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PubMed2000

Experimental study of lymphogenous peritoneal cancer dissemination: migration of fluorescent-labelled tumor cells in a rat model of mesenteric lymph vessel obstruction.

Primary gastrointestinal cancer frequently spreads to the mesentery, omentum and other parts of the peritoneum, and these deposits are generally considered to be induced by intraperitoneal seeding from the primary lesion. However, a few peritoneal metastatic cases or cases with positive intraperitoneal lavage cytology, without serosal infiltration, have been reported. Most of peritoneal dissemination is certainly attended with serosal involvement of gastrointestinal malignancy. Nevertheless, we observe an unusual case of peritoneal dissemination without definite serosal invasion of the malignancy. And peritoneal dissemination is likely to be concomitant with lymph node metastasis in both cases with and without definite serosal invasion. In this study, we examined peritoneal cancer dissemination from the viewpoint of lymphogenous metastasis. For the model of lymphatic invasion, we established an animal experimental model of mesenteric lymph vessel obstruction. With these models, lymphangiographical studies were made on the fourth postoperative day (ten animals each) and we obtained mesenteric lymphangiograms of extensive mesenteric lymph vessels and reflux of lymph distal to the obstruction point from all ten animals. Next, in these experimental models, fluorescent-labelled tumor cells (rat hepatoma cell line, N1-S1) were infused from the mesenteric lymph node distal to the obstruction point on the fourth postoperative day (five animals each), and the migration of these tumor cells was investigated via fluorescent micrography. Subsequently, the fluorescent-labelled tumor cells were revealed in the mesenteric lymph nodes, mesenteric lymph vessels, interstitial tissues of the mesentery, submucosal lymph nodules and mucosal layer of the small intestine. Hence, lymphatic invasion and obstruction may cause extensive peritoneal dissemination via the lymphatic route.

Animals↗

PubMed1976

Effect of serotonin on water and electrolyte transport in the in vivo rabbit small intestine.

The influence of intravenously administered serotonin on water and electrolyte fluxes in the in vivo rabbit jejunum and ileum was examined. Animals were divided into four groups: (1) those receiving saline intravenously while a glucose-free isotonic saline solution perfused the jejunum and ileum; (2) serotonin given intravenously while glucose-free intestinal perfusate was used as in group 1; (3) intravenous saline given while a 10 mM glucose-isotonic saline solution perfused the jejunum and ileum; and (4) intravenous serotonin given while the intestinal perfusate was as in group 3. Serotonin administration resulted in highly significant net secretion of H2O and sodium in both jejunum and ileum in the groups with a glucose-free perfusate. In jejunum, serotonin evoked net water and sodium secretion, whereas controls absorbed water and sodium. In ileum, serotonin significantly enhanced secretion. The addition of glucose to the perfusate completely abolished the serotonin effect. Unidirectional 22Na flux analysis revealed a marked diminution in both mucosal to serosal and serosal to mucosal fluxes in serotonin-treated animals. The decrease in mucosal to serosal flux was greater than the decrease in serosal to mucosal flux, thus explaining the enhanced net secretion observed with serotonin in the groups receiving glucose-free perfusate. In spite of its pronounced effect on water and electrolyte transport, serotonin failed to produce any detectable histological alterations in small bowel mucosa, either by light or electron microscopy. We postulate that serotonin may be an important mediator of the diarrhea so frequently noted in the carcinoid syndrome by virtue of its effects on small intestinal H2O and electrolyte transport.

Animals↗

PubMedDate not supplied

Should scirrhous gastric carcinoma be treated surgically? Clinical experiences with 233 cases and a retrospective analysis of prognosticators.

BACKGROUND/AIMS: The prognosis of patients with scirrhous gastric carcinoma has been poorest. METHODOLOGY: To clarify the role of surgical treatment, 233 patients with a primary scirrhous gastric carcinoma were retrospectively analyzed. RESULTS: Of the 233 patients, 182 underwent surgical resection, while the other 51 did not. The median survival time of those with unresectable tumors was 88.0 +/- 15.3 days and that of those who underwent resection was 380.0 +/- 41.8 days. In the 182 patients who underwent resection, multivariate analysis revealed four significant factors; lymphatic invasion, serosal invasion, curability, and lymph node dissection. Of these, curability was the most significant. The median survival time of patients whose tumor were curatively resected was 727.0 +/- 116.3 days, significantly longer than 272 +/- 34.9 days for those whose resection ended noncuratively. In 65 patients whose tumor was curatively resected, subset analyses of factors by multivariate analyses revealed an absence of serosal invasion as the single significant prognosticator. The 5-year survival rate was 55.6% in patients with scirrhous cancer without serosal invasion. CONCLUSIONS: For patients with scirrhous gastric carcinoma, palliative resection should not be attempted for poor outcome. However, if curative resection seems feasible, radical surgery would be justified, especially for tumors without serosal exposure.

