摘要:

The feasibility of using obturator internus muscle autotransplantation in order to construct an anal dilator mechanism for the treatment of obstructive constipation was studied anatomically, physiologically and pathologically. Electromyographic studies of 15 obturator internus muscles in 10 healthy adult male volunteers and 3 other muscles in patients with documented spastic anal sphincters demonstrated the ability of the obturator internus muscles to contract during straining at stools. The proposed surgical approach was studied in 9 cadavers (5 stillbirths and 4 adults), followed by formal anatomical dissection of the obturator internus muscle and tendon, pudendal nerve and vessels, inferior rectal nerve and nerve to the obturator internus. Anatomical studies proved the feasibility, ease, rapidity and safety of the technique with or without division of the obturator internus tendon with no incidence of injury to the surrounding nerves, vessels or muscles using a purely perineal approach.

ISSN:0014-312X    

DOI:10.1159/000129299

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Several studies have suggested that the damage after ischemic injuries increases during reperfusion and that this reperfusion damage is mediated through granulocytes which invade the damaged area. The present study was undertaken to test these hypotheses by histological investigations of the anterior tibial muscles in a rat hind limb tourniquet model after 4.5 h of complete ischemia and graded periods of reperfusion. Uptake of albumin into damaged muscle fibers was demonstrated immunohistochemically and used to determine the extent of the ischemic lesions. The size of the lesions was measured morphometrically on immunostained sections from paraffin-embedded material. Granulocytes in and outside the capillaries were counted on slides from historesin-embedded material. Generally, there was a compact central area in the muscles which showed necrosis of all fibers and many capillaries, little interstitial edema, and little or no invasion of granulocytes or macrophages. The central core did not increase in size during the postoperative period. Outside this are there was a zone of partial tissue destruction with quite marked interstitial edema. This zone also remained unchanged in size but it is uncertain whether the number of necrotic fibers increased with time. There was an increasing invasion of granulocytes in this outer zone from 5 to 24 h after release of the occlusion and monocyte/macrophage invasion was seen from 48 h. Outside this zone there was a subfacial zone with normal muscle fibers in all cases. It is concluded that the central area of complete tissue destruction was present at the time of release of the occlusion and did not increase in size during the further postoperative course. There was no indication that granulocytes participated in this damage. The extent of the partially damaged area also remained unchanged during the postoperative course. It is conceivable that granulocytes aggravated the lesions by increasing the number of necrotic fibers in this peripheral area but not before 5 h after release of the occlusion. This is later than described in previous studies.

ISSN:0014-312X    

DOI:10.1159/000129300

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The effects of activated platelet (Pit) on muscle degradation were investigated, employing the in vivo disseminated intravascular coagulation (DIC) model induced by thrombin injection and the in vitro tissue culture system of skeletal muscles in rats. Both the release of tyrosine and leucine into the culture medium during 2 h incubation from the muscles harvested 30 min after thrombin injection increased by about 50% compared with control muscles. The addition of thrombin-activated platelet supernatant (TAPS) significantly increased the release of leucine into the incubation medium of the soleus muscles dissected from normally fed rats by 31 % in comparison with the respective controls. No significant effect was observed in terms of the release of tyrosine or leucine from the incubated muscles by aspirin treatment before obtaining TAPS, or by the addition of thrombin itself up to the concentration of 0.67 µm/ml which was contained in the incubation medium of TAPS. These data suggest that protein catabolism is accelerated in the muscle from the thrombin-treated rats exhibiting DIC. The supernatant of activated Pit might contain a factor which modulates protein metabolism. That factor is different from prostaglandins or thrombin. Thus, active consumption of Pit may contribute to an increase of muscle breakdown in various catabolic states

ISSN:0014-312X    

DOI:10.1159/000129301

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The present study evaluates colonic anastomosis healing in the presence of fecal peritonitis in rats. After induction of fecal peritonitis, the animals were treated by surgery alone or with the addition of systemic supportive treatment. It is shown that survival in the latter group was significantly better, while burst strength of anastomoses in surviving animals in both groups was identical. The results suggest that the outcome of fecal peritonitis depends mainly on fluid resuscitation and antimicrobial therapy, but not on primary repair.

ISSN:0014-312X    

DOI:10.1159/000129302

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The relationship between wound healing and skin prolylhydroxylase activity was examined in 212 patients undergoing reconstructive procedures and 109 controls using skin prolylhydroxylase activity as an index of collagen synthesis. In the control group, the median value of skin prolylhydroxylase activity was 360 cpm/mg protein. There was a higher skin prolylhydroxylase activity in 274 patients with successful healing (368 cpm/mg protein) than there was in 33 patients who required local wound care (202 cpm/mg protein) and 14 patients with severe local complications (71 cpm/mg protein, p = 0.02). Skin prolylhydroxylase activity was also significantly lower (p = 0.002) in patients with laboratory criteria for malnutrition (albumin <3.5 g/dl, 108 cpm/mg protein; total lymphocyte count <1,500 mm3, 211 cpm/mg protein, and albumin <3.5 g/dl + lymphocyte count < 1,500 mm3, 52 cpm/mg protein), but age, diabetes mellitus, malignancy and wound infection did not affect skin prolylhydroxylase activity. These results suggest that skin prolylhydroxylase activity is reduced in patients with malnutrition and delayed wound healing.

