Mucosal Stripping Research Articles

The Sodium-Alanine Interaction in Rabbit Ileum

The model of the interaction between Na and alanine at the mucosal border of rabbit ileum has been tested further by examining the efflux of alanine from the cells toward the mucosal solution. Alanine efflux shows a tendency toward saturation as cellular alanine concentration increases and is influenced by cellular Na concentration. A decrease in cell Na concentration causes an increase in the apparent Michaelis constant with little change in maximal efflux rate. Studies on strips of mucosa treated with ouabain or cyanide showed that the direction of net alanine transfer between the cells and the medium is determined by the direction of the Na concentration difference. The cells extrude alanine against a concentration difference when cell [Na] exceeds medium [Na] and accumulate alanine when cell [Na] is less than medium [Na]. The observations are consistent with the model previously suggested involving a transport site that combines with and translocates both Na and alanine, and with the concept that the Na concentration difference between mucosal solution and cytoplasm provides at least part of the energy for active transport of alanine.

Displacement of the squamo-columnar junction of the gastric mucosa in the rat after experimental ulceration

The squamo-columnar junction of the rat's stomach was used to study the way in which two adjoining but dissimilar types of epithelium become distributed after injury. Mucosa (including the muscularis) was removed from a circular area of this junction and then allowed to regenerate. When the defect was symmetrically placed about the original line of junction, the two types of epithelium returned to their previous sites and restored the original pattern of mucosa. However, when the defect was placed more over the squamous or the glandular portion of the stomach, the line of junction after regeneration was displaced towards the side where more mucosa was removed. By repeating the procedure it was possible to displace the line of junction further from its original site, and by isolating the migrated epithelium by the removal of a strip of mucosa, 'ectopic' areas of mucosa were produced. These results suggest that (1) when the whole mucosa is removed the non-specific granulation tissue which forms does not prevent the migration of mucosal cells of another type or alter their pattern of cytodifferentiation; (2) the location of the line of junction of the two types of mucosa depends on the position of the defect and the relative speeds of epithelial migration and (3) 'ectopic' mucosa in certain sites may well be acquired.

The muscle structurn of human stomach and its relation to the development of gastric ulcers with special reference to the longitudinal muscle fibers

This study presents a new technique to observe the structure of gastric smooth muscle layers by means of the combined use of “mucosa stripping technique” and “nitric acid treatment”. The mucosa stripping technique has been described elsewhere. After the procedure, the specimens are re-emersed into 20% nitric acid solution for 3 to 7 days. By the time, the muscle fibers contract tightly and the interstitial fibrous tissues become swollen and fragil, and they are easily removed by forceps in running water. Leaving muscle structure is solidly delineated.By this method, the author explored the detailed structure of three layers of gastric smooth muscles and individualized the special muscle bundles; namely, “anterior medial oblique muscle bundle”, “posterior medial oblique muscle bundle” and “border circular muscle bundle”. These muscle bundles constitute, so-called, “upper strain zone” in relation to the development of peptic ulcers at about the gastric angulus where almost all uclers locate.Special interest is emphasized on an existence of “lesser curvature longitudinal muscle bundle” which is confined to the area of upper strain zone and tapering off in gradual fusion with the circular muscle bundles. Although, the functional signfiicance of these muscle bundles remains for the future study.

Surgery of rectal anomalies with presentation of the relationship between the colonic muscular sleeve and the puborectalis muscle

While accepting the views of Stephens regarding the importance of the puborectalis sling in the control of recto-anal continence, we think it equally important to preserve the normal relationship between the rectomuscular sleeve and the puborectalis sling, and also to avoid damage to the nerves within the pelvis. These two principles can be followed by passing the colon down within a special hollow conical dilator, which perforates the rectomuscular wall after mucosal stripping and gradually dilates the puborectalis sling. This operation can be done at any age and we have had good results in the newborn. There is no need to define the puborectalis sling by a sacral approach.

Preservation of continence after mucosal graft in the rectum and its feasibility in man

1. 1. An experimental operation in the dog in which rectal mucosa is replaced by mucosa of the upper part of the colon demonstrates that mucosal stripping and replacement do not destroy fecal continence and can be performed safely. 2. 2. The histories of two patients with chronic ulcerative colitis who had total abdominoperineal colectomy with rectal reconstruction are presented. The first operation failed because of technical factors but the second was successful.

