RESUMEN
Histological and immunohistochemical studies of the healing processes of expanded polytetrafluoroethylene (PTFE) vascular graft were performed. In the animal experiment, endothelial cell lining, confirmed by immunohistochemical staining for anti-Factor VIII related antigen, existed nearly over all of the pannus. The endothelial cells also formed to some extent over the graft without pannus. Endothelialization showed a close dependency on the surface condition of the underlying tissue rather than on a time factor. In the human experiment, an endothelial island was observed in the middle portion of the graft in one case, supporting the hypothesis of the blood stream origin of endothelial cells.
Asunto(s)
Prótesis Vascular , Endotelio Vascular/citología , Politetrafluoroetileno , Anciano , Animales , Perros , Endotelio Vascular/química , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Factor de von Willebrand/análisisRESUMEN
Twelve rabbits were sacrificed one and three days, one, two, four and eight weeks after horizontal gastroplasty in order to investigate morphological changes after operation. Histology of the proximal pouch of the stomach showed various degrees of mucosal damage and a close relationship between its severity and high pH of the pouch. This suggested the usefulness of pH measurement of the gastric juice in the proximal pouch as an indicator of mucosal damage after gastroplasty.
Asunto(s)
Mucosa Gástrica/patología , Gastroplastia , Complicaciones Posoperatorias/patología , Estómago/patología , Animales , Peso Corporal , Ácido Gástrico/metabolismo , Determinación de la Acidez Gástrica , Masculino , ConejosRESUMEN
In an effort to investigate the healing process of resected liver stump and the significance of portal and hepatic arterial flow. In addition to hepatectomy in the first group, an arterial and a portal branch were ligated in the second and third groups, respectively. It was demonstrated that portal branch ligation influenced a delay in healing of resected liver stump rather than hepatic arterial branch ligation. It is assumed that portal blood flow is more responsible for liver stump healing as well as hepatic regeneration than is hepatic arterial flow.
Asunto(s)
Regeneración Hepática , Hígado/cirugía , Sistema Porta/cirugía , Animales , Hepatectomía , Ligadura , Sistema Porta/fisiología , Ratas , Ratas Endogámicas , Cicatrización de HeridasRESUMEN
The mechanism of preventing intestinal regurgitation by means of a telescoped intestinal valve has been investigated in this study. Ten telescoped intestinal valves were uniformly created in dogs. A tolerance test to barium reflux was performed before the animals were sacrificed 16 weeks postoperatively, which yielded various barium tolerance values. Statistical analysis revealed that the differences in barium tolerance values in the uniformly constructed valves were closely related to the proportion of the enteric plexuses which contained ganglion cells with normal shapes (r = 0.97, p less than 0.001) and their intestinal segment coverage (r = 0.94, p less than 0.001), but no correlation was found between barium tolerance and the thickness of the valvular musculature (r = 0.04) or the length of the artificial valve (r = 0.39). The results in this study suggest that the intact enteric plexuses play an important role in modulating the competency of the telescoped intestinal valve.
Asunto(s)
Válvula Ileocecal/cirugía , Plexo Mientérico/fisiología , Animales , Perros , Reflujo Gastroesofágico/cirugía , Válvula Ileocecal/inervación , Válvula Ileocecal/fisiología , Manometría , Modelos Biológicos , Músculo Liso/citología , Músculo Liso/inervación , Músculo Liso/fisiología , Plexo Mientérico/citología , Degeneración NerviosaRESUMEN
The effect of intragastric balloons as a noninvasive method for weight reduction was observed in nine castrated Yorkshire pigs. None of the animals lost weight. The appetites of the experimental animals were inhibited for only a short period of time. A significant dilatation of the stomach after balloon insertion was noted which resulted from increased food intake and obliterated the effect of the intragastric balloons. A long-standing lower blood glucose level played an important role in the increments in food intake and dilatation of the stomach. At the same time, ulceration was seen in 83.3 percent of the animals that received balloons. We conclude that intragastric balloon therapy may not be an effective approach for managing morbid obesity in human subjects.
