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Andrew H. Boyarsky

Bio: Andrew H. Boyarsky is an academic researcher from University of Medicine and Dentistry of New Jersey. The author has contributed to research in topics: Hernia & Cholecystectomy. The author has an hindex of 4, co-authored 5 publications receiving 217 citations.

Papers
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Journal ArticleDOI
TL;DR: This study represents the first attempt to define individuals with an abnormality in collagen production that may be specifically related to herniation, and suggests a constitutive and systemic increase in type III collagen synthesis may result in reduced collagen fibril assembly in the abdominal wall, eventually leading to the development of hernia.
Abstract: ObjectiveThe aim of this study was to determine if alterations in fibrillar collagen synthesis were associated with the development of inguinal hernias.Summary Background DataPrevious work has suggested that alterations in connective tissue accumulation may play a functional role in the development

189 citations

Journal ArticleDOI
TL;DR: This case report demonstrates the utility of transesophageal echocardiography in the rapid diagnosis of cardiac injury from blunt thoracic trauma by identifying a flail tricuspid valve leaflet and regurgitation in a patient with jugular venous distention and hemodynamic instability.

20 citations

Journal ArticleDOI
TL;DR: An unusual case of empyema of the gallbladder associated with a pyogenic liver abscess secondary to acute cholecystitis in the unique population of Crohn’s disease patients on Infiiximab is presented.

17 citations

Journal ArticleDOI
TL;DR: Athlete's hernia, although somewhat elusive, can be easily established with a high degree of suspicion after doing a thorough history and physical exam augmented with ultrasonography and can be surgically corrected allowing return to full activity.
Abstract: Athlete's hernia (AH) is an activity limiting condition that presents as chronic inguinal pain in elite athletes The diagnosis involves a thorough history and physical examination and can be aided

5 citations


Cited by
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Journal ArticleDOI
TL;DR: Among patients with midline abdominal incisional hernias, mesh repair is superior to suture repair with regard to the recurrence of hernia, regardless of the size of the hernia.
Abstract: Background Incisional hernia is an important complication of abdominal surgery. Procedures for the repair of these hernias with sutures and with mesh have been reported, but there is no consensus about which type of procedure is best. Methods Between March 1992 and February 1998, we performed a multicenter trial in which we randomly assigned to suture repair or mesh repair 200 patients who were scheduled to undergo repair of a primary hernia or a first recurrence of hernia at the site of a vertical midline incision of the abdomen of less than 6 cm in length or width. The patients were followed up by physical examination at 1, 6, 12, 18, 24, and 36 months. Recurrence rates and potential risk factors for recurrent incisional hernia were analyzed with the use of life-table methods. Results Among the 154 patients with primary hernias and the 27 patients with first-time recurrent hernias who were eligible for the study, 56 had recurrences during the follow-up period. The three-year cumulative rates of recurren...

1,722 citations

Journal ArticleDOI
TL;DR: All experimental evidence and first clinical data indicate the superiority of the lightweight large porous mesh concept with regard to a reduced number of long-term complications and particularly, increased comfort and quality of life after hernia repair.
Abstract: In modern hernia surgery, there are two competing mesh concepts which often lead to controversial discussions, on the one hand the heavyweight small porous model and on the other, the lightweight large porous hypothesis. The present review illustrates the rationale of both mesh concepts and compares experimental data with the first clinical data available. In summary, the lightweight large porous mesh philosophy takes into consideration all of the recent data regarding physiology and mechanics of the abdominal wall and inguinal region. Furthermore, the new mesh concept reveals an optimized foreign body reaction based on reduced amounts of mesh material and, in particular, a significantly decreased surface area in contact with the recipient host tissues by the large porous model. Finally, recent data demonstrate that alterations in the extracellular matrix of hernia patients play a crucial role in the development of hernia recurrence. In particular, long-term recurrences months or years after surgery and implantation of mesh can be explained by the extracellular matrix hypothesis. However, if the altered extracellular matrix proves to be the weak area, the decisive question is whether the amount of material as well as mechanical and tensile strength of the surgical mesh are really of significant importance for the development of recurrent hernia. All experimental evidence and first clinical data indicate the superiority of the lightweight large porous mesh concept with regard to a reduced number of long-term complications and particularly, increased comfort and quality of life after hernia repair.

367 citations

Journal ArticleDOI
TL;DR: It is confirmed that the presence of incisional hernia is accompanied by impaired collagen synthesis in the skin, which might explain the high recurrence rates of hernia repair by simple closure, as a repetition of the primarily failing technique, and the improvement by the additional use of alloplastic material.
Abstract: The surgical mesh-free repair of incisional hernias has to face recurrence rates of up to 50%. Apart from technical faults this is probably due to collagen metabolic disorders, known to play an import

200 citations

Journal ArticleDOI
01 Jul 2004-Surgery
TL;DR: Increased collagen breakdown mediated by matrix metalloproteinase-2 (MMP-2) is suggested to be involved in inguinal hernia formation and published data point towards hernia disease as an inherited disease.

189 citations

Journal ArticleDOI
TL;DR: This study has identifiedTCF8 as the gene responsible for approximately half of the cases of PPCD, has implicated TCF8 mutations in developmental abnormalities outside the eye, and has presented the TCf8 regulatory target, COL4A3, as a key, shared molecular component of two different diseases, PPCd and Alport syndrome.
Abstract: Posterior polymorphous corneal dystrophy (PPCD, also known as PPMD) is a rare disease involving metaplasia and overgrowth of corneal endothelial cells. In patients with PPCD, these cells manifest in an epithelial morphology and gene expression pattern, produce an aberrant basement membrane, and, sometimes, spread over the iris and nearby structures in a way that increases the risk for glaucoma. We previously mapped PPCD to a region (PPCD3) on chromosome 10 containing the gene that encodes the two-handed zinc-finger homeodomain transcription factor TCF8. Here, we report a heterozygous frameshift mutation in TCF8 that segregates with PPCD in the family used to map PPCD3 and four different heterozygous nonsense and frameshift mutations in TCF8 in four other PPCD probands. Family reports of inguinal hernia, hydrocele, and possible bone anomalies in affected individuals suggest that individuals with TCF8 mutations should be examined for nonocular anomalies. We detect transcripts of all three identified PPCD genes (VSX1, COL8A2, and TCF8) in the cornea. We show presence of a complex (core plus secondary) binding site for TCF8 in the promoter of Alport syndrome gene COL4A3, which encodes collagen type IV α3, and we present immunohistochemical evidence of ectopic expression of COL4A3 in corneal endothelium of the proband of the original PPCD3 family. Identification of TCF8 as the PPCD3 gene provides a valuable tool for the study of critical gene regulation events in PPCD pathology and suggests a possible role for TCF8 mutations in altered structure and function of cells lining body cavities other than the anterior chamber of the eye. Thus, this study has identified TCF8 as the gene responsible for approximately half of the cases of PPCD, has implicated TCF8 mutations in developmental abnormalities outside the eye, and has presented the TCF8 regulatory target, COL4A3, as a key, shared molecular component of two different diseases, PPCD and Alport syndrome.

182 citations