Adenocarcinoma, Scirrhous↗

PubMed2000

Location of tumor and distribution of lymph node metastasis in gastric cancer: lesser curve or greater curve.

BACKGROUND: The aim of this study was to clarify the relationship between the location of tumor and distribution of lymph node metastasis in node-positive gastric cancer. Pathologic findings of tumors in which location of tumors or positive nodes was confined within the lesser or greater curve were evaluated, and candidates of limited resection were assessed. METHODS: A total of 211 patients with node-positive gastric cancer treated by D2 or D3 gastrectomy was studied. Location, size, gross type, and histologic type of tumors, presence or absence of serosal, lymphatic, and vascular invasions, and status of lymph node metastasis were investigated. Tumors were divided into lesser curve tumors, greater curve tumors, and others; and lymph node metastases were classified as lesser curve metastasis, greater curve metastasis, and both curves metastasis. RESULTS: Lesser or greater curve tumors were featured by small size, negative serosal invasion, negative vascular invasion, metastasis confined to the perigastric nodes, and number of positive nodes less than seven. Cases of lesser or greater curve metastasis were featured by tumor location within the lesser or greater curve, small size, grossly superficial type, negative serosal invasion, negative lymphatic invasion, and number of positive nodes less than seven. When size of lesser or greater curve tumors was less than 4 cm, lymph node metastasis was mostly restricted to the same lesser or greater curve. CONCLUSION: Among node-positive gastric cancers, tumors located within the lesser or greater curve were characterized by small size, negative serosal invasion, and a few metastases confined to the perigastric lymph nodes. When tumor size was less than 4 cm and tumor invasion was not into serosa, lesser or greater curve tumors rarely extend into lymph nodes along the other curve. Limited resection or less invasive treatment is acceptable for such small gastric cancers along the lesser or greater curve.

Gastrectomy↗

PubMed2003

Antifibrinolytic proCPU is present in the peritoneal cavity during surgery.

The fibrinolytic capacity of the peritoneum plays a pivotal role in peritoneal wound healing. During surgery the balance between fibrin deposition and degradation is tilted towards deposition, leading to the formation of adhesions. In blood, carboxypeptidase U (CPU) stabilizes clots by retarding fibrinolysis. The purpose of this study was to investigate whether the more stable zymogen, proCPU, is also present in the peritoneal cavity and, if so, to examine its origin. Levels of proCPU were measured in plasma and serosal peritoneal fluid collected during surgery. Peritoneal biopsies were stained for proCPU. Two-dimensional gel electrophoresis was performed to study the protein composition of the serosal fluid compared to plasma and Western blotting to identify differences in glycosylation of proCPU, indicating possible different cellular origin. Cultured human mesothelial cells were examined for proCPU production under normal conditions and conditions mimicking surgery. We found comparable and correlating levels of proCPU in serosal fluid and plasma. ProCPU was also found where fibrin covered the injured peritoneal surface. A protein composition very similar in serosal fluid and plasma was shown by two-dimensional gel electrophoresis, and the proCPU pattern did not indicate a different origin. No proCPU production was found in cultured mesothelial cells. This is the first study to report on the presence of proCPU in the peritoneal cavity, which seems to be the result of plasma oozing out during the inflammatory reaction to the surgical trauma. This is likely to be important for the balance between fibrin deposition and degradation and thereby in the formation of postoperative adhesions.

Antifibrinolytic Agents↗

PubMed2005

[Prediction of lymph node metastasis with binary logistic regression in gastric carcinoma].

OBJECTIVE: To investigate more specific markers to predict the lymph node metastasis in gastric carcinoma. METHODS: The expression of heparanase mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR) in 43 cases with gastric cancer. The expressions of CD44V6, MMP-7, nm23 and syndecan-1 protein were examined by streptavidin-peroxidase (SP) two-step method. Clinicopathological features influencing lymphatic metastasis such as age,sex,tumor size,tumor location, Borrmann classification, histological type, differentiation and serosal infiltration were also analyzed. RESULTS: Twenty-seven cases (62.8%) in 43 gastric cancer patients had lymphatic metastasis. The incidence of metastatic lymph nodes was(36.3 +/- 30.8)%. The median incidence was 19%. Univariate analysis showed that tumor size, serosal infiltration, expressions of heparanase mRNA, CD44V6, nm23 and syndecan-1 protein were risk factors for lymph node metastasis in gastric carcinoma. Multivariate analysis showed expressions of nm23 and syndecan-1 protein, serosal infiltration were independent factors for lymph node metastasis. CONCLUSION: Gastric cancer with serosal infiltration, positive expressions of nm23 and syndecan-1 has greater possibility of lymph node metastasis.