ISSN:0014-312X    

DOI:10.1159/000129303

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The composition and content of the gastric phospholipids were followed during development and healing of indomethacin-induced chronic, antral ulcers in rats. The individual phospholipids were identified by thin-layer chromatography and quantitatively estimated by spectrophotometric analysis of phosphate. No changes were found in phospholipid composition and content after a 24-hour fast or during the first 24 h after indomethacin was given. The total phospholipid content and the content of lysophosphatidylcholine and phosphatidylcholine were increased on the 5 th day, when chronic ulcers were established. After 4 weeks, when the ulcers were healed, the total phospholipid content, and content of phosphatidylcholine, phosphatidylethanolamine and phosphatidylinositol, respectively, were decreased, while the content of lysophosphatidylcholine was increased. In conclusion, the composition and content of gastric phospholipids were altered in rats with ulcers as well as in rats with healed ulcers.

ISSN:0014-312X    

DOI:10.1159/000129304

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Syngeneic pancreaticoduodenal transplantations were performed in Wistar-Furth rats. Fourteen days after implantation, blood perfusion of the whole native and transplanted pancreas, the pancreatic islets and the native and transplanted duodenum was measured with a microsphere technique 5 min after an intravenous injection of 0.5 ml of either saline (n = 6) or terbutaline (1 mg/kg BW; n = 9). Terbutaline decreased the mean arterial blood pressure by approximately 30% (p < 0.001). The substance also decreased the whole pancreatic blood flow of the native pancreas (p < 0.05), but not of the transplanted gland. However, the vascular conductance of the whole pancreas was unchanged after terbutaline administration in both the native and transplanted gland. Islet blood flow (p < 0.001) and islet vascular conductance (p < 0.01) were markedly decreased in the native pancreas. In the transplanted gland, there was, however, no change in islet vascular conductance and only a slight decrease in islet blood flow (p < 0.05). Both the native and transplanted duodenal blood flows were unaffected by terbutaline. One likely explanation for the different effects of terbutaline on the blood perfusion of the native and transplanted pancreas may be that the latter gland is devoid of any physiologically relevant exogenous innervantion.

ISSN:0014-312X    

DOI:10.1159/000129305

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The effect of distal gastrectomy on gut hormone release was investigated by electrical stimulation of the posterior truncal vagus in dogs. Peripheral and portal plasma gastrin release was significantly inhibited, but peripheral and portal somatostatin release was unchanged. Peripheral and portal pancreatic polypeptide (PP) release was significantly inhibited. Our results suggest that the following factors might be some of the reasons why the secretion of PP was inhibited after distal gastrectomy: (l)transection of the posterior vagal branches close to the antrum and pylorus which might go to the pancreas; (2) changes in other hormones such as gastrin; (3) elimination of the PP secretagogue from the gastric antrum.

ISSN:0014-312X    

DOI:10.1159/000129306

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

An improved anatomical technique for extended hepatectomy in dogs is described as a model to study the process of liver regeneration. The crucial steps in the technique as well as the site of bile duct ligation and dissection of the left hepatic vein are described in detail. Using this method extended hepatectomy was done without any mortality or morbidity in more than 20 dogs.

ISSN:0014-312X    

DOI:10.1159/000129307

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The present study describes the clinical significance of the anorectal tightening reflex (ATR) in normal and incontinent subjects. It was examined in 16 healthy volunteers and 11 subjects incontinent to flatus and fluid stools; 5 of the latter had in addition fecal soiling. The rectum was distended by a condom inflated with carbon dioxide, while the rectal and rectal neck (RN) (anal canal) pressures were measured, and the external (EAS) and internal anal sphincter (IAS) EMG activity was recorded. The rectum was inflated at two rates: slow and rapid. In normal subjects, the RN pressure increased upon slow rectal inflation; the IAS EMG was augmented. Pudendal nerve block and phentolamine administration revealed that this pressure increase is due to increased IAS tone which tightens the RN against the slow rectal filling by the time adaptive reaction occurs. Rapid rectal filling evoked Gower’s rectoinhibitory reflex. Thus, while increased IAS tone in the ATR protects against involuntary incontinence upon ‘slow’ rectal filling, the increased EAS tone of Gower’s reflex protects in the case of ‘rapid’ filling. Of the 11 incontinent patients, the 5 with fecal soiling did not show ATR, and investigative results pointed to the IAS as being responsible for incontinence. The other 6 patients had normal ATR but nonresponsive EAS on rapid filling. Findings suggest that the ATR plays a role in maintaining continence during slow rectal distension and that a disordered ATR due to IAS dysfunction leads to fecal incontinence. Thus ATR may be useful as an investigative tool in anorecta

ISSN:0014-312X    

DOI:10.1159/000129308

出版商:S. Karger AG    

年代:1993

数据来源: Karger