Postoperative pericardial adhesions. The role of mild serosal injury and spilled blood.
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Biomedical subjects
Publications and source records attributed to G B Ryan.
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CONTRACTING GRANULATION TISSUES CONTAIN FIBROBLASTS THAT DEVELOP CHARACTERISTICS TYPICAL OF SMOOTH MUSCLE: (a) They contain an extensive cytoplasmic fibrillar system. (b) They show immunofluorescent labeling of their cytoplasm with human anti-smooth muscle serum. (c) The nuclei show complicated folds and indentations, indicative of cellular contraction. (d) There are cell-to-cell and cell-to-stroma attachments. (e) It is possible to extract similar quantities of actomyosin (having the same adenosine triphosphatase activity) from granulation tissue and from pregnant rat uterus. (f) Strips of granulation tissue, when tested pharmacologically in vitro, behave similarly to smooth muscle. All these data support the view that, under certain conditions, fibroblasts can differentiate into a cell type structurally and functionally similar to smooth muscle and that this cell, the "myo-fibroblast," plays an important role in connective tissue contraction.
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Strips of granulation tissue from three different experimental models contract in vitro when treated with substances that induce contraction of smooth muscle. Because the fibroblasts in such tissues have some ultrastructural features typical of smooth muscle, our findings indicate that fibroblasts are able to modulate toward a cell type that is morphologically and functionally close to smooth muscle.
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THIS PAPER DESCRIBES AN EXPERIMENTAL MODEL OF PERITONEAL ADHESIONS, IN THE RAT, BASED ON TWO RELATIVELY MINOR ACCIDENTS THAT MAY OCCUR DURING ABDOMINAL SURGERY IN MAN: drying of the serosa, and bleeding. Drying alone had little effect; drying plus bleeding consistently produced adhesions to the dried area. Fresh blood alone produced adhesions between the three membranous structures [omentum and pelvic fat bodies (PFBs)]. The formation of persistent adhesions required whole blood. Preformed clots above a critical size induced adhesions even without previous serosal injury; they were usually captured by the omentum and PFBs. If all three membranous structures were excised, the clots caused visceral adhesions. The protective role of the omentum, its structure, and the mechanism of omental adhesions, are discussed. These findings are relevant to the pathogenesis of post-operative adhesions in man.
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