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PubMed1981

Ultrastructural studies on the peritoneum with special reference to chronic ambulatory peritoneal dialysis.

Specimens of peritoneum from normal rat, mouse, man, uraemic patients and patients on chronic ambulatory peritoneal dialysis (C.A.P.D.) were examined by en face silver stained preparations and by electron microscopy. The ultrastructural features of the mesothelium and subjacent tissues in normal man, animal and uraemic patients were closely similar. Cellular degeneration and oedema were observed in the mesothelium of patients on C.A.P.D.

Animals↗
PubMedDate not supplied

Use of parietal peritoneum for aortic stump coverage following removal of an infected aortic prosthesis: A case report.

Aortic graft infections, albeit rare, pose a significant treatment challenge. Aortic stump disruption, in particular, is a potentially devastating complication. We describe a novel technique of using the parietal peritoneum to bolster a friable aortic stump in a 56-year-old man after an infected aortobifemoral graft was removed. The parietal peritoneal pedicle, in our experience, provides an effective alternative to reinforce an aortic stump when conventional coverage options have been exhausted.

Aorta, Abdominal↗
PubMed1985

Experimental evaluation of various available contrast agents for use in the gastrointestinal tract in case of suspected leakage. Effects on peritoneum.

The effects of seven contrast agents were studied on the peritoneum of rats in order to find the most suitable and safe contrast agent in cases where leakage might be expected from the gastrointestinal tract into the peritoneal cavity. Hexabrix appeared to give the least tissue reaction, with Amipaque and Gastrografin in second place (but not significantly different statistically).

Animals↗
PubMed2004

Transient overexpression of TGF-{beta}1 induces epithelial mesenchymal transition in the rodent peritoneum.

Epithelial mesenchymal transition (EMT), a process involved in many growth and repair functions, has been identified in the peritoneal tissues of patients who undergo peritoneal dialysis. The sequence of changes in gene regulation and cellular events associated with EMT after TGF-beta1-induced peritoneal fibrosis is reported. Sprague-Dawley rats received an intraperitoneal injection of an adenovirus vector that transfers active TGF-beta1 (AdTGF-beta1) or control adenovirus, AdDL. Animals were killed 0 to 21 days after infection. Peritoneal effluent and tissue were analyzed for markers of EMT. In the animals that were treated with AdTGF-beta1, an increase in expression of genes associated with EMT and fibrosis, such as type I collagen A2, alpha-smooth muscle actin, and the zinc finger regulatory protein Snail, was identified. Transition of mesothelial cells 4 to 7 d after infection, with appearance of epithelial cells in the submesothelial zone 7 to 14 d after exposure to AdTGF-beta1, was demonstrated. This phase was associated with disruption of the basement membrane and increased expression of matrix metalloproteinase 2. By 14 to 21 d after infection, there was evidence of restoration of normal submesothelial architecture. These findings suggest that EMT occurs in vivo after TGF-beta1 overexpression in the peritoneum. Cellular changes and gene regulation associated with EMT are evident throughout the fibrogenic process and are not limited to early time points. This further supports the central role of TGF-beta1 in peritoneal fibrosis and provides an important model to study the sequence of events involved in TGF-beta1-induced EMT.

Animals↗
PubMed1999

Tissue sources and blood flow limitations of osmotic water transport across the peritoneum.

Despite the daily use of hypertonic solutions to remove fluid from patients throughout the world who are undergoing peritoneal dialysis, the tissue sources of this water flow are unknown. To study this phenomenon in specific tissues, small plastic chambers were affixed to parietal and visceral surfaces of the peritoneum and were filled with either an isotonic or hypertonic solution. The volume changes over 60 to 90 min were determined and divided by the chamber area to yield the volume flux. The hypertonic solution produced a positive flux into the chamber of 0.6 to 1.1 microl/min per cm2 in all tissues tested. In contrast, the isotonic solution resulted in a net loss or an insignificant change in the chamber volume. Additional experiments tested the influence of blood flow on the hypertonic water flux during periods of control, reduced (50 to 80%), or postmortem (no) blood flow, as determined by laser Doppler flowmetry. With the exception of the liver, small but insignificant changes in the flux into the chamber were observed during the period of reduced flow; all water fluxes were markedly depressed during the postmortem period. It is concluded that both parietal and visceral tissues are sources of osmotically induced water flow into the cavity. Except for the liver, marked blood flow reductions have small but insignificant effects on osmotic water transport.

