| Application of distractive forces to the small intestine: defining safe limits. | |
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MedLine Citation:
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PMID: 20605600 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Distraction enterogenesis is a novel method for increasing small bowel length by the application of linearly directed forces. However, the magnitude of distractive forces that human and animal small bowel can safely withstand is unknown. METHODS: Acute ex vivo force-displacement curves for human (n = 5) and pig (n = 6) small intestine (with and without mesentery) were made by applying increasing amounts of distractive forces to bowel immersed in normal saline (39°C). Progressive load was applied until gross disruption of the tissue was detected, or the applied force reached 1000 gram-force (gf). Histology was used to detect evidence of load-induced damage. In vivo blood flow to pig bowel with distractive loads (30-200 gf) was measured by laser Doppler. RESULTS: The relationship between the level of force and degree of displacement was linear. The presence of a mesentery increased stiffness of pig bowel, but did not affect human bowel. Gross tissue disruption in pig and human tissue was seen at forces between 235 and 295 gf, respectively. However, in grossly undamaged areas, histology was unchanged even after application of higher loads. With in vivo testing, mesenteric blood flow was present up to 200 gf; however, blood flow to the bowel wall was reduced to undetectable levels at loads exceeding 100 gf. CONCLUSIONS: While whole bowel tissue may tolerate greater applied loads, blood flow to the bowel wall was compromised at loads over 100 gf, suggesting that any higher forces place the bowel at risk for ischemia. These measurements will help guide the clinical application of distraction enterogenesis. |
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Authors:
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Eiichi A Miyasaka; Manabu Okawada; Brent Utter; Haytham Mustafa-Maria; Jonathan Luntz; Diann Brei; Daniel H Teitelbaum |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-04-21 |
Journal Detail:
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Title: The Journal of surgical research Volume: 163 ISSN: 1095-8673 ISO Abbreviation: J. Surg. Res. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-20 Completed Date: 2010-10-12 Revised Date: 2012-04-27 |
Medline Journal Info:
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Nlm Unique ID: 0376340 Medline TA: J Surg Res Country: United States |
Other Details:
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Languages: eng Pagination: 169-75 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Section of Pediatric Surgery, Department of Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan 48109-0245, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Animals Compressive Strength Female Humans Intestine, Small / blood supply, pathology, physiopathology* Middle Aged Short Bowel Syndrome / physiopathology, therapy* Splanchnic Circulation Stress, Mechanical Swine |
| Grant Support | |
ID/Acronym/Agency:
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1R21DK075413-01A1/DK/NIDDK NIH HHS; FD003787-01/FD/FDA HHS; R21 DK075413-01A1/DK/NIDDK NIH HHS; R21 DK075413-02/DK/NIDDK NIH HHS; T32HD007505/HD/NICHD NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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