2.An experimental study of colonic mucosal graft for urethral reconstruction.
Yuemin XU ; Yong QIAO ; Yinglong SA ; Huizhen ZHANG ; Xinru ZHANG ; Jiong ZHANG ; Rong CHEN
Chinese Medical Journal 2002;115(8):1163-1165
OBJECTIVETo investigate the possibility of urethral reconstruction with a free colonic mucosal graft.
METHODSTen female dogs underwent a procedure in which the urethral mucosa was totally removed and replaced with a free graft of colic mucosa. A urodynamic study was performed before the operation and sacrifice. The dogs were sacrificed 8 to 16 weeks after the operation for histological examination of the urethra.
RESULTSUrethral stricture developed in 1 dog. The results of urody namic studies showed that the difference in maximum urethral pressure between pre-operation and pre-sacrifice in the remaining 9 dogs was not of significance (P > 0.05). Histological examination revealed that the colonic free mucosa survived inside the urethral lumen of the 9 dogs. Plicae surface and unilaminar cylindric epithelium of the colonic mucosa was observed in dogs sacrificed 8 weeks after the operation. Plicae surface and unilaminar cylindric epithelium of the colonic mucosa was not observed and metaplastic transitional epithelium covered a large proportion of the urethral mucosa in dogs sacrificed 12 weeks after the operation.
CONCLUSIONSUrethral mucosa can be replaced by colonic mucosa without damaging the continence mechanism in female dogs. This technique is useful when local or preputial skin and buccal or bladder mucosa are not available.
Animals ; Colon ; transplantation ; Dogs ; Female ; Intestinal Mucosa ; transplantation ; Urethra ; pathology ; surgery ; Urologic Surgical Procedures
3.Use of canine small intestinal submucosa allograft for treating perineal hernias in two dogs.
A Jin LEE ; Wook Hun CHUNG ; Dae Hyun KIM ; Kyung Pil LEE ; Hyun Jung SUH ; Sun Hee DO ; Ki dong EOM ; Hwi Yool KIM
Journal of Veterinary Science 2012;13(3):327-330
Here, we describe two dogs in which canine small intestinal submucosa (SIS) was implanted as a biomaterial scaffold during perineal herniorrhaphy. Both dogs had developed severe muscle weakness, unilaterally herniated rectal protrusions, and heart problems with potential anesthetic risks. Areas affected by the perineal hernia (PH) located between the internal obturator and external anal sphincter muscles were reconstructed with naive canine SIS sheets. In 12 months, post-operative complications such as wound infections, sciatic paralysis, rectal prolapse, or recurrence of the hernia were not observed. Symptoms of defecatory tenesmus also improved. Neither case showed any signs of rejection or specific immune responses as determined by complete and differential cell counts. Our findings demonstrate that canine SIS can be used as a biomaterial scaffold for PH repair in dogs.
Animals
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Biocompatible Materials
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Dog Diseases/*surgery
;
Dogs
;
Hernia, Abdominal/surgery/*veterinary
;
Herniorrhaphy/veterinary
;
Intestinal Mucosa/*transplantation
;
Intestine, Small/*transplantation
;
Male
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Perineum/surgery
;
Postoperative Complications/veterinary
;
Transplantation, Homologous/veterinary
4.Compound graft of porcine small intestinal submucosa with Schwann cells to reconstruct injured cavernous nerves and restore erectile function.
Hong-kai LU ; An-ji REN ; Xiao-lu SUN ; En-jiang GAO ; Zhi-yong YU ; Bo YAN
National Journal of Andrology 2010;16(9):834-839
OBJECTIVETo investigate the restoration of rat penile erection by reconstructing injured cavernous nerves (CN) with a compound graft prepared from porcine small intestinal submucosa (SIS) and Schwann cells (SC).
METHODSSCs were cultured in vitro and a compound graft was prepared from the SCs and SIS. Thirty-three healthy SD rats were randomly divided into three groups of equal number, sham-operation, CN ablation, and SIS + SC graft. Three months after the operation, all the rats underwent the apomorphine test, followed by immunohistochemical staining of the tissues from the middle part of the corpus cavernosum penis.
