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Ultrasonic detection of viscera slide as an indicator of abdominal wall adhesions.

Real-time ultrasonography can detect the movement of viscera immediately deep to the abdominal wall. This motion of abdominal contents is called viscera slide, and is produced by the force of respiratory motion (spontaneous viscera slide) or by manual ballottement of the abdomen (induced viscera slide). Viscera slide was observed in 18 "normal" subjects (no history of previous abdominal surgery or peritonitis) and in 24 subjects at "risk" for abdominal wall adhesions because of previous abdominal operations or past history of peritonitis. In 14 of the 24 "risk" group subjects, spontaneous and induced viscera slide was restricted to excursions of less than 1 cm (58.3%). Operations were performed on 18 patients, which confirmed the fact that restriction of ultrasonically detected viscera slide identified abdominal wall adhesions in all cases, but no adhesions were found in patients with normal viscera slide. This ultrasonic finding of restricted viscera slide may be useful in the preoperative discovery and localization of abdominal wall adhesions prior to laparoscopy or laparotomy.

Abdomen

The importance of the abdominal viscera to peritoneal transport during peritoneal dialysis in the dog.

The authors sought to evaluate the dialyzing surfaces important for peritoneal dialysis. They reasoned that the most definitive way to evaluate whether any of the gut and associated membranes contributed to transport was to see if transport changed when they were removed. Paired studies measuring rates of peritoneal uptake of glucose, urea, and inulin were carried out in dogs. In the morning, the animals were tested with all peritoneal membranes intact. In the afternoon, the studies were repeated after evisceration. The mass transfer coefficients (MTC ml/min)--glucose (viscera 4.4 +/- 0.7, no viscera 4.9 +/- 0.3)--urea (viscera 16.8 +/- 2.4, no viscera 13.8 +/- 1.0);--inulin (viscera 1.6 +/- 0.6, no viscera 2.2 +/- 0.7) were not changed nor was the amount of mass absorbed significantly different. MTC and peritoneal absorption were unaffected by omentectomy, mesenterectomy, or evisceration. Whether these results were due to nonparticipation of these structures in peritoneal transport or other mechanisms await further studies.

Absorption

Dietary arginine deficiency alters flux of glutamine and urea cycle intermediates across the portal-drained viscera and liver of rats.

The effect of an arginine-deficient diet on net flux of amino acids across the portal-drained viscera and across the liver was studied in rats. Blood was obtained after food deprivation and 1 and 2 h after a meal of a 1.0% arginine control diet or an arginine-deficient diet containing 3.4% glutamate. The arginine-deficient diet decreased net portal-drained viscera flux of arginine and increased net portal-drained viscera flux of ornithine and proline. However, net portal-drained viscera flux of citrulline (0.35 +/- 0.05 mumol/min) was not influenced by diet; of this rate, 46% (0.16 mumol/min) bypassed the liver and was available for extrahepatic arginine synthesis. However, rats continued to exhibit signs of arginine deficiency such as decreased blood arginine concentrations (by 28%) and increased orotic acid excretion (90-fold). Arterial blood glutamine concentration was 25% higher in rats fed the arginine-deficient diet. In the fed state, net hepatic flux of glutamine was elevated from 0.15 (control) to 1.39 mumol/min, indicating that the liver was a major source of the increased blood glutamine concentrations. Increased production of hepatic glutamine and orotic acid may help rats compensate for dietary arginine deficiency, whereas splanchnic output of citrulline was not increased with dietary arginine deficiency even with a substantial dietary supply of glutamate.

Amino Acids

Oxygen consumption by portal-drained viscera of cattle: comparison of analytical methods and relationship to whole body oxygen consumption.