Asunto(s)
Obesidad Mórbida/terapia , Estómago/cirugía , Animales , Apetito , Peso Corporal , Dilatación/métodos , Ingestión de Alimentos , Úlcera Gástrica/etiología , PorcinosRESUMEN
Serial histologic observations of the healing process of expanded polytetrafluoroethylene (PTFE) vascular grafts in dogs were performed. The common iliac arteries of 12 mongrel dogs were replaced with a 2-cm segment of 6 mm PTFE graft, bilaterally. The grafts were studied microscopically after the animals were killed at 4, 8, 12, 16, 20, and 24 weeks. All the grafts remained patent up to 24 weeks. Special attention was paid to the histological characteristics of pannus growth, which were divided into two types: smooth appearing and irregular. The former type was characterized by smooth, thinner connective tissue growth along the graft, and the latter was defined as irregular-shaped pannus containing large and small thrombi. Only pannus of the smooth type showed similar growth patterns and growth rates. These findings suggest essentially that pannus develops smoothly from both ends of the graft; however, thrombi disturbed this growth pattern. In 24 grafts, eight nodular lesions of the pannus (greater than 500 mu in height) were found: five distally and three proximally. All eight lesions were found within 3 mm of the anastomoses. Among these eight lesions, five were on the completely healed pannus, and the remainings were all on the irregular pannus. This suggests that thrombi organization followed by nodular lesions are major offending factors that lead to the formation of intimal hyperplasia.
Asunto(s)
Prótesis Vascular , Oclusión de Injerto Vascular/patología , Músculo Liso Vascular/patología , Politetrafluoroetileno , Trombosis/patología , Animales , Perros , Femenino , Oclusión de Injerto Vascular/etiología , Hiperplasia/etiología , Arteria Ilíaca/cirugía , Masculino , Trombosis/etiología , Cicatrización de HeridasRESUMEN
In 20 dogs the distal one-third of the small intestine and the proximal 10 cm of the ascending colon were resected. Bowel continuity was established by the telescoping technique to create an intestinal valve in ten dogs (group A) and by conventional end-to-end anastomosis in ten dogs (group B). Diarrhea and weight loss were similar in both groups. The ileal bacterial growth was significantly higher than the jejunum in group A (P less than 0.001) but not in group B. The jejunal bacterial growth in group B was significantly higher than that in group A (P less than 0.01). Intestinal transit times were 212 +/- 16.0, 219 +/- 152.4, and 163 +/- 85.8 minutes for normal dogs, groups A and B respectively. The competence of the normal ileocecal valve, the telescoped valve, and conventional anastomosis were 56 +/- 1.7, 49.9 +/- 17.4 and 13.2 +/- 7.8 cm of barium, respectively. Artificial intestinal valve formed by the telescoping technique is safe, simple, and effective in reducing bacterial overgrowth in the jejunum and appears to prolong intestinal transit time.
Asunto(s)
Colon/cirugía , Íleon/cirugía , Animales , Bacterias/crecimiento & desarrollo , Colon/microbiología , Colon/patología , Colon/fisiopatología , Perros , Motilidad Gastrointestinal , Válvula Ileocecal/cirugía , Íleon/microbiología , Íleon/patología , Íleon/fisiopatología , Yeyuno/microbiología , Métodos , Factores de Tiempo , Cicatrización de HeridasRESUMEN
The effect of Prostaglandin Bx (PGBx) on the development of gastric stress ulceration and bleeding in rats was investigated. The rats were divided into five groups and each rat was injected intravenously with either Saline (control), 0.5 mg, 1 mg, 5 mg, or 25 mg/kg of PGBx, according to group. The rats were then placed in wire conduit cages and placed in a cold room at 4 degrees C for three hours and sacrificed immediately afterwards. Results showed a significant increase in gastric bleeding and ulceration in the groups that received 1 and 5 mg/kg (PGBx) when compared to the control group (p less than 0.01). There was, however, a significant increase in gastric acid output in the group that received 1 mg/kg PGBx when compared to the control group (p less than 0.01). Our results suggest that PGBx, by a mechanism other than the inhibition of gastric acid secretion, maintains the integrity of the gastric mucosa.
