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PubMed1989

[Anatomy and physiology of the peritoneum in CAPD: evolution and methods of surveillance].

The basic structure of the peritoneum appears very simple; it is composed of a monolayer of mesothelial cells separated from capillaries by a thin interstitial tissue. However its roles are multiple. Basically devoted to the mechanical protection of abdominal viscera, it also plays an important part in the local immune defences; in the field of peritoneal dialysis, its integrity is necessary to assure an adequate mass transfer. In dialysis, the characteristics of peritoneal clearances and glucose equilibration curves may help diagnose early damage of the peritoneal membrane and prevent irreversible more severe lesions.

Blood Flow Velocity↗
PubMed1989

Successful transplantation of a free fimbrial graft to the peritoneum.

Loss of fertility due to prior segmental resection of the fallopian tube (for ectopic pregnancy or sterilization) can be treated with a free fimbrial graft, especially when the fimbrial segment is contralateral to the proximal tube that is needed for the anastomosis. To evaluate the structure and function of the fimbria after free grafting, the fimbria was cut from the tube and sewn without a blood supply to the peritoneum in 14 rabbits. After convalescence, scanning electron microscopy showed fewer secondary mucosal folds in the grafted fimbria than in the normal fimbria. The ciliated and secretory cells in the graft were identical to those of normal cells. The transport rate of surrogate ova across the grafted fimbrial mucosa was consistent with that across the normal fimbrial mucosa, demonstrating that near-normal structure and function are preserved after a free graft of the fimbria.

Anastomosis, Surgical↗
PubMed1989

[Cefotiam concentration in the peritoneum in infants during surgery].

1. Supposing the hernia sac to be peritoneum, intraperitoneal transition of cefotiam (CTM) was examined on 57 cases of infantile inguinal hernia subdivided into 7 groups. 2. After one shot intravenous injection, CTM showed rapid transition into the blood and the peritoneal tissue and even at a dose of 40 mg/kg and 120 minutes later. CTM exhibited an excellent antibacterial activity considering of MIC80 against clinically isolated bacterial strains. 3. Healing by first intention of operative wounds was obtained in all of the cases given CTM without any case suggestive of postoperative infection. No clinical side effect was observed in any one of the cases.

Bacteria↗
PubMed1987

Functional deterioration of the peritoneum: does it occur in the absence of peritonitis?

Peritoneal function in relation to the occurrence of peritonitis and the osmolarity of the dialysate was studied in 72 CAPD patients with a mean duration of treatment of 16.5 +/- 9.0 months (group 1). Data from 24 of these patients, who were on CAPD for longer than 2 years (average 28.6 +/- 4.9), were subjected to further detailed analysis (group 2). Each group consisted of two subgroups, one of patients who had experienced peritonitis and one of patients who had had no episodes of peritonitis. Results from group 1 revealed that the use of hyperosmolar bags increased in parallel with the duration of CAPD treatment even in the non-peritonitis subgroup, and that peritonitis enhanced the tendency to use hyperosmolar dialysate solutions. This phenomenon was also observed in the peritonitis subgroup of group 2, but was not apparent in the non-peritonitis subgroup of group 2 when examined as a whole: however, individual analysis revealed that some of them had a similar tendency to use hyperosmolar dialysate, as was seen in the peritonitis subgroup. These results confirm that the peritonitis impairs the ultrafiltration capability of the peritoneum. The results also suggest that the long-term use of hyperosmolar dialysate may be associated with decreased ultrafiltration, hence emphasis should be placed upon the use of hyperosmolar dialysate solutions for long-term CAPD.

Adult↗
PubMed1988

Response of pony peritoneum to four peritoneal lavage solutions.

Peritoneal lavage was performed on ponies to determine the effect on peritoneal surfaces. Lavage solution (20 L) was introduced into each pony's peritoneal cavity through catheters placed in the paralumbar fossa, and the solution was removed by drainage from the ventral portion of the abdomen. Six ponies each were lavaged with sterile saline (0.9% NaCl) solution, sterile saline solution containing 5 X 10(6) U of potassium penicillin and 3 g of neomycin or povidone-iodine diluted to 3% by volume with sterile saline solution, and 3 ponies were lavaged with povidone-iodine diluted to 10% with sterile saline solution. Peritoneal lavage catheters were inserted in 3 control ponies, but lavage fluids were not administered. Peritoneal fluid specimens were collected at 6, 24, 48, and 96 hours after lavage. Nucleated cell counts, RBC counts, total protein determinations, and cytologic analysis were performed. The ponies were euthanatized at 96 hours, and representative sections of the peritoneum were examined. Lavage with saline solution and saline solution with antibiotics induced a mild, transient inflammatory response in the peritoneal fluid, with minimal or no changes observed at necropsy. Solutions containing povidone-iodine induced chemical peritonitis, which was severe in ponies lavaged with 10% povidone-iodine solution. Peritoneal lavage with povidone-iodine solutions as dilute as 3% cannot be accomplished without causing inflammation of peritoneal surfaces.

