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Biomedical subjects

H Plapler

Publications and source records attributed to H Plapler.

16 recordsLinked to original sources
PubMed2000

350 ambulatory hemorrhoidectomies using a scanner coupled to a CO2 laser.

OBJECTIVE: The purpose of this study was to investigate how a scanner device would improve the outcome of laser hemorrhoidectomy regarding pain, healing, secretion, and hemostasis. BACKGROUND DATA: The technology of the laser has been applied since the 1960s in several clinical and surgical specialties. The inherent advantages, due to the biological characteristics of this instrument are: (1) it does not affect the neighborning tissues, (2) it is hemostatic, (3) it favors healing, (4) it is bactericidal, and (5) it presents less postoperative pain. Several authors have questioned these supposed advantages. After scanners were introduced, better results were accomplished, including in proctological surgery. METHODS: A total of 350 patients, consecutively, went through a laser hemorrhoidectomy using a CO2 laser coupled to a scanner device in a 3-year period. Patients were monitored for pain, healing, bleeding, and local secretion for up to 36 months. RESULTS: Almost 13% of the patients required bondage of arteries during the operation; 96% used analgesics for up to 3 days; and 5 patients (1.42%) complained of strong pain for several days. Only 2 patients (0.6%) reported intense pain for more than 7 days. All patients presented complete healing between the 30th and the 40th POD. In the 90th POD tissue regeneration appeared healthy. The immediate complications included 2 cases of nipple hemorrhage that demanded a review. Stenosis occurred in 4 patients. Residual "plicoma" was often present with the laser technique (20%). Return to work, regardless of its nature, was an average, on the 3rd postoperative day. CONCLUSIONS: Our evaluation of the results led to the conclusion that the scanner coupled to the CO2 laser was fundamental for better postoperative outcome in our patients, at least compared to other laser techniques.

Adolescent↗
PubMed1999

Evaluation of the longitudinal musculature of segments of the distal colon interposed following extended jejunum-ileum resection.

Several morbid conditions may necessitate extensive intestinal resection, leading to short-bowel syndrome. When clinical treatment becomes inefficient, a surgical approach is necessary. Distal colon interposition is one of the viable techniques. The interposition of colon segments between remnants of the small bowel improved lifestyle, increased transit time, and diminished diarrhea. The aim of this study is to observe the longitudinal muscular contractions after distal colon interposition. Sixteen male Wistar rats (EPM-1) were submitted to an 80% small bowel resection associated with a partial colectomy of the distal colon immediately after the bifurcation of the middle colic artery followed by a 3-cm isoperistaltic distal colon interposition. After 70 days, the animals were submitted to euthanasia and segments of the jejunum, ileum, remnant colon, and interposed colon were prepared for pharmacological tests. The isometric contractions were measured by a polygraph. After 30 minutes, the dose/effect curves were obtained for both metacholine and barium chloride stimulation through the extraluminal surface (serosa). After this period, we observed a significant increase in the length, diameter, and thickness of the intestinal wall. Regarding the sensibility (pD(2)), no difference was found (interposed colon = 7.21 +/- 0.2; remnant colon = 7.65 +/- 0.1; remnant jejunum 7.46 +/- 0.1; and remnant ileum 7.57 +/- 0.1), even though the animals were submitted to different procedures. In relation to the maximal effect (E(max)), the longitudinal muscle contraction responses (interposed colon = 11.79 +/- 0.1; remnant jejunum = 15.42 +/- 0.2; and remnant ileum = 11.48 +/- 0.2) were lower than those of the remnant colon (E(max) = 22.42 +/- 0.1). This means that there was a possible adaptation of colonic segments to their new location.

Anastomosis, Surgical↗
PubMed1996

Graft-infiltrating cells in rats receiving orthotopic semiallogeneic small intestine transplantation with portal or systemic venous drainage.