Asunto(s)
Polímeros/uso terapéutico , Prostaglandinas B/uso terapéutico , Prostaglandinas/uso terapéutico , Úlcera Gástrica/prevención & control , Estrés Fisiológico/complicaciones , Animales , Relación Dosis-Respuesta a Droga , Mucosa Gástrica/patología , Masculino , Úlcera Péptica Hemorrágica/prevención & control , Ratas , Ratas Endogámicas , Úlcera Gástrica/patologíaRESUMEN
The effect of pyridine in the prevention of cold restraint-induced stress ulcers in rats was investigated. After fasting, rats were administered the appropriate dosage of pyridine and were promptly placed into stress cages for cold room stress. The rats were sacrificed and bleeding, ulceration and vascular patency were examined. At doses of 0.01 mg/kg and 0.20 mg/kg, pyridine significantly decreased the amount of gastric hemorrhage and ulceration (p less than 0.01), as compared with the controls. In addition, microvascular dye, injected after stress, revealed perfused mucosal capillaries in the pyridine group, and occlusion of mucosal capillaries in the control group. These results suggest that the antiplatelet effect of pyridine reduced thrombus formation in the mucosal capillaries with subsequent reduction in mucosal ulceration.
Asunto(s)
Mucosa Gástrica/patología , Úlcera Péptica/prevención & control , Piridinas/farmacología , Estrés Fisiológico/complicaciones , Animales , Capilares/patología , Jugo Gástrico/metabolismo , Mucosa Gástrica/irrigación sanguínea , Masculino , Úlcera Péptica/etiología , Úlcera Péptica/patología , Úlcera Péptica Hemorrágica/patología , Úlcera Péptica Hemorrágica/prevención & control , Agregación Plaquetaria/efectos de los fármacos , Ratas , Ratas EndogámicasRESUMEN
Antiplatelet aggregators such as sulfinpyrazone (10 mg/kg), ticlopidine (200 mg/kg), and pyridine (0.1 mg/kg) significantly inhibited the degree of gastric ulceration in Sprague-Dawley rats subjected to cold restraint stress. The inhibition of platelet aggregation and that of microthrombus formation were evident in rats given antiplatelet aggregating drugs and exposed to cold stress. Therefore, platelet aggregation does play an important role in stress ulcer formation, and drugs which inhibit this aggregation should be given greater attention as to possible clinical application for treatment of stress ulcers.
Asunto(s)
Anticoagulantes/farmacología , Agregación Plaquetaria/efectos de los fármacos , Úlcera Gástrica/prevención & control , Estrés Fisiológico/complicaciones , Animales , Aspirina/farmacología , Capilares/patología , Dipiridamol/farmacología , Mucosa Gástrica/patología , Masculino , Piridinas/farmacología , Ratas , Ratas Endogámicas , Úlcera Gástrica/patología , Sulfinpirazona/farmacología , Tiofenos/farmacología , Trombosis/patología , TiclopidinaRESUMEN
Inverted and everted staple lines, with and without division of the anterior gastric wall, were performed in 15 mongrel dogs to simulate reduction gastroplasty staple line. There were no significant differences in tensile strength and healing between staple lines at different postoperative periods. The tensile strength of the inverted staple line seemed to be stronger due to breakage of the adjacent gastric tissue. However, the tensile strength of the everted stapling without division of the gastric wall, which is used clinically, was almost equal to that of normal gastric tissue. In addition, there was satisfactory healing 4 weeks postoperatively in the everted stapling without dividing the gastric wall. These results suggest that the everted staple line without division of stomach is not inherently weaker to any significant extent than if the gastric wall was divided or inverted. The reported failure rate of this procedure may be due to other factors.