Animals↗
PubMed1986

Bovine peritoneum: fibrinolytic activity and adhesion formation.

The fibrinolytic activity of peritoneum was evaluated in 4-month-old calves before and after peritoneal trauma. In each calf, a peritoneal resection, abrasion, sutured incision, and nonsutured incision were performed. These 4 trauma sites were evaluated for fibrinolytic activity and adhesion formation at 1 of 6 posttrauma intervals (1, 2, 3, 5, 8, or 14 days). Peritoneal plasminogen activator and fibrinolytic inhibitor activities from pre- and posttrauma samples were evaluated, using a fibrin-slide incubation technique. Calf peritoneal specimens consistently had fibrinolytic inhibitor activity, but did not have plasminogen activator activity. Significant differences were not found between fibrinolytic activity before or after trauma and a significant correlation was not found between fibrinolytic activity and the presence of or severity of adhesions.

Animals↗
PubMed1979

[Treatment of gastroduodenal ulcers perforated into the free peritoneum. Apropos of 122 cases].

The treatment used in 122 patients suffering from perforation of gastroduodenal ulcer in free peritoneum is presented. 77 were subjected to straightforward suture of the perforation. Hemigastrectomy was carried out in 43 and in 2 superselective vagotomy associated with removal of the duodenal ulcer and duodenoplasty. Mortality in the series was 11.04% after suture but allowance must be made here for the serious condition of the patients who underwent this form of operation. Of the patients treated with straightforward perforation suture, 36.5% were reoperated for the reappearance of ulcerous symptomatology, while the remaining 63.7% were cured. On the basis of this experience, it is considered that superselective vagotomy associated or otherwise with pyloroplasty, and subtotal gastrectomy are indicated in patients in good general condition and in whom ulcer perforation symptomatology goes back less than 12 hours.

Adult↗
PubMed1979

Evaluation of the participation of parietal peritoneum in dialysis: physiological, morphological and pharmacological data.

Bidirectional fluxes of Na+, K+ and Ca++ were estimated under in vitro conditions through isolated patches of rat peritoneal membranes (parietal and visceral). Morphological (TEM) and functional (changes in fluxes) data are presented to show that mesothelium lining the parietal peritoneum forms a barrier than limits diffusion of ions across this membrane. In addition, it was found that Furosemide and nitroprusside change the permeability of the mesothelium for sodium or potassium, respectively.

Animals↗
PubMed1977

[Construction of the microcirculatory bed of the parietal layers of the pleura and peritoneum in newborns].

Structural organization of the microcirculatory bed of the newborn parietal layers in pleura and peritoneum is described as a morphofunctional single whole. Pecularities in the bed construction revealed characterize it as a certain stage in the process of its formation and development. Elucidation of these peculiarities may help to better understanding of disturbances in microcirculatory hemodynamics and tissue metabolism in the newborns and fetuses.

Humans↗
PubMed1982

Anatomical bases of peritoneal permeability: a reappraisal. Anatomy of peritoneum.

The peritoneal membrane consists of flat mesothelial cells linked together with digitations and containing vesiculae with pinocytic capacity, of endothelial cells (containing Weibel-Palade's bodies and vesiculae) and of an interstitial tissue consisting of a network of watery channels. The cellular structures of mesothelium and endothelium are characterized by tight and gap junctions or perhaps by macular junctions. The visceral peritoneum shows a prevalence of gap junctions, the pericysic veins contain only tight junctions while both types can be found in the arterioles. Two different ways for solute transport are theoretically possible: the vesicles of plasmalemma (via pinocytosis) and the junctions (via size-sieving effect). Studies with tracers did not furnish unequivocal data on this problem and did not clarify if these structures could be the equivalent of the pores of the Landis-Pappenheimer's theory. The studies of Karnowsky and Simionescu, using tracers, have in fact given opposite results.