Biomarkers, Tumor↗

PubMed1991

Cocaine and tracheal epithelial function: effects on short circuit current and neurotransmitter receptors.

After snorting crystalline cocaine, the nasal and airway mucosa will be exposed to high concentrations of this drug. We have examined the actions of mucosal and serosal cocaine application on the basal short circuit current (Isc) and the changes in Isc (delta Isc) induced by acetylcholine (ACh) and isoproterenol (ISO) across swine tracheal epithelium. Cocaine displacement of muscarinic receptor and beta adrenoceptor radioligands was also examined. Cocaine at low, less than 1 mM, concentrations induced basal Isc to increase in some tissues by 9 to 10 microA in some preparations it induced only a decrease in basal Isc. The maximal decrease was 15 to 20 microA in these preparations. In all tissues 14 mM cocaine decreased basal Isc. The IC50 for the cocaine inhibition of Isc was 3 +/- 0.9 mM after mucosal application. Mucosal cocaine (3 mM) did not affect the actions of mucosal amiloride, an epithelial sodium channel blocker (IC50 = 0.6 +/- .1 microM, control; 1.5 +/- 0.3 microM, in the presence of 3 mM cocaine) or serosal tetraethylammonium, a potassium channel blocker. However, cocaine altered the response of the tissue to ACh and ISO. Cocaine (14 mM) applied mucosally reduced the maximal delta Isc induced by ACh (serosal) to 34 +/- 14% of control. By contrast, serosal cocaine (3 mM) caused a parallel shift to the right in the concentration-response relationships for ACh- and ISO-induced increases in Isc (EC50 increased by approximately 6.3 and approximately 2.5 times, respectively) but did not reduce the maximal response.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗

PubMed2006

[Detection of Haemophilus parasuis and Mycoplasma hyorhinis in swine and association of those pathogens with clinical and pathological-anatomic findings].

In routine diagnostic it is difficult to detect a Haemophilus parasuis infection causing a polyserositis. In the presented study, a detection method by means of PCR, from collective swabs of the serosal surfaces from animals, with and without fibrinous serositis, was investigated. A significant association was detected between post mortal findings of fibrinous serositis and molecular biological detection of Haemophilus parasuis and Mycoplasma hyorhinis. However, no significant association existed between cultural detection of Haemophilus parasuis in bronchoalveolar lavage fluid and pathological-anatomical ascertainable fibrinous serositis. A significant association between Haemophilus parasuis and Mycoplasma hyorhinis could be determined in the animals that were included in this study.

Animals↗

PubMed1991

[Acetylcholinesterase and the ADH-dependent transport of water in the amphibian bladder].

It was found that acetylcholine (ACh) at the concentration of 10(-3) M inhibited ADH-stimulated water transport through the wall of amphibian urinary bladder. This effect was suggested to be caused by an interaction of ACh with acetylcholinesterase (AChE) rather than by a stimulation of the M- or N-cholinoreceptor. The inhibitory action of ACh was completely suppressed in the presence of various AChE inhibitors (physostigmine, proserine, armine, Gd-42, acridine-iodmethylate), while an inhibitor of butyrylcholinesterase (BuChE), AD-4, failed to affect it. In accord with this observation the activity of AChE (but not of BuChE) was demonstrated in the urinary bladder epithelium. Since, in addition to the hydrosmotic effects of pituitrine, 8-arginine-vasopressin or oxytocin, ACh blocked also effects of forskolin or cyclic AMP, one may conclude that it acts at some post-cyclic AMP production stage. AChE-dependent inhibition of the ADH-stimulated water transport decreased significantly when the serosal pH was raising from 7.2 to 8.0, but was augmented by serosal acidification (pH 6.8), whereas such pH alterations did not affect the activity of the epithelium AChE. The effect of ACh under consideration was suppressed by adding amiloride (10(-4) M) to the serosal solution. Similarly, the ACh effect was blocked by an inhibitor of Ca-dependent K+ channels, 4-aminopyrdine, which in addition prevented the inhibition of the ADH-stimulated water transport by the serosal acidification. It was noteworthy that some other K+ channel blockers (Ba2+, Cs+, tetraethylammonium, apamine, quinine) did not affect either the water transport or the antipituitrine effect of ACh. In conclusion, we suggest that the inhibitory action of ACh on the ADH-stimulated water transport in the urinary bladder is mediated through the intracellular acidification resulting from ACh interaction with AChE. It is unlikely that the acidification is merely a consequence of the ACh hydrolysis, rather the ACh-AChE interaction induces directly an increase in the proton conductivity of the basolateral membrane of the urinary bladder epithelium.

