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PubMed1995

Contractility and phenotype transitions in serosal thickening of obstructed rabbit bladder.

Partial outlet obstruction of rabbit bladder induces serosal thickening and smooth muscle (SM) cell hypertrophy that are accompanied by phenotypic changes in the expression of cytoskeletal and cytocontractile proteins. In the present study, we compare the observed progressive phenotypic changes with the contractile responses of strips of the thickened serosa. At 15 days after partial outlet obstruction, although cells in thickened serosa demonstrate the presence of nonmuscle (NM) myosin of A-like type, vimentin, and SM alpha-actin, no contractile responses of this tissue were noted. At later times (30 days), this tissue expressed in addition SM myosin, and this pattern was paralleled by the development of KCl-stimulated contractility. It is only after 60 days that the serosa demonstrated the expression of desmin, phosphoglucomutase (PGM)-related protein, and was locally negative for NM myosin, indicating a maturation toward adult SM cells. Concomitant to this phenotypic change, the response to KCl increased, and a bethanechol-stimulated contractile response developed. At no time period did the serosal layer react with anti-synaptophysin or anti-neurofilament proteins nor did the strips respond to field stimulation (via release of neurotransmitters), showing that SM cell differentiation and development of contractile responses during serosal thickening are independent of innervation.

Animals↗
PubMed1987

Intestinal arteriolar responses to mucosal and serosal applications of adenosine analogues.

Adenosine or its synthetic analogues were topically applied to the intestinal jejunum while steady-state blood flow was calculated in submucosal arterioles using video microscopy. Blood flow increased (220 or 130% of control) with the serosal application of 10(-6) M N-ethyl carboxamido adenosine (NECA, A2-selective agonist) or 2-chloro adenosine (2CA, nonselective agonist) but not with cyclohexyl adenosine (CHA, A1-selective agonist). The nonselective competitive antagonist, 8-phenyl theophylline, attenuated the response evoked by NECA. The mucosal application of 10(-6) M CHA caused blood flow decreases (81% of control), but neither NECA nor 2CA evoked a response. These observations suggest a mucosal diffusion barrier, so the concentrations of the analogues were raised one hundredfold. Serosal 10(-4) M CHA or NECA caused blood flow increases, but the effects were negligible with mucosal application, suggesting that the mucosa was indeed impermeable to these compounds. The responses evoked by 10(-4) M 2CA were similar on the serosa or mucosa (200-220% of control), submaximal (maximum = 400% of control at 10(-3) M), and not antagonized by 8-phenyl theophylline or by the cellular uptake inhibitor, nitrobenzyl-6-thio guanosine. In context with earlier studies, greater than 10(-6) M 2CA probably evokes vasodilation that is not entirely mediated by extracellular receptors. Serosal adenosine (10(-4) M) caused submaximal blood flow increases (200% of control) that were not potentiated by nitrobenzyl-6-thio guanosine or another transport inhibitor, dipyridamole.(ABSTRACT TRUNCATED AT 250 WORDS)

2-Chloroadenosine↗
PubMed2005

Absorption characteristics of model compounds from the small intestinal serosal surface and a comparison with other organ surfaces.

We examined the absorption of phenolsulfonphthalein (PSP) and fluorescein isothiocyanate dextrans (FD-4, MW 4400; FD-10, MW 9500; FD-40, MW 40 500) as model compounds through the small intestinal serosal surface. After application to the rat small intestinal serosal surface using a cylindrical diffusion cell, each compound was absorbed at different rates. The absorption ratios in 6 h after PSP, FD-4, FD-10 and FD-40 application were calculated to be 89.2, 34.6, 14.9 and 2.1% of dose, respectively. Elimination profiles of PSP, FD-4 and FD-10 from the small intestinal serosal surface obeyed first-order kinetics. Moreover, we calculated the apparent permeability coefficient P(app) for comparison to other organ surfaces. The kidney had the highest absorption efficiency, as shown by having more than 1.5 times significantly higher P(app) values of PSP, FD-4 and FD-10. Similar to the other organ surfaces, a correlation was observed between the P(app) of the small intestine and the molecular weight of these hydrophilic compounds. In addition, the small intestine is likely to contribute largely to hydrophilic compound absorption from the peritoneal cavity, judging from absorption clearance, CL(a), calculated using the peritoneal organ surface area.