The effect of alterations in venous drainage, from either ivc to portal vein (pv), along with peritransplant systemic (ivc) or portal (pv) venous alloimmunization with irradiated semiallogenic cells, on cell subset recovery in lymphoid organs of Lewis rats receiving orthoptic small bowel allografts (from LewisXBrown Norway) F1, LBNF1) was examined. Combined portal, venous drainage and alloimmunization has been reported to increase graft/recipient survival in this model. FACS analysis using monoclonal antibodies specific for different lymphocyte subsets was performed on cell suspensions of peripheral (P) and mesenteric (M) lymph node (LN), small bowel intraepithelial lymphocytes (SBIEL), and Peyer's patch (PP) lymphocytes on days 2 and 8 posttransplantation. Donor cell contributions to these cellular analyses were estimated by comparison of FACS staining with polyclonal anti-Lewis or Lewis anti-LBNF1 antibodies. Control animals received syngeneic grafts. In both syngeneic and semi-allogenic transplants with pv or ivc drainage there was no consistent difference in cell subsets from in PLN compared with those of control nongrafted rats. Approximately 50% to 60% of these cells were alphabetaTcR+ with a CD4+/CD8+ ratio of 3-4:1 and a (CD4++CD8+)/alphabetaTcR+ ratio of 1:1. Some 5% to 12% ED3+ cells were also present. In IEL, MLN, and PP by contrast, there were significant differences in cells recovered from rats with ivc vs. pv drainage of grafts. The most striking changes reflected a decreased CD4+/CD8+ and alphabetaTcR+gammadeltaTcR+ cells in these tissues in rats predestined to show prolongation of allograft survival (ivc vs. pv injected IEL CD4/CD8+ ratios and alphabetaTcR+gammadeltaTcR+ ratios 1.0, 0.7 and 5.0, 1.0, respectively. These data are consistent with a proposed role for such gammadeltaTcR+ cells in the local regulation of graft rejection.

Animals↗
PubMed1996

Phenotypic and functional assessment of intraepithelial lymphocytes (IEL) isolated from rat colon and small bowel.

We have compared the proliferative potential of IELs isolated from rat colon (CIEL) and small bowel (SBIEL), and compared this with that observed using spleen lymphocytes. Unless additional irradiated spleen cells were added as a source of accessory cells, both IEL populations show poor proliferation in response to Con A stimulation. The CD4/CD8 ratio in spleen, SBIEL and CIEL was markedly different (3:1, 1:3, and 1:1, respectively). Cells expressing surface markers characteristic of macrophages were not routinely found in SBIELs. Both IEL preparations inhibited spleen cell proliferation in response to Con A or immobilized anti-CD3, and produced a soluble factor(s) capable of causing similar inhibition. For CIEL this inhibition was dependent upon a proliferation-independent but cell-cell contact dependent event.

Animals↗
PubMed1994

Colonic fermentation and nutritional recovery in rats with massive small bowel resection.

BACKGROUND/AIMS: After massive small bowel resection, malabsorbed carbohydrates reach the colon and undergo fermentation. This study investigates the role of colonic fermentation in rats with 80% small bowel resection on weight gain, nitrogen balance, body composition, and intestinal adaptation. METHODS: Resected or transected rats were fed a liquid diet enterally for 16 days with or without 30 mg/kg metronidazole to reduce fermentation. Weight gain was monitored until the rats were killed. Carcass composition, short-chain fatty acids in cecal content, total nitrogen output, and intestinal mucosal dry weight, protein, and DNA were measured. RESULTS: Resected rats without metronidazole had a significantly better weight gain, carcass protein, nitrogen balance, and mucosal dry weight, protein, and DNA compared with that of resected rats receiving metronidazole. There were no significant differences between the two transected groups. CONCLUSIONS: Decreasing colonic fermentation, measured by short-chain fatty acids in cecal content, reduced intestinal adaptation and nutritional recovery in rats with massive small bowel resection.

Animal Nutritional Physiological Phenomena↗
PubMed1994

Hepatic regulation of lymphocyte adhesion to, and activation on, syngeneic endothelial monolayers.