Acetylcholine↗

PubMed1991

In vitro transport of cycloleucine by equine cecal mucosa.

Mucosa obtained from the cecum of healthy horses and incubated in vitro with 0.1 mM cycloleucine could accumulate this amino acid against an apparent concentration gradient after 60 and 120 minutes. Accumulation by the serosal (antiluminal) surface of the tissue was 3 times greater than accumulation by the mucosal (luminal) surface after 120 minutes (P less than 0.001). Cycloleucine accumulation was significantly reduced by Na deprivation after 60 minutes (P less than 0.05) and 120 minutes (P less than 0.01) and by anoxic conditions after 120 minutes (P less than 0.05). Transmucosal flux from mucosal to serosal surface of the tissue was significantly (P less than 0.05) greater than the opposing flux, but both unidirectional fluxes were small and were largely attributed to passive processes. It was concluded that the most avid transport system for cycloleucine was on the serosal surface of the horse's cecal mucosa, and an active transport system was not evident on the mucosal surface. An active transport system for amino acids on the serosal surface could be explained by the need for crypt cells, the predominant epithelial cell type in the cecum, to obtain nutrients from blood, rather than from the intestinal lumen.

Animals↗

PubMed1990

C-reactive protein levels during disease exacerbations and infections in systemic lupus erythematosus: a prospective longitudinal study.

We prospectively studied the value of measuring C-reactive protein (CRP) levels in patients with systemic lupus erythematosus (SLE) to distinguish between disease exacerbation and infection. During a 2 year followup of 71 lupus patients, 38 episodes of disease exacerbation and 36 episodes of infection could be analyzed. Plasma samples were obtained at least once a month. CRP levels were increased (greater than 6 mg/l) during 25 of the 38 exacerbations and during 32 of the 36 infections. Median CRP levels during infection (60 mg/l; range 1-400) were higher than during disease exacerbation (16.5 mg/l; range 1-375) (p less than 0.05). Levels of CRP rose prior to the exacerbation (p less than or equal to 0.01) and fell afterwards (p less than or equal to 0.01). During exacerbations accompanied by serositis, median levels of CRP (76 mg/l; range 2-375) were higher than during exacerbations without serositis (16 mg/l; range 1-53) (p less than 0.02). CRP levels exceeding 60 mg/l during exacerbations without serositis indicated infection in all cases. Thus, measurement of CRP in SLE is valuable to distinguish between infection and exacerbation only in the absence of serositis.

Adolescent↗

PubMed1979

Effect of 1,4-dimorpholino-7-(4-hydroxyphenyl)pyrido[3,4-d]) pyridazine [DS-511(4'-OH)] on the transepithelial transport of sodium and water and the permeability to urea in the toad urinary bladder.

To elucidate the mechanism of the inhibitory action of 1,4-dimorpholino-7-phenylpyrido[3,4-d]pyridazine (DS-511) on water and sodium reabsorption at the renal tubules, the effect of DS-511 (4'-OH), which is similar in diuretic effect to but more water-soluble than DS-511, on the transepithelial transport of sodium and water and permeability to urea was studied in isolated toad urinary bladder. Application of DS-511(4'-OH) at concentrations above 2 x 10(-4) mol/l to the serosal side of the bladder depressed the transepithelial potential difference, short circuit current (SCC), and membrane conductance as well as the increased response of the SCC to arginine vasopressin (AVP) and cyclic AMP. The effect of DS-511 (4'-OH) applied to the mucosal side was delayed in onset and less pronounced. Neither serosal nor mucosal 10(-3) mol/l DS-511(4'-OH) depressed the increased response of the SCC to amphotericin B. 2 x 10(-4) mol/l DS-511 (4'-OH) applied to the serosal side did not affect osmotic water flow, but potentiated the increase in water flow caused by AVP. Basal urea permeability as well as the increase in urea permeability caused by AVP were depressed by serosal 10(-3) mol/l DS-511 (4'-OH). The results show that DS-511(4'-OH) has two actions, the depression of the transepithelial transport of sodium and urea, and the potentiation of the increased water permeability caused by AVP.