Animals↗
PubMed2005

The serosal mesothelium is a major source of smooth muscle cells of the gut vasculature.

Most internal organs are situated in a coelomic cavity and are covered by a mesothelium. During heart development, epicardial cells (a mesothelium) move to and over the heart, undergo epithelial-mesenchymal transition (EMT), and subsequently differentiate into endothelial and vascular smooth muscle cells. This is thought to be a unique process in blood vessel formation. Still, structural and developmental similarities between the heart and gut led us to test the hypothesis that a conserved or related mechanism may regulate blood vessel development to the gut, which, similar to the heart, is housed in a coelomic cavity. By using a combination of molecular genetics, vital dye fate mapping, organ culture and immunohistochemistry, we demonstrate that the serosal mesothelium is the major source of vasculogenic cells in developing mouse gut. Our studies show that the gut is initially devoid of a mesothelium but that serosal mesothelial cells expressing the Wilm's tumor protein (Wt1) move to and over the gut. Subsequently, a subset of these cells undergoes EMT and migrates throughout the gut. Using Wt1-Cre genetic lineage marking of serosal cells and their progeny, we demonstrate that these cells differentiate to smooth muscle of all major blood vessels in the mesenteries and gut. Our data reveal a conserved mechanism in blood vessel formation to coelomic organs, and have major implications for our understanding of vertebrate organogenesis and vascular deficiencies of the gut.

Animals↗
PubMedDate not supplied

Histologic evaluation of preventive measures for scald injury on the peritoneo-serosal surface due to intraoperative hyperthermic chemoperfusion for patients with gastric cancer and peritoneal metastasis.

To histologically assess the preventive efficacy of cimetidine against scald injury on the peritoneo-serosal surface during intraperitoneal hyperthermic chemoperfusion (IHCP) for advanced gastric cancer, a randomized histologic study using cimetidine, a histamine H2-receptor antagonist, was performed for 20 patients with advanced or recurrent gastric cancer and peritoneal metastasis. Cimetidine 50 mg/kg was administered intravenously to 10 patients just prior to the IHCP (cimetidine group), and the remaining 10 patients underwent the IHCP without cimetidine (control group). The background factors and IHCP treatments of these two groups were nearly the same. Although the antitumour efficacy of the IHCP was not histologically different between the two groups, the histological analysis revealed that the peritoneo-serosal surface in the cimetidine group was protected against scald injury, compared with the control group. This finding suggests that pre-IHCP cimetidine is of great benefit for protecting the peritoneo-serosal surface from scald injury due to IHCP.

Antineoplastic Agents↗
PubMedDate not supplied

Improvement of the prognosis of gastric cancer with extensive serosal invasion using left upper abdominal evisceration.

BACKGROUND/AIMS: The prognosis of gastric cancer patients with serosal invasion is very poor. In this study, the effectiveness of the LUAE (left upper abdominal evisceration) procedure for these patients was evaluated retrospectively. METHODOLOGY: Thirty-seven gastric cancer patients who had serosal invasion but no massive peritoneal metastasis or hepatic metastasis, and underwent LUAE, were enrolled in this study (LUAE group). As a control, 66 gastric cancer patients who had the same disease conditions as the LUAE group, and underwent conventional total gastrectomy with the combined resection of the pancreatic body and tail and spleen (TPS group), were also investigated. RESULTS: The survival rate (5-year, 42.2%) of the LUAE group was significantly better than that (5-year, 21.2%) of the TPS group (P = 0.009). Although D4 super-extended lymphadenectomy and intraperitoneal chemotherapy during surgery was performed more frequently in the LUAE group than those in the TPS group, multivariate analysis demonstrated that the LUAE procedure was a better independent prognostic factor. CONCLUSIONS: The LUAE procedure in combination with D4 super-extended lymphadenectomy and intraperitoneal chemotherapy improved the prognosis of gastric cancer patients with extensive serosal invasion.

Aged↗
PubMedDate not supplied

Postoperative adjuvant chemotherapy is effective in gastric cancer with serosal invasion: significance in patients chosen for multivariate analysis.

