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Biomedical subjects

P H Schillings

Publications and source records attributed to P H Schillings.

At least 19 recordsLinked to original sources

Morphometric analysis of the effects of antineoplastic drugs on mucosa of normal ileum and ileal anastomoses in rats.

Antineoplastic agents affect the healing of intestinal anastomoses. They often induce anorexia and diarrhea, possibly caused by morphological changes in the small intestinal mucosa. These changes were evaluated in the rat ileum. Animals in group I underwent only intestinal surgery while those in groups II and III underwent surgery on the third day of a 5-day course with cisplatin (in two different doses), bleomycin, and 5-fluorouracil. The parameters were: number of mitoses in crypts, crypt depth, villus height, width, and contour length, measured in the mucosa of primarily resected segments of the ileum and of the anastomotic area. Surgery yields an increased crypt depth and villus length in the anastomotic area without changing villus width. The changes in intestinal crypts precede those in villi. Antineoplastic drugs decrease crypt mitotic rate, villus height, width, and contour length. After cessation of antineoplastic chemotherapy mitotic activity increases. The shallower and shorter villi increase in width and length resulting in an increased villus contour length and area. A linear relation exists between villus contour length and villus height and width. Thus, antineoplastic polychemotherapy, dose-dependently, reduces and surgical trauma increases intestinal proliferative activity. However, the morphologic changes do not unequivocally explain possible metabolic disturbances causing retarded intestinal wound healing.

Analysis of Variance↗

Histologic evaluation of wound healing in experimental intestinal anastomoses: effects of antineoplastic agents.

Histologic evaluation of intestinal wound healing with and without cytostatics was performed in 36 rats. Variables were the relative position of the wound edges in mucosa and muscularis, necrosis, exudate, granulation tissue, granulocytes, macrophages, fibroblasts, restoration of the mucosal epithelium, and repair of the muscularis propria. The relative position of the wound edges in the mucosa and the muscularis in the initial phase of wound healing depended on technique but appeared to improve in the later phases of wound healing. It was not affected by the administration of antineoplastic agents; neither were muscularis repair, epithelial restoration of the mucosa, necrosis, nor exudate. Granulation tissue, fibroblasts and macrophages were present in maximal amounts after 7 days appearing later or showing this maximum at a different moment in time when antineoplastic agents were given. The processes of epithelial and muscularis repair were not influenced by the relative position of the wound edges. Granulation tissue, macrophages, and fibroblasts were the best parameters for measuring the histologic evolution of intestinal wound healing, and the effects of antineoplastic agents upon it.

Anastomosis, Surgical↗

[Pathological anatomy in The Netherlands showing new ways].

In the early nineteenth century microscopical examination gained a lasting place in medicine, due especially to support by a more dynamic way of thinking in pathology. Morbid anatomy discovered new ways of examination which were reflected in the illustrations. In the first 70 volumes of the Nederlandsch Tijdschrift voor Geneeskunde the artist still played an important part in representing microscopical findings; it was only recently that this part was definitely terminated. Illustrations of pathological processes and structures published in the Journal are represented, subdivided according to the various disciplines.

History, 19th Century↗

Neutrophil function and lipid peroxidation in a rat model of multiple organ failure.

Multiple organ failure (MOF) was induced by sterile intraperitoneal inoculation of zymosan in the rat. This results in a typical triphasic illness with maximal clinical signs at Days 2 and 14. In this study, granulocyte superoxide production (unstimulated and phorbol myristic acid stimulated) was studied as well as lipid peroxidation (TBAR) in plasma, liver, and lung tissue. Mainly TBAR levels in liver and lung tissue closely correlated with the triphasic clinical illness, while bacteriological data did not. It is concluded that the severe inflammatory response in this experimental model probably is the result of excessive toxic oxygen radical production. The first phase of illness may mainly be due to oxygen radical formation by activated PMN, the third phase of illness to the production of lysosomal enzymes (proteinases) from PMN, and activated macrophages as indicated by elevated N-acetylglucosaminidase levels.

Alanine Transaminase↗

Multiple-organ failure and sepsis without bacteria. An experimental model.

Multiple-organ failure is generally attributed to bacterial infection, although a correlation with positive blood cultures is not consistently found. Consequently, we studied the effects of a local nonbacterial inflammatory stimulus on distant organ functions and metabolism. Wistar rats were inoculated intraperitoneally with zymosan. Heart and ventilatory rates, oxygen consumption, and body temperature were measured. Survivors were killed at day 12 for blood analysis, weighing of organs, and microscopy. Intraperitoneal zymosan resulted in an early hyperdynamic "septic" response with a 35% mortality. After a few days, oxygen consumption decreased, serum lactate levels increased, and the function of multiple organs deteriorated, while blood cultures remained sterile. The experiment was repeated in germ-free rats with similar results but a lower mortality. We concluded that a severe inflammatory response in itself is capable of inducing multiple-organ failure with "sepsis."

Animals↗

Acute generalized microvascular injury by activated complement and hypoxia: the basis of the adult respiratory distress syndrome and multiple organ failure?