Animals↗
PubMed2000

Vascular proliferation and enhanced expression of endothelial nitric oxide synthase in human peritoneum exposed to long-term peritoneal dialysis.

Long-term peritoneal dialysis (PD) is associated with alterations in peritoneal permeability and loss of ultrafiltration. These changes originate from increased peritoneal surface area, but the morphologic and molecular mechanisms involved remain unknown. The hypothesis that modifications of activity and/or expression of nitric oxide synthase (NOS) isozymes might play a role in these modifications, via enhanced local production of nitric oxide, was tested in this study. NOS activities were measured by the L-citrulline assay in peritoneal biopsies from seven control subjects, eight uremic patients immediately before the onset of PD, and 13 uremic patients on short-term (<18 mo, n = 6) or long-term(>18 mo, n = 7) PD. Peritoneal NOS activity is increased fivefold in long-term PD patients compared with control subjects. In uremic patients, NOS activity is positively correlated with the duration of PD. Increased NOS activity is mediated solely by Ca(2+)-dependent NOS and, as shown by immunoblotting, an upregulation of endothelial NOS. The biologic relevance of increased NOS in long-term PD was demonstrated by enhanced nitrotyrosine immunoreactivity and a significant increase in vascular density and endothelial area in the peritoneum. Immunoblotting and immunostaining studies demonstrated an upregulation of vascular endothelial growth factor (VEGF) mostly along the endothelium lining peritoneal blood vessels in long-term PD patients. In the latter, VEGF colocalized with the advanced glycation end product pentosidine deposits. These data provide a morphologic (angiogenesis and increased endothelial area) and molecular (enhanced NOS activity and endothelial NOS upregulation) basis for explaining the permeability changes observed in long-term PD. They also support the implication of local advanced glycation end product deposits and liberation of VEGF in that process.

Adult↗
PubMed2006

MRI of the peritoneum: spectrum of abnormalities.

OBJECTIVE: Our objective was to detail peritoneal anatomy, techniques for optimizing peritoneal MRI, and the MRI characteristics of several disease processes that frequently involve the peritoneum. CONCLUSION: Homogeneous fat suppression and dynamic contrast-enhanced imaging, including delayed imaging, are critical technical factors for successful lesion detection and characterization on peritoneal MRI.

Adult↗
PubMedDate not supplied

Granulocytic sarcoma of the peritoneum.

Granulocytic sarcoma is an unusual extramedullary tumor composed of immature cells of the myelogenous series; it usually occurs during the course of myelogenous leukemia. This paper presents a rare case of granulocytic sarcoma of the peritoneum, occurring without evidence of myelogenous leukemia in peripheral blood and bone marrow.

Aged↗
PubMedDate not supplied

Analgesia after inguinal herniorrhaphy with laparoscopic inspection of the peritoneum in children. Caudal block versus ilioinguinal/iliohypogastric block.

The authors prospectively evaluated the efficacy of caudal epidural block versus local infiltration combined with ilioinguinal/iliohypogastric block for analgesia after inguinal herniorrhaphy with laparoscopic inspection of the peritoneum. During standardized anesthetic care, 24 children were randomized to Group I (caudal epidural block with 1.2 mL/kg of 0.25% bupivacaine) or to Group II (local infiltration with an ilioinguinal/iliohypogastric block). Postoperative pain scores were significantly lower at all four evaluation points in Group I than in Group II. Patients in Group I had a significantly decreased requirement for supplemental intravenous fentanyl. Intra-operative requirements for isoflurane were decreased in Group I. The expired concentration of isoflurane was 0.4 +/- 0.1 (mean +/- SEM) in Group I and 1.5 +/- 0.3 in Group II. Time to extubation was 3.8 +/- 0.5 minutes in Group I and 8.2 +/- 1.1 minutes in Group II. The time from arrival in the postanesthesia care unit until discharge home was 113 +/- 3 minutes in Group I and 152 +/- 11 minutes in Group II. Caudal epidural block was more effective than local infiltration in controlling pain after herniorrhaphy with laparoscopy in children and resulted in earlier discharge home.

Analgesia, Epidural↗
PubMed1999

[A scanning microscopy study of the peritoneum in mice after application of a CO2-pneumoperitoneum].