There are few reports on overall usefulness of adjuvant chemotherapy in gastric cancer patients. We tried to clarify, using multivariate analysis, usefulness of postoperative adjuvant oral chemotherapy in advanced gastric cancer patients after curative resection. Four hundred and eighty-two gastric cancer patients enrolled in a randomized controlled trial were classified into 2 groups based on postoperative chemotherapeutic regimen: oral doxifluridine (5'-DFUR, an intermediate metabolite of capecitabine) (n=245) or oral 5-fluorouracil (5-FU) (n=237). The significant prognostic factors in patients with serosal invasion were chemotherapeutics (5'-DFUR vs. 5-FU) (risk ratio 1.649; 95% CI, 1.112-2.437), lymph node metastasis (no vs. yes) (2.823; 1.422-5.604), and tumor differentiation (differentiated vs. undifferentiated) (1.727; 1.068-2.791). Significant factors influencing peritoneal recurrence time were chemotherapeutics (1.756; 1.063-2.902), serosal invasion (no vs. yes) (2.237; 1.264-3.961), lymph node metastasis (2.541; 1.267-5.095), tumor differentiation (2.656; 1.374-5.136), and tumor location (others vs. total) (3.595; 2.006-6.443). There were no differences in the overall survival between chemotherapy. However, 5'-DFUR produced a better survival time of patients with serosal invasion than 5-FU, that might be attributed to the prevention of peritoneal recurrence in this subset.

Aged↗
PubMed1991

[Gastrectomy for advanced gastric carcinoma with serosal involvement].

Four hundred and eighty five gastric cancer patients underwent gastrectomy in the past 6 years and of those 332 patients (68.2%) were found to have only serosal involvement (se) or adjacent organ invasion (sei). Simple gastrectomy (SG) was carried out in 144 cases while radical gastrectomy (RG), which included systemic lymphadenectomy, was performed in 188 cases. This type of operation was chosen by the operators arbitrarily except in the presence of non-curative factors such as multiple liver metastasis, peritoneal seeding and distant metastasis, in which case SG was always used to relieve gastrointestinal obstruction or bleeding. The operative mortality of SG was 2.7% and that of RG was 3.2%. On average, 15.8 lymph nodes were taken out per patient in SG and 33.6 lymph nodes in RG. The chance of nodal metastasis was higher in sei than in se. According to the Japanese General Rules of Gastric Cancer Study, we found that for gastric cancer with serosal involvement: (1) the long term result of RG was superior to SG in both stage 3 and 4 patients, (2) when absolute curative resection was achieved, the result was the best in stage 3 patients, (3) no patient in stage 4 who underwent absolute non-curative resection survived for more than 42 months, therefore this result was the worst. RG is recommended for advanced gastric cancer patients with serosal involvement whenever the patient's condition permits and in absence of the unresectable non-curative factors.

Gastrectomy↗
PubMed1989

[Relation of the serosal invasion mode to a recurrence in advanced gastric carcinomas].

Discussed are the attributable factors affecting the type of carcinomatous recurrence seen in 126 patients who had been operated on for their gastric carcinomas from 1979 to 1982 and who later showed a macroscopically positive serosal invasion (S0) and a histologically ss alpha approximately se invasion and required a curative resection. Forty-six percent of the patients with an ss beta approximately se invasion had a peritoneal recurrence, 21% a liver recurrence, and 33% a recurrence of some other type, whereas those with ss alpha had no such recurrence. Peritoneal recurrence tended to increase with the increase in the length of the serosal invasion and its rates were: one third in serosal invasions of less than 3 cm, one third in invasions of 3 approximately 6 cm and another third in invasions of over 6 cm. The smaller ratio of submucosal length to subserosal length, especially when less than 1.0, meant a greater frequency of peritoneal recurrence. The histologic characteristics of carcinomas that developed a peritoneal recurrence were poorly differentiated, contained INF alpha and had weaker cellular cohesion, whereas those that developed a liver metastasis were well differentiated carcinomas, contained INF beta and had a tighter cellular cohesion.

Adenocarcinoma, Mucinous↗
PubMed1987

[Prognosis of gastric cancer patients with special reference to the area of serosal cancerous invasion].

The area of serosal cancerous invasion and intraperitoneal free cancer cells were examined in 360 gastric cancer cases. The positivity rate of intraperitoneal free cancer cells was 20% in the group with under 20 cm2 of serosal invasion, 59% with 20 cm2 to 30 cm2, and 76% over 30 cm. The postoperative survival rate was significantly lower in the group with free cancer cells than in the group without them. Prognosis was better in case with the area of serosal invasion was smaller. Hematogenous metastasis was frequent under 20 cm2, but over 20 cm2, peritoneal metastasis predominated.