Endothelial monolayers were prepared from neonatal heart or liver tissue of Lewis (Le) rats. Cells in their first passage of culture were used to investigate the short-term (1 hr at 37 degrees) binding of 51Cr-labelled Le rat lymphocytes prepared from the mesenteric lymph node (MLN), peripheral lymph node (PLN) or Peyer's patches (PP) to those endothelia, or the activation by concanavalin A (Con A) or irradiated (Lewis x Brown Norway)F1 (LBNF1), of Le cells on the monolayers after 84 hr in culture. MLN and PP showed preferential binding to, and activation on, liver endothelium compared with heart endothelium (approximately twofold difference), while the converse was seen with PLN. No inhibition of binding was seen with antibodies to intracellular adhesion molecule-1 (ICAM-1) or lymphocyte function-associated antigen-1 (LFA-1). Preincubation of endothelial cells with plasma isolated from the portal or hepatic vein of normal adult mice (5% plasma, 37 degrees for 14 hr) caused a 1.5-2-fold stimulation of binding of MLN/PP to heart endothelium, which was inhibited (> or = 75%) by anti-ICAM-1 or anti-LFA-1, and a fourfold stimulation of binding to liver endothelium, which was not inhibited by these monoclonal antibodies (< or = 25% inhibition). In contrast, antibodies to tumour necrosis factor-alpha (TNF-alpha) or interleukin-6 (IL-6) caused inhibition of activation of liver endothelium (> or = 75%), while producing little affect on activation of heart endothelium. Similar results were seen when lymphocyte activation on endothelial cells rather than adhesion cells was investigated. Our data suggest a heterogeneity in lymphocyte-endothelial interactions, which is further regulated, under physiological conditions, by the liver.

Animals↗
PubMed1993

Colon transplantation: a new microvascular technique.

This paper describes a new transplantation technique, using the colon instead of the small bowel for intestinal transplantation. With microsurgical techniques, allogeneic colon transplantation was carried out in rats in a heterotopic fashion. The vascular pedicle containing the aortic cuff and the portal vein was anastomosed to the aorta and the inferior vena cava of the host, respectively. The technique has proven reliable and reproducible, and our preliminary results suggest that the colon produces a milder rejection response than transplantation of the small bowel.

Anastomosis, Surgical↗
PubMed1993

Functional activity in host and graft lymphoid tissue of rats receiving syngeneic heterotopic small bowel transplants with portal or systemic drainage.

Adult Lewis rats received syngeneic accessory small bowel transplants (SBT) with venous drainage to the portal vein (PV) or the inferior vena cava (IVC)/hetero-portal (HP) or hetero-systemic (HS) grafts, respectively. At varying times thereafter (5-300 days post-transplantation) animals were killed and cells from different lymphoid organs were tested in vitro for their generation of lymphoproliferative and cytotoxic T-cell responses, as well as their ability to produce a variety of lymphokines after alloantigen or mitogen stimulation. Despite marked decreases in cell recovery in Peyer's Patches of HS rats, no significant loss of cell function (on a per cell basis) was noted in any animal group. Total recovered activity per organ was decreased in small intestinal tissue (host and graft) of HS recipients regardless of the assay under study.

Animals↗
PubMed1993

Migration patterns of lymphocytes following syngeneic heterotopic small bowel transplantation in rodents.