OBJECTIVE: The application of a CO2-pneumoperitoneum in operative laparoscopy presumably leads to basic alterations of the intraperitoneal homeostasis. In order to better understand the pathophysiology of this phenomenon, the morphologic alterations of the mesothelium after CO2-application will be examined. MATERIAL AND METHODS: In 36 mice (C 57, black mice) a CO2-pneumoperitoneum with an intraperitoneal pressure of 6 mm Hg was applied for 30 minutes. After 1, 2, 6, 12, 24, 48, 72 and 96 hours each of 4 animals were killed and the entire peritoneum was examined by scanning electron microscopy. RESULTS: Already after 1 hour mesothelial cells became cuboidal, were detached and showed condensation. After 2 hours this initial reaction reached its peak; immature cells then attached to the free basal membrane. After 96 hours the entire mesothelium was regenerated. CONCLUSIONS: The morphologic integrity of the mesothelium is temporarily disturbed by a CO2-pneumoperitoneum. Reasons for this phenomenon may be either the abdominal pressure or a CO2-induced surface acidosis. In further studies, the influence of the described phenomena on intraperitoneal formation of metastases will be examined.

Animals↗
PubMed1999

[Defense mechanisms in the peritoneum].

There are many specialised defence mechanisms connected with immunity of peritoneal cavity. These are absorbtion of bacteria and their toxins from peritoneum, phagocytosis, opsonization, activation of the complement and separation of infection in the peritoneal cavity. A very important role in defence mechanisms of peritoneal cavity play GALT and PALT. Among many cells of the immune system mastocytes and gamma delta T cells have important role in induction and regulation of immune mechanisms in the peritoneal cavity. Lymphocytes T gamma delta release many cytokines and chemokines what allows them to play their protecting role during peritonitis. Released cytokines (especially IFN-gamma) activate macrophages to produce and secret many proinflammatory cytokines and factors. On the other hand mast cells play their role in defence of peritoneal cavity via TNF-alpha and histamine release and inhibition of fibrynolysis.

Animals↗
PubMed1999

Adenovirus-mediated gene transfer to the peritoneum and hepatic parenchyma of fetal mice in utero.

BACKGROUND: The development of effective gene transfer in utero will provide alternative approaches to the treatment of genetic disorders. For many disorders, the fetal liver and peritoneum are important target tissues. Our goals were to compare the tissue sites and duration of transferred gene expression after intraperitoneal (i.p.) or intrahepatic adenoviral-mediated gene transfer in utero in the developing murine fetus. METHODS: Day 15 CD-1 fetuses were injected intrahepatically or intraperitoneally with recombinant adenoviruses containing the luciferase or beta-galactosidase reporter gene. Tissue levels of luciferase were quantitated, or tissues were examined for X-gal staining. RESULTS: Luciferase expression was observed in multiple fetal tissues (including brain, intestine, liver, and lung) and persisted up to 32 days after intrahepatic delivery. Significant hepatic tropism was demonstrated. CONCLUSIONS: Intrahepatic and intraperitoneal injection in utero results in transduction of multiple tissues in the developing murine fetus. Transuterine injection of fetal mice via intrahepatic and intraperitoneal routes provides a valuable model for assessing the efficacy of gene delivery vectors in the prenatal treatment of genetic disorders. These studies demonstrate that hepatic and intraperitoneal gene transfer to the developing murine fetus is feasible and may provide therapeutic levels of proteins during fetal development.

Adenoviridae↗
PubMed1999

[Gynecological interventions and cesarean section without suturing of the peritoneum (visceral and parietal)].

The authors reveal advantages of sewing off technics of parietal and visceral peritoneum in gynaecologic operations and Caesarean sections compared with common routine technics of sewing up. This study is prospective, controlled and includes two years period. 170 cases of gynaecologic operations and 45 Caesarean sections are investigated. It is confirmed the role of preoperative microbiologic investigations of cervical secret and vaginal secret. On the base of results similar to world experience in this field authors recommend described technics to gynaecologists and obstetricians.

Cesarean Section↗
PubMed2001

Low serum albumin in elderly continuous ambulatory peritoneal dialysis patients is attributable to high permeability of peritoneum.