Asunto(s)
Estómago/cirugía , Engrapadoras Quirúrgicas , Cicatrización de Heridas , Animales , Perros , Estómago/citología , Resistencia a la TracciónRESUMEN
In 17 fully conditioned mongrel dogs, the small intestine approximately 50 cm proximal to the ileocecal valve was divided. Three centimeters of the proximal bowel was then inserted into the distal bowel and anastomosis was performed using interrupted 3-0 Dexon sutures in the seromuscular layer of the proximal end and through the entire thickness of the distal end. Two to four dogs were then sacrificed 2, 4, 6, 8, and 10 weeks postoperatively. Two dogs died 3 and 4 weeks postoperatively due to mechanical obstruction just proximal to the anastomosis by hair bezoar, and 15 survived without complications. Retrograde contrast radiologic examination of all segments showed no reflux. Microscopically, the serosal surface of the invaginated segment was found to be gradually covered with mucosa, and the whole segment formed a valvelike structure within 10 weeks time.
Asunto(s)
Válvula Ileocecal , Intestino Delgado/cirugía , Animales , Bezoares/etiología , Perros , Válvula Ileocecal/cirugía , Mucosa Intestinal/patología , Obstrucción Intestinal/etiología , Métodos , Complicaciones Posoperatorias , Técnicas de Sutura , Factores de TiempoRESUMEN
The plasma clearance rate of indocyanine green (ICG) by the liver was measured in 39 critically ill surgical patients, 5 of whom died. The clearance rate in survivors and nonsurvivors was 11.1 +/- 7.1% and 4.8 +/- 4.3%, respectively (p less than .001). We believe that indocyanine green clearance in the critically ill surgical patient is a simple, useful measure of hepatic function which is directly associated with outcome.
Asunto(s)
Cuidados Críticos , Verde de Indocianina , Pruebas de Función Hepática , Procedimientos Quirúrgicos Operativos , Humanos , Hígado/metabolismo , Tasa de Depuración Metabólica , Cuidados Posoperatorios , PronósticoRESUMEN
This study was undertaken to confirm the technical feasibility and efficacy of an intestinal anastomosis created with singly placed staples in dogs. In 12 fully conditioned dogs, two end-to-end small bowel anastomoses were performed in an everted manner. In each dog, one anastomosis was performed with singly placed staples utilizing the Auto Suture 4.8 mm disposable skin stapler, and the other anastomosis was performed with a manual technique using 3-0 Dexon interrupted suture. Operation time was measured for each anastomosis. Dogs were sacrificed 2, 4, and 8 weeks postoperatively. Each anastomosis was examined grossly and microscopically, and its tensile strength was measured. All dogs survived without complications. Gross and microscopic examinations showed satisfactory healing of both types of anastomoses at different postoperative intervals. The stapled anastomosis required significantly shorter time (p less than 0.01), and had significantly greater tensile strength (p less than 0.05) when compared with manual anastomosis.
Asunto(s)
Intestino Delgado/cirugía , Engrapadoras Quirúrgicas , Animales , Perros , Estudios de Evaluación como Asunto , Métodos , Periodo Posoperatorio , Resistencia a la Tracción , Factores de TiempoRESUMEN
The preventive effect of aminophylline in the development of stress ulcer by cold restraint was examined in Sprague-Dawley rats. Aminophylline, in a dose of 0.5 mg/kg, significantly inhibited stress ulcer formation in comparison to the control group. The preventative effect of aminophylline appeared to result from the inhibition of thrombus formation produced by the inhibition of platelet aggregation.
Asunto(s)
Aminofilina/uso terapéutico , Úlcera Gástrica/prevención & control , Animales , AMP Cíclico/fisiología , Ácido Gástrico/metabolismo , Mucosa Gástrica/fisiopatología , Masculino , Úlcera Péptica Hemorrágica/fisiopatología , Agregación Plaquetaria/efectos de los fármacos , Ratas , Ratas Endogámicas , Estrés FisiológicoRESUMEN
The preventative effect of anticoagulant (heparin) and antiplatelet aggregators (dipyridamole, low-dose aspirin, and ticlopidine), which are well known as antithrombotic agents, were recognized in this study of the development of stress ulcers in rats under cold restraint stress. On the basis of these findings, we suggest that the development of stress ulceration has a thrombotic etiology and that antiplatelet aggregators may be useful in the treatment of critically ill patients with stress ulcers.