Cell Count↗
PubMed1998

[Clinical result of intraperitoneal hyperthermic chemoperfusion for gastric cancer with serosal invasion to prevent peritoneal recurrence].

In order to evaluate clinical effects of intraperitoneal hyperthermic chemoperfusion (IHCP) to prevent peritoneal recurrence in gastric cancer patients with serosal invasion, the clinical outcome was studied in 126 gastric cancer patients with macroscopic serosal invasion. Results of 59 patients who had surgery combined with IHCP (IHCP group) were compared with those of 67 patients who had surgery alone (control group). IHCP was performed for 120 minutes just after surgery under hypothermic general anesthesia with perfusate containing 10 micrograms/ml of mitomycin C. The inflow temperature and the outflow temperature of the perfusate were controlled to be 44.5 approximately 45 degrees C, and 43 approximately 44 degrees C, respectively. The 2-, 4- and 8-year survival rates for the IHCP group were 86%, 74% and 66%, respectively, against 78%, 59% and 50%, respectively, in the control group. The survival rates of the IHCP group were significantly better than those of the control group. Peritoneal recurrences after surgery were encountered in one of 59 patients in the IHCP group and 17 of 67 patients in the control group. The peritoneal recurrence rate of the IHCP group was significantly lower than that of the control group. These results suggest that IHCP treatment is effective in prevention of peritoneal recurrences after surgery for gastric cancer patients with serosal invasion.

Antibiotics, Antineoplastic↗
PubMed1991

Case report: systemic lupus erythematosus (SLE) serositis mimicking acute cholecystitis.

Systemic lupus erythematosus (SLE) is a well recognized cause of an acute abdomen. What is less well recognized is that the underlying pathology can be varied. The computed tomography (CT) and ultrasound appearances of the gall-bladder in a case of SLE serositis are shown. The imaging findings were strongly suggestive of primary gall-bladder disease although at laparotomy the gall-bladder showed serosal inflammation only.

Acute Disease↗
PubMed1999

Serosal complications of single-agent low-dose methotrexate used in gestational trophoblastic diseases: first reported case of methotrexate-induced peritonitis.

Methotrexate (MTX) is a folate antagonist widely used both as an anticancer drug and as an immunosupressant. Administration of an 8-day methotrexate and folinic acid regime may be associated with pleuritic chest pain and pneumonitis. We have reviewed the toxicity seen in 168 consecutive patients treated with low-dose MTX for persistent trophoblastic disease. Twenty-five per cent of patients developed serosal symptoms, pleurisy was the commonest complaint. The majority of patients had mild to moderate symptoms which were controlled with simple analgesia and did not necessitate a change in treatment; 11.9% had severe symptoms which necessitated a change in treatment. One patient developed a pericardial effusion and a second patient developed severe reversible peritoneal irritation. The possible aetiology and pathophysiology of methotrexate-induced serosal toxicity is discussed.

Adult↗
PubMed1987

Serositis with autoimmune endocrinopathy: clinical and immunogenetic features.

Twenty patients with autoimmune endocrinopathies experienced 45 episodes of pleural and/or pericardial serositis. Seventeen of these patients were women and 15 had clinical or serologic evidence of 2 or more endocrinopathies. Idiopathic primary hypoadrenalism (10 cases), Graves' disease (8 cases), Hashimoto's disease (4 cases), atrophic thyroiditis with hypothyroidism (3 cases), idiopathic primary hypogonadism (3 cases), transient thyroiditides (2 cases), and type I diabetes mellitus (1 case) were diagnosed at a mean age of 24 years. Serositis recurred after asymptomatic intervals of months to years even in patients treated for endocrine dysfunction. Fourteen of 16 Caucasians had circulating immune complexes, including all 9 patients with a C4AQ0 (C4A null) phenotype and including all 12 patients with HLA antigens B8 and DR3, antigens associated with systemic lupus and with autoimmune endocrinopathies. Serositides associated with autoimmune endocrinopathies can occur with chest pain, fever, and exudative effusions in young Caucasian women with the HLA B8 DR3 C4AQ0 phenotype. These serositides may have a common pathophysiologic mechanism.