RESULTSCombined use of mechanical stripping, mixed-enzyme digestion, different-speed adhesion, short-term Ara-C and some other methods yielded SCs of a purity high enough for nerve tissue engineering. The SIS prepared by mechanical and chemical methods exhibited a good biocompatibility with SCs, which could adhere, grow, propagate and differentiate on its surface. The apomorphine test showed that both the rate and frequency of penile erection were significantly higher in the SIS + SC graft than in the CN ablation group (P < 0.01), but lower than in the sham operation group (P < 0.01). The number of nNOS positive nerve fibers in the SIS + SC graft group was significantly different from that of the CN ablation (P < 0.01), but both were smaller than that of the sham-operation group.
CONCLUSIONThe compound of SIS with SCs, as a nerve graft, can be used to reconstruct injured cavernous nerves, and to some extent, restore penile erectile function.
Animals ; Intestinal Mucosa ; transplantation ; Intestine, Small ; Male ; Nerve Regeneration ; Penile Erection ; Penis ; innervation ; surgery ; Rats ; Rats, Sprague-Dawley ; Schwann Cells ; transplantation ; Swine ; Transplantation, Heterologous
5.Gut microbial balance and liver transplantation: alteration, management, and prediction.
Xinyao TIAN ; Zhe YANG ; Fangzhou LUO ; Shusen ZHENG
Frontiers of Medicine 2018;12(2):123-129
Liver transplantation is a conventional treatment for terminal stage liver diseases. However, several complications still hinder the survival rate. Intestinal barrier destruction is widely observed among patients receiving liver transplant and suffering from ischemia-reperfusion or rejection injuries because of the relationship between the intestine and the liver, both in anatomy and function. Importantly, the resulting alteration of gut microbiota aggravates graft dysfunctions during the process. This article reviews the research progress for gut microbial alterations and liver transplantation. Especially, this work also evaluates research on the management of gut microbial alteration and the prediction of possible injuries utilizing microbial alteration during liver transplantation. In addition, we propose possible directions for research on gut microbial alteration during liver transplantation and offer a hypothesis on the utilization of microbial alteration in liver transplantation. The aim is not only to predict perioperative injuries but also to function as a method of treatment or even inhibit the rejection of liver transplantation.
Animals
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Gastrointestinal Microbiome
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Graft Rejection
;
prevention & control
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Humans
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Intestinal Mucosa
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physiopathology
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ultrastructure
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Liver Transplantation
;
Rats
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Reperfusion Injury
;
prevention & control
6.Serial biopsy findings in patients with small bowel allotransplantation.
Bo WU ; Yuan-xin LI ; Xiao-jing AN ; Ru-song ZHANG ; Heng-hui MA ; You-sheng LI ; Xiao-jun ZHOU
Chinese Journal of Pathology 2010;39(7):473-475
Adult
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Biopsy
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Female
;
Graft Rejection
;
pathology
;
Humans
;
Intestinal Mucosa
;
pathology
;
Intestine, Small
;
injuries
;
pathology
;
transplantation
;
Male
;
Organ Transplantation
;
adverse effects
;
Reperfusion Injury
;
etiology
;
pathology
;
Young Adult
7.Protective effect of epidermal growth factor on isograft mucosal structure after small bowel transplantation in rat.
Ke-zhou LI ; Xiao-ting WU ; Ning LI ; Jie-shou LI
Chinese Journal of Gastrointestinal Surgery 2006;9(5):448-451
OBJECTIVETo investigate the effects of epidermal growth factor(EGF) on mucosal structure after small bowel transplantation in rat.
METHODSTotal small bowel transplantation was performed in inbred Wistar(RT1k) rats heterotopically, either total parenteral nutrition(control group, n=10) or TPN supplemented with epidermal growth factor(EGF group, n=10) was given to the recipients from the second day to 10th day after operation. The changes of morphology, ultrastructure, mucosal protein and DNA contents were determined.
