of metalloproteinase-2 in fascia transversalis in patients with MIH compared with those with LIH or control patients and Kayaoglu et al [30] showed lower levels of copper, a cofactor of an enzyme in collagen tissue metabolism, in plasma and in the hernia sac of MIH patients in comparison to LIH patients. A recently published article by Vestergaard et al [31] found that cumulative exposure to daily heavy lifting activities was associated with the risk of LIHs but not with MIH.…”

Connective tissue alteration in abdominal wall hernia

“…The interrelationship between these three factors is not fully established. However, it seems that there is reduced collagen synthesis by the fibroblasts 43,44 , decreased hydroxylation 32 , decreased cross-linking 46,47 and/or increased MMP activity 32,55,65,67,73 , causing accelerated collagen breakdown (Fig. 2).…”

“…Lysyl oxidases are copper dependent, and a study of the copper level in plasma and hernia sacs showed that the amount of copper was significantly lower in patients with a direct inguinal hernia than in people with an indirect inguinal hernia, which might reduce the lysyl oxidase activity 46 . The level of lysyl oxidase-like 1 was significantly lower in patients with a direct inguinal hernia than in controls 47 .…”