Sub-serosal cysts of the peritoneum.
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OBJECTIVE: To compare the host response, architectural integration and tensile strength of polypropylene and porcine small intestine submucosa-derived implants in a rat model. DESIGN: Experimental study. SETTING: Center for Surgical Technologies, Faculty of Medicine, Katholieke Universiteit Leuven, Belgium. SAMPLE: Forty-eight adult male Wistar rats weighing 220-250 g randomised to receive either implant. METHODS: Full thickness abdominal wall defects were primarily repaired with polypropylene mesh (Marlex) (MX group) or porcine small intestine submucosa (Surgisis) (SIS group). Animals were sacrificed at 7, 14, 30 and 90 days after implantation. MAIN OUTCOME MEASURES: The presence of herniation, infection and intra-peritoneal adhesions. Change in thickness and tensile strength of implant. Histopathological and immunohistochemical appearances of inflammatory response and collagen deposition. RESULTS: Implants from the SIS group showed a short term increase in thickness in the first 14 days. Formation of adhesions was significantly more intense in the MX group at 30 days, and more extensive in the SIS group at 90 days. Tensile strength increased over time in both groups but was significantly lower in the SIS group than the MX group at 30 days. Implants in the MX group showed a more pronounced inflammatory response and more pronounced new vessel formation than the SIS group. Collagen formation was initially more fibrous and better organised in the MX group but became greater in the SIS group at 90 days. CONCLUSIONS: Biologically derived implant material induced a less pronounced inflammatory response and differences in collagen deposition. At 30 days tensile strength was weaker in the biological implant group but was equivalent by 90 days. These differences may have implications for the in vivo performance of the materials.
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A 2-year-old boy with peritoneal miliary Crohn's disease is described. In addition to vague gastrointestinal symptoms, ascites was a prominent feature. The jejunal mucosa was markedly atrophic, compatible with a diagnosis of coexistent coeliac disease.
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Transport kinetics were examined for uptake of 65Zn from the lumen and for transport of mucosal 65Zn subsequent to uptake in the isolated, vascularly perfused intestines of rats fed either a zinc-deficient or zinc-adequate diet. Zinc depletion influenced the intestinal transport of zinc by stimulating a saturable uptake mechanism, reducing secretion of mucosal 65Zn into the lumen, and increasing the rate of 65Zn turnover in a rapidly absorbed mucosal zinc compartment. Uptake of 65Zn involved both saturable and nonsaturable processes. The saturable process was stimulated by zinc depletion with the apparent maximal transport rate for the saturable mechanism increasing from 60 to 180 nmol Zn X g-1 X 30 min-1. Most of the 65Zn taken up was not involved in the short-term secretion or absorption, and mucosal 65Zn retention was independent of dietary zinc status. Absorption of mucosal 65Zn was nonsaturable, involved a rapid exchanging zinc compartment, and was stimulated by zinc depletion. The half-life for 65Zn in this mucosal zinc compartment was approximately 24 min in the zinc-adequate group and 13 min in the zinc-depleted group.
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There is evidence implying an active role of airway epithelium in the modulation of bronchomotor tone. To study this phenomenon, we designed an in vitro system allowing pharmacological stimulation of either the inside or outside of the airway lumen. Rat tracheas were excised, cannulated, and their inside and outside perfused independently with Krebs solution. Two hooks were inserted through opposite sides of the tracheal wall, the lower one was attached to a fixed point, while the upper one was connected to a force transducer. Isometric contractions of the tracheal muscle were elicited by carbachol solution perfused in single and cumulative concentrations. In one-half of the preparations the epithelium was mechanically removed. Stimulation of the inside or outside of the trachea produced equal maximal tracheal muscle tension [1.55 +/- 0.14 and 1.2 +/- 0.09 (SE) g in and out, respectively]. The time course of tension development was longer when carbachol was administered inside the trachea: an effect that was abolished when the epithelium was removed. In addition, removal of the epithelium was found 1) to increase the maximal tension irrespective of the route of carbachol perfusion and 2) to increase the sensitivity of the preparation to carbachol stimulation.
Idiopathic myelofibrosis (IMF) is a breakpoint cluster region rearrangement-negative chronic myeloproliferative disease with progressive bone marrow fibrosis. We report a female patient (65 years old) who was admitted to our hospital in 1996. Trephine bone marrow biopsy revealed diffuse fibrosis with atypical multilobulated megakaryocytes. A cellular phase of IMF was diagnosed. Three years later, despite being at intermediate risk, the patient developed generalized lymphadenopathy and multiple sclerosing tumors throughout the peritoneum and retroperitoneum. Biopsy specimens from these tumors revealed sclerosing hematopoietic infiltrates. The present case demonstrates that IMF not only can progress to acute leukemia but can also spread uncontrollably, or 'metastasize' with extensive sclerosing hematopoietic tumors throughout the body.
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