Our study was carried out to investigate changes in nutrition and individual peritoneal membrane transport characteristics in elderly patients on continuous ambulatory peritoneal dialysis (CAPD), expressed as the personal dialysis capacity (PDC). We performed 376 PDC tests in 229 non diabetic patients who were undergoing CAPD from May 1995 to May 1999 in a multicenter study in Japan. We divided the patients into three groups: elderly (age > or = 65 years, n = 56), middle-aged (age 50-65 years, n = 150), and young (age < 50, n = 170). No significant differences were seen in duration of CAPD and incidence of peritonitis between the groups. We then compared the peritoneal function calculated by PDC test in the groups. Serum levels of albumin in elderly patients were significantly lower than those in middle-aged and young patients (elderly: 3.2 +/- 0.1; middle-aged: 3.4 +/- 0.1, p = 0.0447 vs elderly; young: 3.4 +/- 0.1, p = 0.0272 vs elderly). Plasma protein loss from the peritoneum in elderly patients was significantly higher than in middle-aged and young patients (elderly: 0.11 +/- 0.01; middle-aged: 0.09 +/- 0.01, p = 0.0136 vs elderly; young: 0.09 +/- 0.01, p = 0.0161 vs elderly). No significant differences in ultrafiltration volume and water permeability were seen between the groups. Peritoneal area in the elderly group was significantly higher than in the middle-aged and young groups. Peritoneal creatinine clearance (CCr) and Kt/V in elderly patients were significantly higher than in middle-aged and young patients. However, no significant difference in protein nitrogen appearance (PNA) or protein catabolic rate (PCR) was seen between the groups. Urea and creatinine generation rates in elderly patients were significantly lower than in the middle-aged and young patients. These data show that elderly patients receiving CAPD are well maintained from the perspective of urea and water metabolism, indicating that CAPD therapy for the elderly is more acceptable than expected. However, caution should be exercised, owing to the lower serum albumin seen in elderly patients.

Adult↗
PubMed1975

[Reactive growth of the mesothelium of the parietal leaf of the peritoneum].

In the process of reparative regeneration of the mesothelium caused by suturing of a portion of the jugular vein into the peritoneum defect the inflammatory mesothelial growings are formed. They have different configuration, consist only of the mesotheliumor the connective tissue covered with the mesothelium and are observed from the 4th day till 3 months after operation, being always faced to the abdominal cavity. The capacity of mesothelial cells to high mitotic activity and wedging out from the layer underlies the formation of posttraumatic structures of the mesothelium.

Animals↗
PubMed2001

Periodontal healing in humans using anorganic bovine bone and bovine peritoneum-derived collagen membrane: a clinical and histologic case report.

The authors report the clinical and histologic data on the healing of a severe periodontal lesion obtained in a one-walled intrabony defect using anorganic bovine bone under a bovine peritoneum-derived collagen membrane. Eight months after surgery, a bone-like tissue replaced the lost tissues. A biopsy of this tissue was carried out. In the part of the specimen closer to the residual bony wall of the original defect, anorganic bone particles (ABP) appeared to be surrounded by a layer of newly formed bone; its osteocyte lacunae were colonized by osteocytes from the host, and actively secreting osteoblasts were observed in many microscopic fields. No resorption phenomena were observed in the ABP Newly formed cementum with actively secreting cementoblasts was present on the tooth surface, and well-oriented fibers inserting in both newly formed cementum and bone were observed. In an area far from residual bone, all ABP did not appear to be surrounded by newly formed bone. Osteocytic lacunae appeared not to be colonized by cells, and ABP was surrounded by dense connective tissue without osteoblasts near the grafted particles. A very limited amount of newly formed bone, without relations with ABP, was observed close to the root surface. From a clinical point of view, anorganic bone in association with a collagen membrane can be effective in the treatment of bony defects characterized by an unfavorable architecture. From a histologic point of view, the clinical appearance of bone regeneration is not always confirmed in the part of the defect far from the bony walls.

Adult↗
PubMed2001

Gadolinium-enhanced MR imaging of liver capsule and peritoneum.

The ability to accurately depict tumor involving the peritoneum is critical to diagnosis and management in the oncology patient. Unfortunately, the small size of the peritoneal and liver capsular liver implants renders them difficult to image on helical CT scanning or nonenhanced MR imaging. Gadolinium-enhanced, fat-suppressed spoiled gradient-echo (SGE) MR imaging is exquisitely sensitive for the depiction of peritoneal tumors. Compared with helical CT scanning, the superior contrast resolution of fat-suppressed, gadolinium-enhanced SGE MR imaging makes MR imaging superior for depiction of neoplastic and inflammatory diseases involving these hepatic and perihepatic structures.

Contrast Media↗