Adult rats received syngeneic accessory small bowel grafts with venous drainage to either the portal vein (hetero-portal) or the inferior vena cava (hetero-systemic). Lymphoid cell recovery in different lymphoid organs (spleen, pooled peripheral lymph nodes, mesenteric nodes, Peyer's Patches) was evaluated at varying times (days 0-300) post-grafting. While minimal changes were observed for cell recovery in other organ tissues, lymphocyte recovery in Peyer's Patches of both host and graft small intestine of hetero-systemic animals was decreased from 10- to 100-fold with respect to hetero-portal recipients or non-operated controls. These changes were seen throughout the time course of the study. In additional experiments, lymphoid cells from different organs/donors were labelled in vitro with 111In and injected intravenously into normal/transplanted recipients. Recovery of 111In in various organs was assessed at 1 and 6 h postinjection. The major change seen was in the decreased ability of mononuclear cells derived from Peyer's Patches to migrate to small intestinal tissue (host and graft) in hetero-systemic recipients. In addition, Peyer's Patch cells from these animals 'homed' poorly to small intestine in non-operated animals by comparison with cells from normal rats (or hetero-portal donors).

Animals↗
PubMed1992

Glucose absorption by the interposed colon segment after intestinal resection.

One of the proposed surgical treatments of Short Bowel Syndrome is the interposition of a distal colon segment between two portions of the remnant small intestine. This method proved to reverse the nutritional disorders caused by this morbid entity. Surgical technique consisted in an 80% small bowel resection and the interposition of a 3 cm segment of distal colon between the remaining jejunum and ileum. After 70 days, the animals were reoperated and the interposed and the distal colon were isolated and tied. By using the method of rapid and successive absorptions of a glucose solution through the intestinal lumen, the relations between the absorption curves of the interposed and the normal colon could be drawn. Results show that the interposed colon segment absorbs more glucose (mean = 1.43 +/- 1.16 mg/dl) than the distal colon (mean = 0.37 +/- 0.29 mg/dl) and that its absorption pattern is similar to the small bowel rather than the colon. These results allow the use of this method for further studies in which the interposed colon adaptation is studied with other nutrients and/or under specific conditions.

Animals↗
PubMed1991

Small bowel and colon glucose absorption study in rats by an adaptation of Sols and Ponz method.

An adaptation of the Sols and Ponz method for the study of glucose intestinal absorption was developed by considering the special conditions of our line research. The glucose absorption was studied in proximal jejunum, distal ileum and distal colon in Wistar rat. The main adaptations in the method for successive absorptions with intestinal perfusions in vivo were the length of the intestinal segment and the change of the pumping system. The results are very similar to those obtained with the original method.

Anastomosis, Surgical↗
PubMed1988

Transcolonoscopic extraperitoneal cecostomy. A new therapeutic and technical proposal.

The authors propose a new technique of decompression of the colon consisting in percutaneous cecostomy with previous extraperitonization of the cecum under colonoscopic orientation. The technique permits decompression of the entire colon through the insertion of a ceco-anal multiperforated Levine tube on withdrawing the colonoscope. It is a new therapeutic choice for the treatment of the Ogilvie syndrome, toxic megacolon and other morbid entities, which may permit the performance of the procedure and require decompression of the colon, which proved to be extremely effective in the treatment of a patient with the Ogilvie syndrome.

Aged↗
PubMedDate not supplied

Effects of ethanol on energy balance of rats and the inappropriateness of intraperitoneal injection.

Energy balance of female rats that were either injected daily with ethanol or received the alcohol by gavage was determined and the results compared with saline animals. Food intake, feces elimination, and body weight were recorded daily. After a 20-day period of treatment the animals were sacrificed and the energy content of the carcasses and feces was determined by bomb calorimetry. The results indicated that ethanol-injected animals underwent an impairment in the energy balance, with losses in body weight and body energy. Also, there was a decrease in metabolized energy intake. The results of a group of saline rats pair-fed to alcohol-injected rats showed that the impairment of the energy balance was not only a consequence of the decreased energy intake, because the ethanol-fed animals had an energy balance that was worse than the one of the pair-fed rats, even though both had eaten the same amount of food. Nevertheless, when alcohol was given by gavage, no alteration in the energy balance parameters was detected. Macroscopic observation of the abdominal cavity showed adherences in the gut of the alcohol-injected animals. It is concluded that the ethanol by itself does not alter the energy balance; however, depending on the route of administration it could indirectly impair the energy balance.

Animals↗