RESULTSThe height of mucosal villus,the depth of crypt, the thickness of mucosa and the surface area of villus were (284.47+/-31.58)microm, (98.78+/-10.83 microm, (389.56+/-31.72)microm and (0.089+/-0.009 )mm(2) respectively in EGF group,and (176.45+/-14.62)microm, (74.45+/-8.34)microm, (259.38+/-24.65) microm, and (0.041+/-0.005)mm2 respectively in the control group. The morphological parameters were significantly higher in EGF group than those in the control group. Mucosal protein content was (84.65+/-8.32)mg/g wet wt in EGF group,significantly higher than (53.73+/- 11.45) mg/g wet wt in the control group(P=0.012). DNA content was also significantly higher in EGF group than that in the control group. [(0.86+/0.10)mg/g wet wt vs (0.51+/-0.06)mg/g wet wt, P=0.008]. Nearly normal ultrastructure of the graft enterocyte was maintained in EGF group, while atrophic microvilli and broken mitochondrial crista were observed in the control group.
CONCLUSIONEGF can preserve the mucosal structure of the graft, maintain the integrity of the ultrastructure of graft enterocyte after small bowel transplantation in rat.
Animals ; Epidermal Growth Factor ; therapeutic use ; Intestinal Mucosa ; pathology ; ultrastructure ; Intestine, Small ; transplantation ; ultrastructure ; Male ; Parenteral Nutrition, Total ; methods ; Rats ; Rats, Wistar ; Transplantation, Autologous ; Transplants
8.Histopathologic changes after tracheal reconstruction with a scraped partial mucosa jejunal autograft.
Ligang ZHENG ; Yuejian WANG ; Sucheng TANG ; Enkuan CHEN ; Weixiong CHEN ; Qingqing YU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(6):406-409
OBJECTIVE:
To explore the histopathological changes of the new trachea reconstruction with a scraped partial mucosa jejunal autograft hy microscope and transmission electron microscope.
METHOD:
Eight canine models of extensive circumferential tracheal defects with revascularized jejuna combined with NiTi alloy mesh tube were established. Operations were performed on these dogs under general anesthesia by intravenous ketamine. A 6.5 cm length of segment of the jejunum was resected. The graft was prepared by scraping the partial mucosa with operating knife blade and dry gauze. During the resecting course, micro-vascular anastomoses were done between the mesenteric artery and the right common carotid artery,and the mesenteric vein with the right common carotid vein. The silicone intraluminal stent was placed in the lumen of the jejunal segment and was removed the fourth week after operation. A Ni-Ti alloy prothesis was placed over the jejunal segment, with the mesenteric vascular supply egressing through the longitudinal defect of the mesh tube. Then the free jejunum was used to reconstruct the tracheal defects. Biopsy were performed and recorded at the 1 at, 2nd, 3rd and 4th postoperative months. All specimens were observed by microscope and transmission electron microscope examinations.
RESULT:
Eight dogs postoperative all survived expected time. One month after operation, the tracheointestinal snastomosis showed smooth and was covered by continuous internal lining. The mucosa of the jejunum was slightly atrophied. Two months after operation, examination of the jejunal mucosa of the autografts demonstrated obviously thinned. The lumen of the reconstructed trachea was covered by squamous epithelium entirely at 3 months postoperatively. The partial squamous epithelium has transformed ciliated columnar epithelium at 4 months postoperatively.
CONCLUSION
A free scraped partial jejunum reconstructed trachea can accelerated the atrophying process of mucous epithelization and promoted mucosal metaplasia of the jejunum. The reconstructed tracheal lumen has completely transformed squamous epithelium at 3 months postoperatively and partial squamous epithelium has transformed ciliated columnar epithelium at 4 months postoperatively.
Animals
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Atrophy
;
pathology
;
Autografts
;
Dogs
;
Epithelium
;
Intestinal Mucosa
;
pathology
;
transplantation
;
Jejunum
;
pathology
;
transplantation
;
Mucous Membrane
;
pathology
;
transplantation
;
Nickel
;
Reconstructive Surgical Procedures
;
Stents
;
Surgical Mesh
;
Titanium
;
Trachea
;
surgery
;
Transplantation, Autologous
9.Restoration of erectile function by reconstructing cavernous nerves with small intestinal submucosa grafts.