Two experiments were conducted to compare methods of determining oxygen consumption by portal-drained viscera and to relate this consumption to total oxygen consumption by lactating dairy cows. Oxygen consumption was the product of portal blood flow (determined by dilution of dye infused into a mesenteric vein) and portal-arterial concentration differences of oxygen. In Experiment 1, portal-arterial concentrations of oxygen were determined in samples from three cows using equations based on blood pH, hemoglobin, partial pressure of carbon dioxide, and partial pressure of oxygen (method 1) or by direct oxygen determination with an oximeter (method 2). Overall, there were no differences in oxygen concentrations or oxygen consumption by portal-drained viscera between methods. In Experiment 2, oxygen consumption by portal-drained viscera (method 2) and total oxygen consumption were measured in two lactating cows. Oxygen consumption by portal-drained viscera accounted for 18% of total oxygen consumption.

Abdomen

Altered glutamine metabolism in rat portal drained viscera and hindquarter during hyperammonemia.

In normal rats, muscle is the major glutamine releasing organ and gut is the major glutamine consuming organ. It has been suggested that enhanced muscle ammonia detoxification and gut ammonia production occurs during liver insufficiency-induced hyperammonemia. Therefore, ammonia and amino acid fluxes across portal-drained viscera and hindquarter, and muscle concentrations were measured in portacaval shunted and acute liver ischemia rats. Arterial ammonia and most amino acids were increased after portacaval shunting and increased progressively during liver ischemia, but net hindquarter ammonia uptake was not observed. Net hindquarter glutamine efflux was increased during portacaval shunting, but it decreased during liver ischemia, while muscle glutamine concentrations increased. The comparable net portal drained viscera glutamine uptake in normal and portacaval shunted rats changed during liver ischemia from net uptake to release, coinciding with release of most other amino acids. These results cast doubt on the ammonia detoxifying role of muscle during acute liver ischemia-induced hyperammonemia in the rat. The portal drained viscera glutamine release during severe hyperammonemia could be due to intestinal damage.

Amino Acids

Net absorption from portal-drained viscera of nitrogenous compounds by beef heifers fed on diets differing in protein solubility or degradability in the rumen.

The objective of the present study was to evaluate effects of in vitro rumen solubility or degradability of dietary protein on net absorption of nitrogenous compounds from portal-drained viscera of beef heifers. Four protein sources, casein, soya-bean meal, maize-gluten meal and blood meal provided about two-thirds of total dietary nitrogen in semi-purified diets given to four beef heifers in a 4 X 4 Latin square design. Although in vitro degradability of dietary N ranged from 842 (casein) to 310 (blood meal) g/kg total dietary N, net absorption of ammonia-N or alpha-amino-N was not significantly different (P greater than 0.10) among diets. However, net absorption of NH3-N tended to decrease and net absorption of alpha-amino-N tended to increase as intake of in vitro undegradable N increased. Net transfer of urea-N from plasma to portal-drained viscera was greater (P less than 0.10) when heifers were fed on soya-bean meal than when fed on maize-gluten meal or blood meal. The findings show with all diets that the non-protein-nitrogenous compounds, NH3 and urea, played a substantial role in absorption and transfer of N. Overall, net absorption of NH3-N was 61% of net absorption of alpha-amino-N, and transfer of urea-N from plasma to portal-drained viscera was 80% of net absorption of alpha-amino-N.

Animals

Effects of treadmill exercise on the distribution of blood flow between the hindlimb muscles and abdominal viscera of the laying fowl.

1. Blood flow distribution between the abdominal viscera and the leg muscles of regularly-laying Rhode Island Red hens was measured at rest and immediately following treadmill exercise, using the radioactive microsphere technique. 2. Exercise brought about a 150% increase in metabolic rate and this was maintained continuously for 90 min. 3. Although there was a small shift in blood flow distribution towards the hindlimb muscles at the expense of the kidneys and reproductive organs, this was not statistically significant. 4. There was a significant reduction in blood flow to the preovulatory follicles of the ovary during exercise, relative to the rest of the abdominal viscera. 5. It is concluded that exercise of this intensity is insufficient to bring about gross changes in blood flow distribution between the abdominal viscera and the hindlimb muscles. The implications of this finding are discussed in relation to the nutrient and blood flow requirements of the reproductive organs.

