Mesenteric inflammatory veno-occlusive disorder: a rare entity mimicking inflammatory bowel disorder

Mesenteric inflammatory veno-occlusive disorder (MIVOD) is a rare variety of inflammatory bowel disease. In addition to the case presentation, pathogenesis, and conflicting clinical, endoscopic, and computed tomography findings, we present for the first time the angiographic findings that would provide important clues to distinguish MIVOD from the chronic idiopathic variety of inflammatory bowel disease and confirm the diagnosis of MIVOD. Final diagnosis is made on full-thickness biopsy. Although medical treatment of MIVOD is unsuccessful, surgical resection of the involved segment results in resolution of symptoms.     

Bacterial translocation to mesenteric lymph nodes is increased in cirrhotic rats with ascites

Cirrhotic patients are predisposed to develop spontaneous bacteremias and/or peritonitis, mainly caused by enteric bacteria. The aim of this study was to investigate if bacterial translocation, which is the passage of bacteria from the intestinal lumen to regional lymph nodes and/or the systemic circulation, is increased in a rat model of cirrhosis. Rats were studied after 12–16 weeks of CCl₄ inhalation, when samples of mesenteric lymph nodes, blood, liver, and spleen for standard bacteriologic cultures and a fragment of colon and liver for histology were obtained. Immunostaining of the cecum was performed using a polyclonal anti-Escherichia coli antibody. A significantly greater proportion of rats with cirrhosis and ascites (5 of 9; 56%) had positive mesenteric lymph node cultures compared with cirrhotics without ascites (0 of 9) and normal controls (0 of 12) (P < 0.01). In one cirrhotic rat, E. coli was isolated from both mesenteric lymph nodes and ascites. Rats with cirrhosis and ascites had significantly greater cecal submucosal edema and inflammation than rats with no ascites and controls. Immunoreactivity with E. coli was present in the cecal wall in 3 of 5 animals with E. coli translocation to mesenteric lymph nodes. In cirrhotic rats, bacterial translocation is increased after the development of ascites and may be a major factor in the development of spontaneous infections in cirrhosis.     

Expression of inducible nitric oxide synthase in cultured smooth muscle cells from rat mesenteric lymphatic vessels

OBJECTIVE: The objective was to devise a method for establishing cultures of rat mesenteric lymphatic vessel smooth muscle cells (LSMC) and to investigate if inducible nitric oxide synthase (iNOS) expression could be activated in LSMC treated with bacterial lipopolysaccharide (LPS). METHODS: LSMC were successfully grown from explanted rat lymphatic microvessels and maintained by subculture. Treatment of LSMC for 24 h with LPS (1-100 microg/mL) activated iNOS protein induction, associated with (1) assay of increased nitrite concentrations in the medium representing cellular nitric oxide synthesis, and (2) demonstration of iNOS in cell extracts by Western blotting. RESULTS: The protein synthesis inhibitor cycloheximide (10 microM) blocked both LPS-induced nitrite formation and iNOS protein expression in LSMC. 1400 W (1 microM), a selective iNOS inhibitor, prevented LPS-induced nitrite formation but not iNOS expression. As well as induction of iNOS by LPS, "constitutive" iNOS was present in some cultures, producing nitrite in amounts that were also subsequently reduced after cell treatment with 1400 W. CONCLUSION: Rat mesenteric LSMC produce nitrite and express iNOS in response to bacterial LPS. Cultured LSMC may provide a useful model for studying mechanisms of iNOS induction in relation to possible influences of iNOS upon lymphatic vessel function.     