It has been suggested that generalized endothelial damage and permeability changes, induced by prolonged activation of the complement system and ensuing release of lysosomal enzymes, prostaglandins and toxic oxygen products, underlie the genesis of the Adult Respiratory Distress Syndrome (ARDS) and Multiple Organ Failure (MOF). The effects in New Zealand white rabbits were investigated of a 4 h infusion of activated complement and its combination with a short hypoxic episode on respiratory function, leukocyte count, platelet count and morphology of the lungs, heart, liver, kidney and spleen. Prolonged activation of the complement system induced hyperventilation with respiratory alkalosis and hypocapnia, depletion of granulocytes (PMN), and a variable accumulation PMN in the capillaries of all organs examined, in combination with interstitial, and, in the liver, cellular oedema. Electron microscopy of the lungs revealed degranulation of PMN, endothelial swelling and widening of the alveolar septa. The combination of hypoxia and systemic complement activation appeared to aggravate this microvascular injury with the occurrence of protein rich alveolar oedema and haemorrhage in the lungs and accumulation of PMN debris containing macrophages in the spleen. The alterations in respiratory function and pulmonary morphology in these rabbits, imitate the clinical and morphological characteristics of the early phase of ARDS. The inflammatory reaction, found in all other organs examined, might represent the early phase of MOF. If so, ARDS and MOF -- clinically closely interconnected syndromes -- might be interpreted as manifestations of the same syndrome and as the clinical expression of an uncontrolled whole body inflammation.

Animals↗

Loss of collagen from experimental intestinal anastomoses: early events.

Collagen lysis, which always occurs to some extent in the wound area, is thought to be the underlying cause for breakdown of intestinal anastomoses. Therefore, we have studied the loss of collagen around ileal and colonic anastomoses in New Zealand White rabbits during the first 48 hr after operation. In the ileum, significant lysis of collagen in the anastomotic area, as represented by a decreased level of hydroxyproline, occurs from 12 hr postoperatively onward. Maximal loss of hydroxyproline, as compared to preoperative values, is 27% measured 24 hr after operation. In the colon, significant lysis of collagen occurs after 3 hr. The lowest level of hydroxyproline measured during the experimental period is found 48 hr after operation, where the concentration is decreased by 38%. Changes in ileum are restricted to the anastomotic area, while in the colon the decrease in hydroxyproline extends along the intestinal wall, particularly in a proximal direction. The fact that total protein concentrations do not vary significantly indicates that the lowered hydroxyproline levels are specific. Microscopic examination of the wound area shows that the cellular response during the first 24 hr after wounding is restricted to granulocytes. It is suggested that granulocyte collagenase is mainly responsible for the observed lysis of collagen after intestinal anastomosis.

Animals↗

Histological features of wound repair: a comparison between experimental ileal and colonic anastomoses.

Various histological parameters of wound repair have been studied in intestinal anastomoses in the rabbit in order to compare the healing processes in ileum and colon. The sequentional appearance of granulocytes, macrophages and fibroblasts has been studied from 3 h to 7 days after operation. Also, degree of necrosis, formation of capillaries and mucosal repair were analysed semi-quantitatively. Significant differences were observed between ileal and colonic anastomoses with respect to occurrence of granulocytes, necrosis and mucosal repair, particularly 7 days after operation. At that time, granulocytes and necrosis were virtually absent from ileal anastomoses, while mucosal integrity was restored in the majority of cases examined. In contrast, granulocytes and necrosis were still abundantly present in colonic anastomoses and mucosal repair was poor. These results support biochemical evidence that wounds in the ileum heal more rapidly than wounds in the colon. Possibly, the sustained presence of granulocytes, which are a potential source of collagenase activity, is important in this respect. Investigation of the same features of intestinal wound healing in rabbits with peritonitis induced by infection showed similar results and no differences were found between infected and non-infected animals.

Animals↗

Comparison of saphir infrared coagulation and YAG-laser in the surgery of parenchymatous organs: an experimental study.

In an experimental study the efficiency of infrared coagulation and the neodymium-yttrium-aluminium and garnet laser (YAG-laser) were compared in operations on the liver, spleen and kidney in the dog. In surgery of the liver, both the YAG-laser and infrared coagulation gave good results. In surgery of the spleen, results with infrared coagulation were excellent, allowing extensive transections and partial resections. Kidney surgery was unsuccessful with either method. Our results are consistent with comparable clinical experience, in that infrared contact coagulation is extremely useful in surgery of the spleen.

Animals↗

[Double and multiple carcinomas of the colon (author's transl)].

Double or multiple carcinomas of the colon represent approximately 4% of all colon carcinomas. They may arise spontaneously or occur as a result of some predisposing disease. It is necessary to distinguish between double or multiple carcinomas arising synchronously or in sequence. Diseases such as ulcerative colitis, colonic polyposis and adenomatous polyps are pre-disposing conditions whereas familial polyposis is pre-cancerous.

Adenocarcinoma↗