Rectal mucosa stripping with abdominoperineal pull-through procedure: An anatomic and physiologic study

The use of the seromuscular cuff of the rectum, denuded of submucosa and mucosa, as a conduit for abdominoperineal pull-through procedure has merit. The procedure is not technically difficult. Postoperative complications are minimized by careful dissection, adequate hemostasis, and appropriate postoperative drainage. The technical problems of pelvic dissection and its complications are avoided. The results of this procedure are excellent, as judged by clinical observation and functional studies, up to 2 years following surgery. Microscopically there is significant muscular atrophy and fibrosis in the muscular cuff and in the wall of the colon within the cuff. Frequently definite evidence of a double muscular wall is lacking in the distal portion of the pull through. The significance of these changes cannot be determined by this study. There was no correlation between the histologic abnormalities and functional behavior which was observed over a 2-year period. More detailed anatomic studies and a longer period of followup should clarify this apparent contradiction.

Regeneration of bladder epithelium after mucosal denudation (stripping) in guinea pigs. An interim report.

In 22 guinea pigs the urinary bladder was macroscopically denuded of mucosa and a permanent cystostomy was made. The animals were killed at various times after the operation—up to six weeks. In seven control guinea pigs, cystostomy was done without mucosal stripping.Microscopy, however, showed that total stripping of the mucosa was not feasible with the technique used. Regeneration to apparently normal transitional epithelium took place from multiple foci. When inflammatory complications could be kept within bounds, the re-epithelialization was complete within four to five weeks. Severe inflammatory changes of the upper urinary pathways and the kidneys occurred in many of the guinea pigs, presumably secondary to stenosis around the ureteral orifices. The mucosal stripping greatly reduced the animals' resistance to ascending urinary-tract infection.

The polarographic determination of the respiration of the small intestine of rat

1. 1. Methods are described for the polarographic determination of the oxygen consumption of various preparations of rat small intestine. 2. 2. In the presence of glucose the rate of respiration of sacs of everted jejunum is less than the rate for rings cut from the whole wall of the jejunum. When either pyruvate, glucose, galactose or 3- O-methylglucose is added to the medium, the rate of respiration of rings of the upper jejunal wall is increased above the level found with no substrate present. 3. 3. In the presence of either pyruvate, glucose, galactose or 3- O-methylglucose, the respiration rate of strips of jejunal mucosa in media which contain Na is reduced below the high level found with no exogenous substrate. 4. 4. In the absence of exogenous substrate, the respiration of strips of jejunal mucosa is reduced when either choline, lithium or potassium chloride is substituted for the NaCl in the incubation medium. 5. 5. It is concluded that in the presence of glucose, the respiration rate of the mucosal cells is highest in the case of strips of isolated mucosa, has an intermediate value for the mucosa of rings of the whole wall and has the lowest value in the case of the mucosa of the whole everted sacs. It is suggested that the findings are explicable if the rate of respiration of the mucosal cells is determined in part by the intracellular ionic composition.

ARTIFICIAL VAGINA

THE SURGICAL creation of an artificial vagina still intrigues the medical profession. In the past 135 years, countless and tedious methods have been devised only to be discarded because of the magnitude of the procedure and/or the inability to cope with the serious complications. Dupuytren in 1817, Villaume in 1829, and Amussat in 1832,1made a simple opening between the bladder and rectum but could not satisfactorily maintain its caliber. Eventually, methods and materials for lining the pouch were outlined. Free skin flaps, strips of vaginal mucosa from other patients, intestinal wall from both the small and large bowel, hernial sac lining, guinea-pig intestine, peritoneum, fetal membranes, and, lately, Thiersch grafts have been utilized. Heppner, Gersung, Baldwin, Schubert, Graves, Wharton, Falls, Counsellor, and Frank contributed techniques to this end. While all these methods were initiated by the dissection of the area between the bladder and rectum, their greatest differences

Histological Study of Vesical Urothelium Intervening Between Gross Neoplasms in Total Cystectomy

Histological Study of Vesical Urothelium Intervening Between Gross Neoplasms in Total Cystectomy