Amphotericin B↗

PubMed1985

Fibroblasts maintain the phenotype and viability of the rat heparin-containing mast cell in vitro.

Rat serosal heparin-containing mast cells (HP-MC) were maintained in vitro for as long as 30 days when co-cultured with mouse skin-derived 3T3 fibroblasts. In contrast, when the mast cells were cultured alone, on fibronectin-, gelatin-, or dermal-collagen-coated dishes, on acid and heat-killed fibroblasts in the presence or absence of 24 hr fibroblast-conditioned medium, or on a monolayer of mouse serosal macrophages, they failed to adhere to the dishes, released significant amounts of their histamine and lactate dehydrogenase, and stained with trypan blue, indicating a loss of viability. The rat serosal HP-MC cultured with the 3T3 fibroblasts became so adherent to the fibroblasts that the two cell types could be separated from one another only by trypsinization. The cultured HP-MC stained with both alcian blue and safranin and continued to synthesize proteoglycan at a rate comparable to that of freshly isolated cells. The 35S-labeled proteoglycan synthesized by these cultured cells, like that produced by freshly isolated rat serosal HP-MC, was a 750,000 to 1,000,000 m.w. proteoglycan containing only heparin glycosaminoglycans of 50,000 to 100,000 m.w. When HP-MC were cultured for 1 wk with the fibroblasts and were then incubated for 5 min with a 1/20 dilution of rabbit anti-rat IgE, they generated and released an average of 22 +/- 10 ng (mean +/- SD, n = 5) of prostaglandin D2 per 10(6) cells and exocytosed a higher net percentage of their total histamine content (44 +/- 11% [mean +/- SD, n = 8]) than did cells just isolated from the animal (6 +/- 4% [mean +/- SD, n = 4]). As assessed by electron microscopy, many of the cultured HP-MC resembled freshly isolated cells except that some secretory granules had fused with one another in some cells. Morphologically, after activation the cultured HP-MC underwent compound exocytosis like freshly isolated cells. These results demonstrate that the in vivo differentiated rat HP-MC maintain their histology, morphology, immunologic responsiveness, histamine content, and ability to synthesize heparin proteoglycan when co-cultured with living fibroblasts.

Animals↗

PubMed1989

SK&F 104353: selective antagonism of peptidoleukotrine-induced changes in electrolyte transport by rat ileal mucosa in vitro.

Effects of the peptidoleukotriene receptor antagonist, SK&F 104353, were examined in vitro using stripped rat ileal mucosa in Ussing chambers. Changes in short-circuit current (Isc), transepithelial conductance (G1) and unidirectional and net Na+ and Cl fluxes measured in the absence or presence of SK&F 104353 (1 microM) revealed that serosal addition produced a decrease in net Na+ absorption and serosal-to-mucosal Cl- flux. Serosal addition of leukotriene (LT)D4 (10 muM) or LTE4 (10 microM) elicited transient increases in Isc and sustained decreases in G1 which were antagonized by serosal addition of SK&F 104353 in a concentration-dependent manner. Mucosal addition of SK&F 104353 (1 microM) also reduced the increase in Isc elicited by LTD4 (10 microM). LTD4 (10 microM) decreased unidirectional and net Na+ and Cl- fluxes along with G1 in the steady state. All of these changes were abolished by pretreatment with SK&F 104353 (1 microM). The intestinal secretagogues prostaglandin F2 alpha, histamine, serotonin, substance P and the thromboxane mimic, U46619, produced changes in Isc qualitatively similar to those of LTD4. However, the transient increase in Isc produced by these secretagogues was not antagonized by SK&F 104353 (1 microM). Additionally, lysbradykinin- and prostaglandin E1-induced increases in Isc were not antagonized by SK&F 104353 (1 microM). Stimulation with histamine (10 microM) or pretreatment with LTB4 (5 microM) did not alter the increase in Isc or decrease in Gt produced by the subsequent addition of LTD4 (10 microM). Pretreatment of the tissues with mepyramine (10 microM) also did not reduce the increase in Isc elicited by LTD4 (10 microM), although it inhibited completely the increase in Isc produced by histamine (10 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1985

Pentavalent antimonial inhibition of the osmotic effect of oxytocin on the isolated toad bladder.