Animals

Net metabolism of volatile fatty acids, D-beta-hydroxybutyrate, nonesterifield fatty acids, and blood gasses by portal-drained viscera and liver of lactating Holstein cows.

Net flux of VFA, D-beta-hydroxybutyrate, nonesterified fatty acids, and blood gasses across portal-drained viscera and liver was measured in four lactating Holstein cows fed a 60:40 corn silage: concentrate diet ad libitum and milked at 12-h intervals. Twelve consecutive hourly measurements of net flux (venous-arterial concentration difference times blood flow) were obtained during wk 4 and 8 postpartum for each cow. Milk yield and DM intake averaged 32.2 and 15.6 kg/d. On a net basis, hepatic tissues produced acetate and removed 63 to 101% of other VFA absorbed by portal-drained viscera. Hepatic and portal-drained visceral tissues produced 60 and 40%, respectively, of D-beta-hydroxybutyrate produced by splanchnic tissues. Hepatic tissues removed 9.3% of nonesterified fatty acids in portal vein and hepatic arterial blood. Oxygen use was greater by liver than for portal-drained viscera (3062 vs. 2394 mmol/h). Net portal-drained visceral flux of VFA, D-beta-hydroxybutyrate, alpha-amino nitrogen, L-lactate, and oxygen together accounted for 84.9% of calculated metabolizable energy intake. Net hepatic removal of propionate, L-lactate, and alpha-amino nitrogen maximally accounted for 55.1, 17.4, and 16.5% of carbon in glucose produced by hepatic tissues.

3-Hydroxybutyric Acid

Evidence against high pressure, arterial baroreceptors in the abdominal viscera of cats.

The abdominal viscera of cats have been postulated to contain a site of cardiovascular regulation. In particular, a baroreceptive function has been ascribed to splanchnic afferent nerves. We wished to determine whether afferents with a cardiac-rhythmic discharge functioned as arterial baroreceptors. Nineteen afferents with a cardiac rhythmic discharge were studied. All afferents were A fibers, whose endings were located in either the pancreas, mesentery, or porta hepatis region. We examined their characteristics of discharge with regard to changes in mean pressure, pulse pressure, and dP/dt of the arterial pulse. Hemodynamic alterations were achieved by intravenous administration of isoproterenol, norepinephrine, or phenylephrine and by occlusion of the descending thoracic aorta. After isoproterenol, increases in nerve activity occurred when pulse pressure and dP/dt were increased but while mean pressure was decreasing, indicating that mean pressure was not the stimulus for discharge of these afferents. Additionally, under similar hemodynamic conditions, afferents did not demonstrate reproducible patterns of activity. The afferents generally discharged with one impulse per cardiac cycle, rarely with two to three impulses per cycle. None demonstrated a bursting pattern even when arterial blood pressure was quite elevated. The spontaneous pattern of discharge changed frequently, often after the viscera were repositioned, and sometimes remained even after complete occlusion of the aorta. The data indicate that these visceral afferents do not respond as high pressure, arterial baroreceptors. All afferents adapted extremely rapidly and exhibited a low gain (0.02 +/- 0.00 impulses X s-1 X mmHg-1), indicating that these fibers would be ineffective in signaling physiologically significant changes in hemodynamic variables. The data from this study do not support the existence of baroreceptors in the abdominal viscera of cats.

Afferent Pathways

Net metabolism of hormones by portal-drained viscera and liver of lactating holstein cows.