Asunto(s)
Anticoagulantes/uso terapéutico , Agregación Plaquetaria/efectos de los fármacos , Úlcera Gástrica/etiología , Trombosis/complicaciones , Animales , Aspirina/uso terapéutico , Dipiridamol/uso terapéutico , Determinación de la Acidez Gástrica , Mucosa Gástrica/fisiopatología , Heparina/uso terapéutico , Masculino , Úlcera Péptica Hemorrágica/fisiopatología , Recuento de Plaquetas , Ratas , Ratas Endogámicas , Úlcera Gástrica/tratamiento farmacológico , Estrés Fisiológico , Tiofenos/uso terapéutico , Trombosis/tratamiento farmacológico , TiclopidinaRESUMEN
The preventative effect of low-dose aspirin in the development of stress ulcer induced by cold restraint were examined in Sprague-Dawley rats. The bleeding and ulceration scores in the control group were 2.14 and 13.50, respectively. The bleeding score in the 1 mg/kg aspirin group was 1.32 and the ulceration score was 6.89. The scores in 50 mg/kg aspirin group were 2.86 and 38.74, respectively. A significant decrease of ulceration in low-dose aspirin and significant increase in high-dose aspirin were demonstrated. A significant decrease in gastric acid secretion in the low-dose aspirin group was recognized. However, the inhibition of platelet aggregation induced by low-dose aspirin was thought to play a major role in the prevention of stress ulcer.
Asunto(s)
Aspirina/administración & dosificación , Úlcera Gástrica/prevención & control , Animales , Ácido Gástrico/metabolismo , Mucosa Gástrica/fisiopatología , Masculino , Úlcera Péptica Hemorrágica/fisiopatología , Agregación Plaquetaria/efectos de los fármacos , Recuento de Plaquetas , Ratas , Ratas Endogámicas , Estrés FisiológicoRESUMEN
The retrospective study of 38 male patients undergoing aorto-iliac reconstructive and abdominal aortic aneurysm surgery was carried out. The study demonstrates the deficiency in the pre-operative, intra-operative, and post-operative evaluation of these patients regarding the factors affecting impotence. Recommendations are made, and a flow sheet is compiled to assist the vascular surgeon in the evaluation and management of these patients.
Asunto(s)
Aorta/cirugía , Aneurisma de la Aorta/cirugía , Disfunción Eréctil/etiología , Arteria Ilíaca/cirugía , Adulto , Anciano , Aorta Abdominal/cirugía , Enfermedades de la Aorta/cirugía , Arteriopatías Oclusivas/cirugía , Humanos , Plexo Hipogástrico/irrigación sanguínea , Masculino , Persona de Mediana Edad , Pelvis/irrigación sanguíneaRESUMEN
Monitoring the central peripheral temperature gradient in critically ill surgical patients is a simple, sensitive, noninvasive and inexpensive method that can accurately reflect the state of peripheral circulation. It serves as an early warning sign, and its return to normal is a good measure of the efficacy o f therapy. Recognition of the cause of an abnormal gradient is essential to successful management since it can result from pain as well as hypovolemia. Warm-up patterns vary, and every patient should be treated individually. Forcing vasodilatation is usually unnecessary and amy be dangerous in hypothermic patients and in patients with hypovolemia if blood volume is not corrected simultaneously. Peripheral vascular disease, central hypothermia and the use of vasoactive drugs limit the usefulness of this method.
Asunto(s)
Temperatura Corporal , Temperatura Cutánea , Procedimientos Quirúrgicos Operativos , Adolescente , Adulto , Anciano , Presión Sanguínea , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Presión Esfenoidal Pulmonar , MicciónRESUMEN
Results of a bacteriologic study of 194 intravascular catheters inserted in 56 critically ill surgical patients showed that with strict adherence to aseptic insertion techniques and proper care, catheter contamination could be reduced to a minimum, and catheter-induced septicemia could be avoided. Our findings in septic patients showed that in the critically ill surgical patients, routine bacteriologic studies of intravascular catheters helped in anticipation and diagnosis of sepsis as well as selection of appropriate antiobiotic therapy.