Adolescent↗
PubMed1995

Systemic lupus erythematosus serositis.

The imaging appearances of a case of systemic lupus erythematosus, which manifested initially as a serositis, is described. Barium small bowel study showed segments of spiculation with tethering, angulation, and obstruction. On computed tomography there was ascites and segments of asymmetrical thickening of small bowel wall were observed. Laparotomy revealed extensive patchy serosal and peritoneal plaques but biopsy of these lesions did not lead to a definitive diagnosis. The diagnosis was made on the basis of marked elevation of antinuclear and anti-double stranded DNA antibodies.

Adult↗
PubMed1989

Prognostic factors in gastric cancer with serosal invasion. Univariate and multivariate analyses.

Univariate and multivariate analyses of possible prognostic factors were carried out on data from 142 patients who had undergone curative resection for a carcinoma of the stomach invading beyond the muscularis propria. In the univariate analysis, factors including age, size of cancer, gross form, depth of penetration, lymph node metastasis, lymphatic invasion, width of serosal invasion, mode of invasion, volumetric shape of invasion, and stage had an individual prognostic significance. The multivariate analyses indicated that stage, lymph node metastasis, and depth of penetration were the most significant prognostic factors and that the prognosis in cases of obvious serosal invasion, or those with secondary or tertiary nodal involvement, was poor. For such patients, we prescribe postoperative intensive chemotherapy, even when a "curative" operation is done.

Adenocarcinoma↗
PubMed1996

Clinicopathologic study of advanced gastric cancer without serosal invasion in young and old patients.

Fifty-seven patients treated by radical gastric resections were retrospectively studied to understand the clinicopathologic characteristics of advanced gastric cancer without serosal invasion (the depth of tumor invasion limited to the muscularis propria or subserosal layer) in young and old age persons. There were 36 patients in the old age group (age > 60 years) and 21 in the young age group (age < or = 40 years). The clinical and pathologic parameters for this study included sex, gross type, location, maximum tumor size, depth of invasion, lymph node metastasis, tumor stage, histologic type, and rate of curative resection. The old patients had a higher percentage of small tumors, subserosal invasion and lymph node metastasis, but these parameters were not significantly different from those of the young patients, nor did the sex ratio, gross type, location, and rate of curative resection show significant differences. The histologic feature was the only statistically significant parameter, determined by univariate and multivariate analyses. Poorly differentiated adenocarcinoma and signet ring cell carcinoma were detected in 10 (47.6%) and 4 (19.0%) of the 21 younger patients, respectively, while there were 4 (11.1%) and 2 (5.6%) in the old age group. Although the gastric cancer in young patients had more aggressive histologic characteristics than it did in elderly patients, survival rates between the two groups did not differ to any great degree. Our findings indicate that the prognosis for younger patients with advanced gastric cancer without serosal invasion was favorable when curative resection was performed.

Adenocarcinoma↗
PubMed2000

The relationship between inflammatory and serosal connective tissue changes in ileal Crohn's disease: evidence for a possible causative link.

The relationship between the gross connective tissue and inflammatory changes in ileal Crohn's disease remains unclear. This study investigated 20 patients undergoing ileal resection for Crohn's disease and 20 normal controls. The specimens were blocked in 1 cm serial sections and fully examined, including fresh morphometry and documentation of a range of pathological features. Pathological features of disease showed uniform distributions within affected segments, although specimens showed different patterns and severity of affliction. Serosal fat wrapping (FW) was present in all cases and was significantly greater than normals [mean 63.5% (SD 27. 8) vs. 21.0% (6.4), p<0.001], as was mesenteric thickening (MTh) [mean 18.0 mm (SD 11.1) vs. 5.9 mm (2.2), p<0.001]. The extent of FW correlated significantly with the degree of acute and chronic inflammation (r()=0.32 and 0.23 respectively, p<0.01), particularly the extent of transmural inflammation in the form of lymphoid aggregates (r()=0.35, p<0.01). MTh did not correlate with any features studied. These findings support the hypothesis that serosal connective tissue changes in Crohn's disease are related to the local effects of underlying chronic inflammatory infiltrates. Full thickness, radial samples from a grossly affected area are representative of the histopathological features present in a diseased segment as a whole.

Acute Disease↗