17β-雌二醇对人肠系膜动脉的舒张作用及其机制

目的研究17β-雌二醇(E2)对人肠系膜动脉的舒张作用及其机制。方法采用离体血管环灌流的方法,观察E2对内皮完整和去内皮人肠系膜动脉的舒张作用,以及一氧化氮合酶(eNOS)选择性抑制剂N-硝基-L-精氨酸甲酯(L-NAME)、L-NAME+前列环素(PGs)抑制剂吲哚美辛(INDO)、格列本脲(GLY)对这一过程的影响。结果E2(0.5~20.0μmol/L)均可剂量依赖性地舒张人肠系膜动脉;该作用在低水平时内皮完整组明显大于无内皮组(P<0.01),且在内皮完整组E2的舒张作用可分别被L-NAME、L-NAME+INDO、GLY减弱(P均<0.01);高水平时去内皮组与内皮完整组E2的舒张比例差异无统计学意义(P>0.05),在内皮完整组各阻滞剂孵育20 min后E2的舒张作用不能被阻断(P均>0.05)。结论E2对人肠系膜动脉的舒张作用在低水平时具有内皮依赖性,与内皮NO和内皮源性超极化因子(EDHF)的释放、KATP的激活有关,且EDHF比NO更重要;而高水平时的E2舒张人肠系膜动脉是非内皮依赖的,为E2的临床应用提供了重要的实验依据。     

Sympathetic Input to Multiple Cell Types in Mouse and Human Colon Produces Region-Specific Responses

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Transhepatic fibrinolysis of mesenteric and portal vein thrombosis in a patient with ulcerative colitis： A case report

AIM: To present a case of acute mesenteric and portal vein thrombosis treated with thrombolytic therapy in a patient with ulcerative colitis in acute phase and to review the literature on thrombolytic therapy of mesenteric-portal system. Treatment of acute portal vein thrombosis has ranged from conservative treatment with thrombolysis and anticoagulation therapy to surgical treatment with thrombectomy and/or intestinal resection. METHODS: We treated our patient with intraportal infusion of plasminogen activator and then heparin through a percutaneous transhepatic catheter. RESULTS: Thrombus resolved despite premature interruption of the thrombolytic treatment for neurological complications, which subsequently resolved. CONCLUSION: Conservative management with plasminogen activator, could be considered as a good treatment for patients with acute porto-mesenteric thrombosis.     

文仲渝主任中医师治疗小儿肠系膜淋巴结炎经验

文仲渝主任中医师结合小儿生理病理特点及重庆地区地理环境、饮食习惯,认为该地区小儿肠系膜淋巴结炎病因病机为脾胃薄弱,运化失司,湿浊内生,聚湿成痰,饮食积滞,湿、痰、积滞阻碍气机,气滞血瘀,不通则痛。脾弱为本,湿、痰、滞、瘀为标,本虚标实,虚实夹杂。治以运脾化湿、消滞和中、行气止痛,自拟腹痛方并随证加减,同时配合日常饮食及生活方面的调护,临床疗效显著。附案例1则,以资验证。     

微血管张力测定技术在血管内皮去除中的应用

目的通过建立离体小动脉血管内皮去除的研究方法,提高微血管测量技术研究数据的可信度。方法选取♂自发性高血压大鼠(SHR)和正常血压大鼠(WKY),测量血压后,获取肠系膜动脉环。采取机械(血管环围绕电极尖端旋转、推注气体)和药物(L-NAME和吲哚美辛)相结合的方式去除内皮。采用压力肌动图技术检测苯肾上腺素(PE)、乙酰胆碱(ACh)、硝普钠(SNP)对肠系膜动脉直径变化的影响。结果(1)SHR血压值高于WKY大鼠(P<0.01);(2)PE浓度依赖地收缩肠系膜动脉。内皮完整和内皮去除时,与WKY相比,SHR的收缩增强(P<0.05);(3)ACh、SNP能够浓度依赖地舒张肠系膜动脉。内皮完整时,与WKY相比,SHR的舒张减弱(P<0.01);内皮去除时,与WKY相比,SHR的舒张增强(P<0.01)。结论(1)成功建立离体微小动脉血管内皮去除的研究方法。(2)高血压大鼠存在明显的血管舒缩功能障碍。