Net flux of insulin, glucagon, somatotropin, somatomedin-C, and somatostatin across the portal-drained viscera and liver of four lactating Holstein cows was measured at 4 and 8 wk postpartum. Cows were fed ad libitum intake a 60:40 corn silage:concentrate diet and milked at 12-h intervals. Milk yield and DM intake were 32.2 and 15.6 kg/d respectively. Twenty-four consecutive measurements of insulin, glucagon, and somatotropin net flux were obtained at 30-min intervals; 12 hourly measurements were obtained for somatomedin-C and somatostatin. Net flux is venous-arterial concentration difference times blood flow. Net flux of somatomedin-C was not detectable across the portal-drained viscera or liver. Somatotropin was removed by total splanchnic tissues. There was net production of somatostatin across portal-drained viscera, but net flux of somatostatin across liver was not significant. On a net basis, removal of insulin and glucagon by liver accounted for 66% of portal-drained visceral production. Within cows and sampling days, increases in net portal-drained visceral production of insulin and glucagon often were mirrored by increases in net removal by liver. As in other species, the bovine liver is an important regulator of circulating concentrations of insulin and glucagon.

Animals

[Support and suspension of the pelvic viscera in women. Functional and surgical anatomy].

This work is an attempt to settle the semantics of the pelvic connective tissues based on the international nomenclature (Nomina Anatomica) on the one hand on the other following a study of the macroscopic anatomy together with the microscopic appearances and a functional study together with a radiological study which includes in particular tomodensitometry. The Pelvic viscera are held in position by visceral fasciae which are continuous with the parietal pelvic fascia and the retro peritoneal connective tissue. This connective tissue, which is moderately loose, is arranged around the blood vessels as visceral ligaments. These are more obvious when traction is exerted during surgical operations and it resembles the way strands of a net come together when they are being stretched. It is essential to ligate and cut these ligaments if the viscera are to be freed. The surfaces which join the viscera together (the septum and the retro-pubic and retro-rectal spaces) are very important and from the biomechanical point of view resemble bonds that are stuck together. In fact, their resistance has the effect of interlocking neighbouring surfaces, and so effects a better distribution of pressures that are exerted and of their absorption. The changes that take place at rest and at movement of the pelvic organs during the menopause and during pregnancy and the puerperium have been studied. The role of episiotomy in particular as a step towards preventing urinary incontinence is emphasized. In fact, it lessens the pull on the external fibres of the sphincter muscle of the urethra which are bound up with the tissues of the vaginal wall. We have found in 140 women who have been operated on for stress incontinence that 62% had a tear or an episiotomy that was carried out late and that was insufficiently large; 13.9% had a tear: and 11.4%, on the other hand, had an episiotomy without a tear. On the other hand, in another group of similar women over the age of 45 who had had an episiotomy, 16.17% had stress incontinence.

Episiotomy

The effects of experimentally induced fever on the estimated blood flow to and oxygen utilization by the liver and the viscera drained by the portal vein in sheep.

Intrajugular injection of a purified E. coli lipopolysaccharide induced a biphasic fever in sheep after a latent period of 12 to 20 min. The changes in the blood flow from the liver and from the viscera drained by the portal vein were: (a) in the latent period, decreases in total hepatic blood flow (THF) due to decreased portal venous blood flow (PVF); (b) during the first febrile phase, increases in THF due to increased hepatic arterial blood flow and, (c) in the second febrile phase, decreases in THF due to decreased PVF. Although there were large variations in the oxygen supply to the viscera drained by the portal vein and to the liver, there were relatively small or no changes in their oxygen consumption.

Analysis of Variance

Dichotomizing unmyelinated afferents supplying pelvic viscera and perineum are rare in the sacral segments of the cat.

We have tested the hypothesis that referred pain of pelvic viscera is elicited by dichotomizing branches of unmyelinated primary afferents projecting via the pelvic nerve to the viscera and through the pudendal nerve to the perineum where pelvic pain is commonly referred to. Using neurophysiological techniques 588 unmyelinated single units projecting into either nerve were recorded in the ventral (n = 228) and dorsal (n = 360) root S2. In each sample only one neurone sent an axon into both nerves. Thus, dichotomizing afferents account for less than 0.5% of the afferent neurones and appear to be an unlikely explanation for referred pain in this body area.

