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At least 289 records · Page 16Linked to original sources
PubMed1989

Localized fibrous tumor of the serosal cavities. Immunohistochemical, electron-microscopic, and flow-cytometric DNA study.

Localized fibrous tumor of the serosal cavities (localized fibrous mesothelioma) is a generally benign spindle cell neoplasm of uncertain histogenesis. Fourteen histologically similar primary tumors from different mesothelium-lined sites (11 pleural and 1 each in the pericardium, peritoneal cavity, and pouch of Douglas) and 2 recurrences of those tumors (pericardium and pouch of Douglas) were examined histopathologically and by flow cytometry to relate histologic features and DNA ploidy to biologic behavior (follow-up, 48-255 months among 13 patients). All 16 tumors (14 primaries and 2 recurrences) displayed diploid DNA pattern, and none of 13 patients died of disease (1 patient was lost to follow-up). To elucidate the histogenesis, seven primary tumors were examined for vimentin and keratin immunostaining and six primary tumors were assessed by electron microscopy. All cases exhibited spindle-fibroblastic cell proliferation with a prominent hemangiopericytic pattern. All cases so examined had positive results for vimentin and negative results for keratin. Ultrastructurally, the tumor cells showed mesenchymal-fibroblastic features. These results support a mesenchymal origin, most likely from submesothelial fibroblasts. Further, this neoplasm may recur but retain its basic histologic features, diploidy, and benign outcome.

Adult↗
PubMed1997

The effect of training and duration of surgery on adhesion formation in the rabbit model.

In order to evaluate the effect of training upon postoperative adhesions, standard bipolar and mechanical, nonopposing injuries were performed in the uterine horns and side walls of 52 mature female rabbits using a conventional three-puncture laparoscopy, by an endoscopic surgeon with limited experience. An additional injury, either bipolar or mechanical or both, was performed in the retro-uterine space. With experience, the duration of surgery decreased progressively from 12 +/- 2 to 8 +/- 1 min in the first and last 10 animals respectively. The amount of perioperative bleeding was not affected by experience. With experience the postoperative adhesions decreased in extent (P = 0.0001), tenacity (P = 0.004), type (P = 0.002) and inflammation (P = 0.003) and for total score (P = 0.0002). These changes were correlated with the briefer duration of surgery but not with the amount of perioperative bleeding. The strong correlations of adhesion scores in the pouch of Douglas, and around both uterine horns confirmed the importance of the inter-animal variability in making adhesions. By logistic regression, the adhesions in the pouch of Douglas were explained simultaneously by the adhesions on the uterine horns (P = 0.0004, thus correcting for inter-animal variability) by the amount of bleeding (P = 0.01) and the duration of surgery (P = 0.05). No major differences were found in adhesions following a mechanical or a bipolar injury or following such a lesion in the pouch of Douglas or at the uterine horns. In conclusion, experience, expressed by the duration of surgery and to a lesser extent perioperative bleeding, is a major co-factor in postoperative adhesions, suggesting that duration of surgery should be strictly standardized in endoscopic adhesion studies. The important inter-animal variability can be circumvented by using a standard control lesion, making each animal its own control.

Animals↗
PubMed1954

[Culdoscopy].

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Culdoscopy↗
PubMed1956

[Culdoscopy].

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Culdoscopy↗
PubMed1988

[Incidence and significance of pathogen detection in Douglas fluid in non-inflammatory genital diseases].

Between 1976 and 1986 the secretions from the pouch of Douglas of 1,219 patients with non-inflammatory genital diseases were microbiologically studied. Microorganisms were detected in 3.4%. In the majority of cases they were physiological skin organisms, with a count of less than 10 per ml of Douglas fluid. These findings support the view, that secondary contamination of the specimens occurred during removal, transportation, or laboratory processing.

Bacteria↗
PubMed2003

Radioactivity in cervical mucus after intraperitoneal deposition of Tc-99m labelled albumin particles before and after sterilisation.

OBJECTIVE: To study the transport of radiolabelled albumin particles from the pouch of Douglas to cervical mucus. STUDY DESIGN: A prospective randomised study, including 10 healthy women, undergoing laparoscopic sterilization. A solution of human serum albumin particles, labelled with Technetium 99(m) (Tc-99(m)) was injected into the pouch of Douglas, either before or after sterilisation. RESULTS: Gamma camera images showed gradual spread to the entire peritoneal cavity. Blood samples, showed increasing levels of radioactivity. Measurement of radioactivity in cervical mucus showed significant activity both in women sterilized before and after the deposition. CONCLUSION: The study showed evidence of transport of radioactivity from the pouch of Douglas to cervical mucus. The transport seemed to consist of free activity since no radionuclide labelled particles could be detected in cervical mucus. The transport was probably haematogenous or lymphatic and not intraluminal through the fallopian tube. Further studies utilizing particles comparable in size to fertilized ova are required to design methods for evaluating the transport from the fallopian tube to the uterine cavity.

Adult↗
PubMed1958

Culdocentesis.

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Douglas' Pouch↗
PubMed1995

Treatment of pelvic abscesses: value of one-step sonographically guided transrectal needle aspiration and lavage.

OBJECTIVE: The percutaneous treatment of pelvic abscesses has traditionally involved the placement of drainage catheters via a transgluteal, transrectal, or transvaginal route. These procedures are painful and prolonged. The goal of this study was to demonstrate the effectiveness of a one-step, single-puncture method for draining pelvic abscesses by use of a transrectal sonographically guided needle for aspiration and lavage instead of a two-step Seldinger technique for catheter placement. SUBJECTS AND METHODS: Thirty-three pelvic abscesses in 24 patients were drained by use of transrectal ultrasound guidance. All abscesses were initially seen on transrectal sonograms or CT scans and ranged from 2 to 11 cm in diameter. Abscesses were located in the prostate (n = five), seminal vesicles (n = five), pouch of Douglas (n = 21), and interloop (between bowel loops) (n = two). Causes of pouch of Douglas (cul-de-sac) abscesses included appendicitis (n = two), Crohn's disease (n = two), diverticulitis (n = three), trauma (n = six), HIV infection (n = two), complications of sigmoidectomy (n = one), complications of colectomy (n = one), pelvic inflammatory disease (n = two), and severe prostatitis (n = two). Interloop abscesses were attributable to HIV infection (n = one) and lymphoma (n = one). The procedure was performed without a cleansing enema or local anesthesia and required less than 30 min. An 18-gauge needle was inserted transrectally into the abscess cavity under transrectally guided sonography. The fluid collection was completely aspirated, and the cavity was lavaged with saline. Administration of antibiotics for 7-21 days, rather than prolonged catheter drainage, was used to treat residual infection. Resolution was documented after 7 days by sonography or CT examination. RESULTS: Transrectal aspiration was successful in treating 28 (85%) of the 33 pelvic abscesses in 21 (88%) of the 24 patients. Failure occurred in three patients, two with multiple abscesses and one with an enteric fistula for whom surgical drainage was subsequently required. The volume of aspirates ranged from 5 to 220 ml. There were no complications. CONCLUSION: Transrectal sonographically guided needle aspiration-lavage offers a one-step method for treating pelvic abscesses that does not require catheter placement or prolonged drainage. The procedure produces minimal discomfort and essentially no complications. Our results show that transrectal sonographically guided needle aspiration combined with antibiotic therapy is an effective treatment for pelvic abscesses.

Abscess↗