The inhibition of osmotic stimulated water flow in the isolated toad bladder by 0.1 mM sodium stibogluconate (pentavalent antimony) is described. Pentavalent antimony on the serosal surface significantly inhibited oxytocin-induced water flow but when the drug was added to the mucosal surface only the effect of low oxytocin concentrations was reduced. The phosphodiesterase inhibitor pentoxifylline, when present on the serosal side, blocks the effect of pentavalent antimony on stimulated water flow. No effect was detected when indomethacin was present on the serosal side. It is suggested that phosphodiesterase activation might play a role in the mechanism of pentavalent antimonial inhibition of oxytocin-induced water flow in the isolated toad bladder. The effect obtained when sodium stibogluconate on the serosal side was replaced with antimony pentachloride (SbCl5) supports the view that the metal in the molecule is responsible for the inhibition of the effect of oxytocin.

Animals↗

PubMed1988

[Extension and reduction of surgery of cancer occupying mainly the upper third part of the stomach--indications and limitations].

To improve the therapeutic result of patients with advanced carcinoma of the upper third of the stomach, it is necessary to extend further the range of resection and dissection especially in case of invading the lower esophagus with serosal involvement. The extended surgery consists of the following: abdominophrenicotomy or abdominothoractomy, lower esophagectomy and total gastrectomy, dissecting completely the second group of nodes combined with distal pancreatectomy and splenectomy, a block resection of adjacent organs in case of direct invasion, and even dissection of nodes in the lower mediastinum, within the hepatoduodenal ligament, behind the head of the pancreas and along the superior mesenteric vein. Operative procedures are, however, to be palliative in case of moderate or severe peritoneal or hepatic involvements or distant metastasis to the fourth group of nodes. Reduced procedures in case of no serosal invasion nor lymph node metastasis consist of 1/2 proximal gastrectomy and of dissection of the first group of nodes especially in superficial carcinoma. However, in cases free from serosal invasion but with metastasis to the first group of nodes or in cases with a slight serosal invasion, total gastrectomy with dissection up to the second group of nodes is recommended.

Gastrectomy↗

PubMed1980

Effects of clofibrate on water permeability and short-cicuit current of toad urinary bladder.

The effects of the oral antidiuretic drug clofibrate on water permeability of the urinary bladder of the toad, Bufo marinus, were studied. Clofibrate did not alter control water flow along an osmotic gradient. Water flow increases due to vasopressin were reversibly inhibited by 1 to 10 mM clofibrate from the serosal side. Clofibrate in the serosal bathing medium inhibited water flow increases due to cyclic AMP but not due to theophylline. Serosal clofibrate concentrations less than 1 mM or clofibrate in the mucosal solution (1 mM) was ineffective in inhibiting the osmotic water permeability response to vasopressin. Clofibrate in the serosal bathing medium (1 mM) inhibited base-line short-circuit current but had no effect on vasopressin-stimulated short-circuit current.

Animals↗

PubMed1984

Infrarenal aortic occlusion, colonic blood flow, and the effect of nitroglycerin afterload reduction.

Colonic ischemia has been reported to occur in 1% to 13% of all cases of aortic reconstruction. To examine intestinal blood flow in aortic occlusion, three groups of dogs were subjected to measurement of hemodynamic parameters and mesenteric blood flow. Group I served as a control group, while group II underwent balloon catheter occlusion of the infrarenal aorta. Group III received intravenous nitroglycerin infusion during and after aortic occlusion. There was no statistically significant change in intestinal blood flow in group I. Small bowel mucosal blood flow fell in group II. Small bowel serosal blood flow was preserved but total small bowel and small bowel mucosal values fell sharply in group III. Ascending and descending colonic blood flow was unaltered in group I but fell significantly in groups II and III. After restoration of normal aortic circulation, small bowel mucosal flow remained significantly below baseline in groups II and III. Ascending and descending colonic blood flow also remained depressed in groups II and III. Both mucosal and serosal blood flow fell and serosal values remained constant in group III. Both groups exhibited decreased total, mucosal, and serosal blood flow in the descending colon after release of the aortic occlusion. These data show that temporary infrarenal aortic occlusion causes significant changes in intestinal blood flow. The mechanism is due to persistent autoregulatory vasoconstriction. Nitroglycerin used for afterload reduction in aortic reconstruction does not ameliorate decreases in intestinal blood flow and may actually shunt blood away from the distal colon and the distal intestinal mucosa during aortic occlusion.

Animals↗