Afferent Pathways

The minimal importance of the hollow viscera to peritoneal transport during peritoneal dialysis in the rat.

The authors investigated whether the abdominal viscera are important surfaces for peritoneal transport by performing peritoneal dialysis in rats without their abdominal viscera and again when the parietal walls were shielded from contact with dialysate. Urea, creatinine, glucose, and inulin were added to the peritoneal cavity and the percentage of the administered dose absorbed was calculated. Controls with and without parietal shields only absorbed 11% more urea and creatinine, 5-15% more glucose, and 7-12% more inulin, respectively, than eviscerated rats. The findings raise the possibility that the abdominal contents do not account for most of peritoneal transport.

Absorption

Net absorption of macrominerals by portal-drained viscera of lactating Holstein Cows and beef steers.

Net absorption of macrominerals by portal-drained viscera of cattle was measured in two experiments. In Experiment 1, net portal-drained visceral and liver flux of Na, K, Ca, P, and Mg were measured in four lactating Holstein cows fed a 60:40 corn silage:concentrate diet ad libitum and milked at 12-h intervals. Twelve measurements of net flux (venous-arterial concentration difference x blood plasma flow) were obtained hourly at 4 and 8 wk postpartum. Intake of DM and milk yield averaged 15.6 and 32.2 kg/d, respectively. Excluding Na, net absorption of these macrominerals was measurable across portal-drained viscera. Flux of Na was negative at wk 4 postpartum (net removal from blood) and positive at wk 8 (net absorption into blood). Excluding Mg, differences in venous-arterial concentrations for macrominerals across the liver were not different from zero. In Experiment 2, net portal-drained visceral flux of Na, K, Ca, P, and Mg was partitioned into stomach and poststomach sections in two Hereford steers. Poststomach tissues accounted for essentially all such absorption of K, Ca, and P and, on a net basis, removed Na and Mg. Stomach tissues absorbed Mg and small amounts of K, Ca, and P. Net stomach flux of Na was positive, denoting net absorption, but highly variable. Net portal-drained visceral absorption of K increased with intake in both experiments. Net portal-drained visceral absorption of P was greater than total intake in both experiments, reflecting recycling of P via saliva and other digestive secretions.

Absorption

Hepatic regeneration in the absence of portal viscera.

In an effort to investigate the influence of portal factors on hepatic regeneration in the rat and to clarify glucagon's apparent regulatory role, a rat preparation was developed which was totally devoid of portal viscera and thus deficient in all possible hepatotrophic substances of portal origin. It was found that, following partial hepatectomy, such an eviscerate rat was able to undergo hepatic deoxyribonucleic acid (DNA) synthesis, but the peak DNA synthetic response was significantly delayed by such portal deprivation. As demonstrated by a group of rats with intact portal viscera, but with a portacaval shunt, reduction of blood supply to the hepatic remnant by diversion of portal flow accounted for only a portion of the delay. The remainder of the delay encountered in the eviscerate group was attributed to the deprivation of specific portal substances. Since glucagon supplementation administered to the deficient eviscerate animal restored peak DNA synthesis to the time of its appropriate shunted control, this hepatotrophic substance is a major portal factor modifying the response to partial hepatectomy. Evidence is cited which suggests that glucagon's influence on DNA synthesis is mediated through the formation of cyclic adenosine monophosphate (AMP) and subsequent histone phosphorylation.

Animals

Fasciola hepatica: early lesions in the viscera of seven pulmonate species after penetration of the miracidium.

Early lesions were studied in four viscera of seven pulmonate species on the 2nd day after miracidial exposure. The albumen gland, the digestive gland, and the gonad of infected snails demonstrated not only normal tissue but also the presence of two stages of epithelial necrosis. Multifocal necrosis predominated, with varying percentages of frequency depending on the snail species and stage of life; generalized necrosis was more seldom observed. In the kidney, epithelial necrosis was encountered more frequently than intralamellar deposits.

Animals