Hong-Kai LU ; Hai-Jun ZHOU ; En-Jiang GAO ; Lu-Jie SONG ; Hai-Zhen ZUO ; Bo YAN ; Zhi-Yong YU ; Jing DU ; Wen-Hua BI
National Journal of Andrology 2010;16(2):150-153
OBJECTIVETo investigate the restoration of erectile function by reconstructing cavernous nerves (CN) with small intestinal submucosa (SIS) grafts.
METHODSWe prepared SIS grafts, established rat models and divided the models into a CN ablation, a sham-operation and an SIS graft group. The CNs at both sides were severed with 1 cm ablated in the first group, and 0.5 cm removed in the third, followed by reconstruction with the SIS grafts. Three months after surgery, the apomorphine test was performed to evaluate the erectile function, and then all the rats were sacrificed to detect the expression of nNOS in the penis.
RESULTSPenile erection was observed in 72.73% (8/11) of the rats for (1.07 +/- 0.89) times within 30 min in the SIS graft group, as compared with 0% (0/11) of the rats for (0.00 +/- 0.00) times in the CN ablation group (P < 0.01), and 90.91% (10/11) of the rats for (2.19 +/- 1.17) times in the sham-operation group (P < 0.01). The number of nNOS nerve fibers was significantly larger in the SIS graft than in the CN ablation group (70.36 +/- 10.09 versus 22.09 +/- 4.76, P < 0.01), but both were significantly smaller than that of the sham-operation group (90.81 +/- 5.69, P < 0.01).
CONCLUSIONThe SIS grafting technique contributes to the recanalization of the severed CN and restoration of erectile function in rats after surgical injury.
Animals ; Erectile Dysfunction ; surgery ; Intestinal Mucosa ; transplantation ; Intestine, Small ; Male ; Nerve Regeneration ; Nerve Tissue ; injuries ; surgery ; Penile Erection ; Penis ; innervation ; Rats ; Rats, Sprague-Dawley
10.Porcine Small Intestinal Submucosa Mesh for Treatment of Pelvic Organ Prolapsed.
Ting-Ting CAO ; Xiu-Li SUN ; Shi-Yan WANG ; Xin YANG ; Jian-Liu WANG
Chinese Medical Journal 2016;129(21):2603-2609
BACKGROUNDPelvic organ prolapse (POP) is a major health concern that affects women. Surgeons have increasingly used prosthetic meshes to correct POP. However, the most common used is synthetic mesh, and absorbable mesh is less reported. This research aimed to evaluate the clinical effectiveness of porcine small intestinal submucosa (SIS).
METHODSConsecutive forty POP patients who met the inclusion criteria underwent pelvic reconstruction surgery with SIS between March 2012 and December 2013. The patients' clinical characteristics were recorded preoperatively. Surgical outcomes, measured by objective and subjective success rates, were investigated. We evaluated the quality of life (QOL) using the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). Sexual QOL was assessed by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12).
RESULTSAt postoperative 12 months, the subjective recurrence rate (7.5%) was much lower than the objective recurrence rate (40.0%). Postoperatively, no erosion was identified. One underwent a graft release procedure because of urinary retention, and one had anus sphincter reconstruction surgery due to defecation urgency. Another experienced posterior vaginal wall infection where the mesh was implanted, accompanied by severe vaginal pain. Estrogen cream relieved the pain. One patient with recurrence underwent a secondary surgery with Bard Mesh because of stage 3 anterior vaginal wall prolapse. Scoring system of PFDI-20 was from 59.150 ± 13.143 preoperatively to 8.400 ± 4.749 postoperatively and PFIQ-7 was from 73.350 ± 32.281 to 7.150 ± 3.110, while PISQ-12 was from 15.825 ± 4.050 to 12.725 ± 3.471.
CONCLUSIONSQOL and the degree of subjective satisfaction were significantly improved postoperatively. Anterior repair deserves more attention because of the higher recurrence rate. The long-term follow-up of the patient is warranted to draw firm conclusion.
Aged ; Animals ; Female ; Humans ; Intestinal Mucosa ; transplantation ; Male ; Middle Aged ; Pelvic Organ Prolapse ; surgery ; Prospective Studies ; Surgical Mesh ; Swine ; Tissue Scaffolds