Animals↗
PubMed1980

The investigation of small vessel anatomy by scanning electron microscopy of resin casts. A description of the technique and examples of its use in the study of the microvasculature of the peritoneum and bile duct wall.

Scanning electron microscopy of microvascular resin casts has revolutionised the study of small blood vessel anatomy in various animals. The present report is the first in which the technique has been used to study capillary networks in man and baboon. The microvasculature of human visceral peritoneum has been described for the first time and the small vessels within the bile duct wall of the baboon have been demonstrated using stereo pairs. The technique is a valuable tool that deserves wider application in both human and animal anatomical research.

Animals↗
PubMed1982

Multilocular cysts of the peritoneum.

Multilocular cysts of the peritoneum diagnosed at the Mayo Clinic from 1907 through 1981 were examined and divided, on the basis of their light microscopic features, into two groups--cystic mesotheliomas and cystic lymphangiomas. There are apparent clinical differences between the two groups. Cystic mesotheliomas tend to occur in adult females and often recur. Cystic lymphangiomas occur most often in males, often develop in children, and rarely recur, if at all. The distinguishing histologic features are the cytologic characteristics of the cells lining the cysts and the presence or absence of smooth muscle in the wall of the cysts.

Adolescent↗
PubMed1978

[Ulcers of the neck in hiatal hernias. Perforation into the free peritoneum (author's transl)].

Perforation into the free peritoneum of ulcers of the neck of hiatal hernias is a rare complication. On the basis of one case, which would appear to be the third reported in the literature but the only one in which the special circumstances resulted in the diagnosis being made preoperatively, the authors propose a new therapeutic attitude based upon the physiopathology of ulcers of the neck, combining suturing and reduction of the hernia with anterior repositioning of the greater curvature of the stomach, mobilised according to Thal's technique, and thereby simultaneously producing an anterior hemi-valve.

Aged↗
PubMed1994

Closure or non-closure of visceral peritoneums after abdominal hysterectomies and Wertheim-Meigs radical abdominal hysterectomies.

The effect of visceral peritoneal closure after conventional abdominal hysterectomies and Wertheim-Meigs radical operations was studied clinically. No considerable differences were found in the postoperative staying period; however, the incidence of complications were less in the peritoneal non-closure group (n = 91) than in the control, peritonealized group (n = 149). Significantly lower was the number of postoperative irregular pyelogram in cases without peritoneal closure (n = 25) of radical abdominal operations than in the control group (n = 49) with peritoneal suturing. We therefore suggest that the lack of suturing of visceral peritoneums has some advantages after abdominal hysterectomies and especially has benefits for Wertheim-Meigs operations.

Adult↗
PubMed1995

[How to use the peritoneum as a dialysis membrane. Methods of surveillance, criteria of efficacy and longevity as a dialysis membrane, consequences with respect to techniques of peritoneal dialysis].

The structure of the peritoneum is well known. However, the real surface of the membrane which participates to solute transports during dialysis is purely putative, depending on numerous factors as cardiac output and consequently mesenteric blood flow, mesothelial cell junctions, interstitial thickness, number of functional peritoneal capillaries and so on. In addition lymphatic absorbtion of peritoneal fluid interacts with transcapillary water shifts. These various factors vary from one moment to another in a same patient and from patient to patient. Eventually, mechanical problems related to peritoneal catheter may alter fluid and solute transfer evaluation when estimated from analysis of drained dialysate. Notwithstanding, solute peritoneal equilibration curves may be used as a guide to prescribe dialysis, provided they are repeated several times. They appear more reliable to detect, and therefore prevent peritoneal structure alterations. The APEX (Accelerated Peritoneal Examination) test is more convenient than Peritoneal Equilibration Test (PET), as it summarizes in a single number the peritoneal permeability both to glucose and urea: hence, it represents the time at which glucose and urea equilibration curves (using percentages as units) cross; the shorter is the APEX time, the higher is the peritoneal permeability and, reversely, the longer is this time, the lower is the peritoneal permeability. The peritoneal membrane may be used at least five years without concern with lactate buffered solutions if peritonitis are efficiently prevented. Some patients have been followed for more than ten years without detectable adverse effects, but further evaluations still have to be performed to evaluate the longterm consequences of peritoneal dialysis. Peritoneal dialysis and haemodialysis must be considered as complementary technics which must be both available to patients.

Humans↗