Bibliometric analysis of qualitative research on patients' experiences of intestinal stoma published between 2002 - 2018.

AIMS: The purpose of this paper was to perform a bibliometric analysis of the production of qualitative research in scientific journals through aggregation by levels and to identify factors of diversity, such as types of designs, in qualitative research on the experience of having an intestinal stoma between 2002 and 2018. DESIGN: Descriptive bibliometric study focused on the production of qualitative research on the subject of study, on three levels: micro, meso and macro. METHODS: Databases such as PubMed, CINAHL, Web of Knowledge, Scopus, SciELO, CUIDEN, Lilacs and Google Scholar were used to collect the data, between August - November 2018. RESULTS: Nursing was the main area of knowledge. Brazil was the predominant country of origin. The most productive journal was the Journal of Wound, Ostomy & Continence Nursing. English and Portuguese were the main languages of scientific communication. The number of authors was typically between 2 and 6. Authors conducted descriptive and phenomenological studies. CONCLUSION: The present bibliometric study helps us to map the qualitative research on the experiences of individuals with an intestinal stoma and to understand patterns in the designs, methods, disciplines and journals involved in this area of research. This will allow nurses to have a leading contribution to stoma care at their disposal.

Health Utility, Social Interactivity, and Peristomal Skin Status: A Cross-Sectional Study.

PURPOSE: The objective of this study was to examine relationships among social interaction, health utility, and peristomal skin status in adults with ostomies. DESIGN: Cross-sectional, descriptive. SUBJECTS AND SETTING: 15,591 persons residing in the United States were randomly selected from 3 multinational proprietary databases of individuals who had undergone surgery. METHODS: The study was a cross-sectional assessment utilizing the SF36v2 survey instrument. Potential subjects were sent an e-mail letter of invitation that included instructions for completing the questionnaire, an informed consent form, and nontransferable link to an electronic survey. Health utility was derived from the SF6D, and the Hawthorne Friendship Scale was used to measure social connectivity. Social functioning was derived from the SF36v2. A minimally important social value of health (MISVH) is reported as the minimum quality-adjusted life-days to be of benefit (influence) within indices of social connectivity and function. A self-reported determinant of peristomal skin health was included. RESULTS: Increased social interactivity, defined as social functioning and social connectivity, was associated with increased health utility. In addition, health utility decreased as peristomal skin integrity worsened. A MISVH can be demonstrated. CONCLUSION: Findings indicate that peristomal skin complications are more than dermatologic issues. They negatively affect the well-being of those who must cope and adapt to their impact and the community at large. Social interaction is also negatively influenced.

A Quasi-experimental Study to Explore the Effect of Barrier Cream on the Peristomal Skin of Patients With a Tracheostomy.

Peristomal skin problems represent one of the most common complications of a tracheostomy. A quasi-experimental study was conducted among patients ages 18 to 65 years hospitalized in a Turkish university hospital ear-nose-throat clinic between August 15, 2013, and December 15, 2013, to compare the effect of using or not using a barrier cream on the peristomal skin with regard to pH, moisture, temperature, color, odor, turgor, infections, and lesions after tracheostomy surgery. Patients were selected using a purposeful sampling method and included if they had not undergone another operation for a complication (eg, pneumothorax, tube misplacement, hemorrhage) within 24 hours following the tracheostomy operation. In phase 1 of the study, 9 registered nurses were observed 3 times each by the researcher, who completed an observation form. From these observations and related nursing textbooks, the researcher developed a protocol entitled "Nursing Care Steps for Patients with a Tracheostomy." This protocol was followed during phase 2 of the study during which participants were alternately assigned to either the intervention (a barrier cream containing dimethicone, acrylate terpolymer, oils, paraffin, water, dicapryladipate, isopropyl palmitate, and PPG-15 stearyl ether followed by gauze) or control (gauze only) group (n = 30 each) and observed for 7 days. Demographic characteristics were gathered for each patient upon admission to the study. Peristomal skin was assessed in terms of pH, temperature, and moisture (relative humidity [RH]) using a surface pH meter, surface thermometer, and digital skin moisture tester, as well as for lesions, infection, and maceration. Findings were documented on a skin condition assessment form. Twenty-four (24) hours post surgery, the barrier cream plus gauze was applied over peristomal area in the study group and gauze dressing only in the control group. Peristomal skin pH, moisture, and temperature were within the normal range for both groups during all observations throughout the study but closer to normal ranges in the intervention group. Mean peristomal skin pH in the intervention group was significantly higher (5.452 ± 0.043) than in the control group (5.123 ± 0.057; P &.001), mean peristomal skin moisture in the control group (46.90 ± 0.132 RH) was significantly greater than in the intervention group (41.71 ± 0.774 RH; P &.001), and mean peristomal skin temperature in the control group (33.59 ± 1.3˚ C) was significantly higher than in the intervention group (31.64 ± 0.607˚ C; P &.001). In both groups, Staphylococcus epidermidis was the most commonly cultured microorganism, and S aureus was the most cultured pathological microorganism in addition to the normal skin flora. Peristomal skin condition was maintained for both the intervention and control groups. Use of a barrier cream to protect tracheostomy peristomal skin beneath absorbent dressings (eg, gauze) is recommended, but additional short-term and long-term studies are needed.

Institutional Experience with Ostomies Created During Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemoperfusion.

BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion (CRS-HIPEC) is a complex procedure that often requires ostomy creation to protect high-risk anastomoses. This study aimed to evaluate the authors' institutional experience with CRS-HIPEC-associated ostomies, determine predictors of ostomy creation and reversal, and assess their impact on survival. METHODS: The study analyzed clinicopathologic, perioperative, and oncologic data from a prospective database of 1435 CRS-HIPEC procedures for peritoneal metastases. The Kaplan-Meier method was used to estimate survival. Multivariate analyses identified associations with ostomy creation/reversal and survival. RESULTS: Ostomies were created in 34% of the patients, most commonly loop ileostomies (82%). Loop ileostomies were reversed in the majority of patients (83%), whereas non-loop ileostomies were infrequently reversed (< 10% reversal rate). In a multivariate logistic regression model, intermediate or high tumor grade, colectomy/proctectomy, longer operative time, and lower Charlson comorbidity index were associated with loop ileostomy creation, whereas incomplete macroscopic resection, colorectal histology, and major postoperative complications were associated with non-reversal of loop ileostomy. In a multivariate Cox proportional hazards model, intermediate or high tumor grade and non-reversal of loop ileostomy were associated with worse overall survival. CONCLUSIONS: Loop ileostomies were almost always reversed, whereas non-loop ileostomies were almost always permanent. Hospital readmissions for loop ileostomy-related complications were common. Therefore, formal outpatient protocols for prevention and management should be implemented. Non-reversal of loop ileostomy was associated with very poor survival.

Stoma Creation and Reversal After Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy.

INTRODUCTION: Cytoreductive surgery with heated intraperitoneal chemotherapy (CRS/HIPEC) often includes stoma creation. We evaluated the indications, morbidity, and mortality associated with stoma creation and reversal after CRS/HIPEC. METHODS: Retrospective analysis of a prospective database of 1149 CRS-HIPEC procedures was performed. Patient demographics, type of malignancy, comorbidities, Clavien-graded morbidity, mortality, indications for stoma creation, and outcomes of subsequent reversal were abstracted. RESULTS: Sixteen percent (186/1149) of CRS/HIPEC procedures included stoma creation, whereas 1.1 % (11/963) of patients without initial stoma creation developed anastomotic leaks requiring stoma. Patients who required a stoma had worse preoperative performance status (ECOG 0/1: 77.2 vs. 86.1 %, p = 0.002), greater burden of disease (PCI 17.6 vs. 12.9, p < 0.0001), and were more likely to have R2 resections (74.5 vs. 48.8 %, p < 0.0001) than those without stoma creation. Stomas were intended to be permanent in 17.5 % (35/199). Of 164 patients with potentially reversible ostomies, only 26.2 % (43/164) underwent reversal. Disease progression (43/164, 26.2 %) and death (40/164, 24.3 %) most commonly precluded reversal. After reversal, 27.9 % (12/43) suffered a Clavien I/II morbidity, 27.9 % (12/43) suffered Clavien III/IV morbidity, and 30-day mortality was 4.7 % (2/43). Anastomotic leak occurred after 9 % (3/33) of ileostomy and 10 % (1/10) of colostomy reversals. CONCLUSIONS: Stomas are more common among CRS/HIPEC patients with a high burden of disease and poor functional status. Reversal is uncommon and is associated with significant major morbidity. Preoperative counseling for those with high disease burden and poor functional status should include the risk of permanent stoma.

Pioderma gangrenoso periestomal asociado a cáncer de colon / Peristomal pyoderma gangrenosum associated with colon cancer

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The discovery of the synovial lymphatic stomata and lymphatic reabsorption in knee effusion.

To illustrate the mechanism of lymphatic reabsorption in knee joint effusion. The current investigation employed transmission electron microscopy (TEM) and scanning electron microscopy (SEM) techniques to reveal the ultrastructure of the knee synovial membrane in New Zealand rabbits and human. Ultrastructural changes of the synovial lymphatic stomata were observed by using trypan blue absorption and sodium hydroxide (NaOH) digestion methods, and the animal models of synovitis. New Zealand rabbits and human synovial membranes were composed of two types of synovial cells: type A and type B. No lymphatic stomata were found among type A synovial cells, whereas lymphatic stomata with the diameters ranging 0.74-3.26 µm were found in type B synovial cells, and some stomata were closed. After the NaOH digestion, a number of sieve pores, similar to lymphatic stomata in size and shape, were observed in the dense fibrous connective tissue underneath the type B synovial cells. After injecting trypan blue into the rabbit knee joint cavity, absorption of trypan blue through the lymphatic stomata was observed, suggesting the absorption function of the synovial lymphatic stomata. In the rabbit knee joint synovitis models, the synovial lymphatic stomata diameter enlarged. Some macrophages migrated from the lymphatic stomata, indicating that the synovial lymphatic stomata were involved in the joint effusion absorption and inflammatory response. Our study is the first to report the existence of synovial lymphatic stomata in the New Zealand rabbits and human knee joints. Lymphatic stomata may have an important role in the reabsorption of joint effusion.

Lymphatic Stomata in the Adult Human Pulmonary Ligament.

BACKGROUND: Lymphatic stomata are small lymphatic openings in the serosal membrane that communicate with the serosal cavity. Although these stomata have primarily been studied in experimental mammals, little is known concerning the presence and properties of lymphatic stomata in the adult human pleura. Thus, adult human pleurae were examined for the presence or absence of lymphatic stomata. METHODS AND RESULTS: A total of 26 pulmonary ligaments (13 left and 13 right) were obtained from 15 adult human autopsy cases and examined using electron and light microscopy. The microscopic studies revealed the presence of apertures fringed with D2-40-positive, CD31-positive, and cytokeratin-negative endothelial cells directly communicating with submesothelial lymphatics in all of the pulmonary ligaments. The apertures' sizes and densities varied from case to case according to the serial tissue section. The medians of these aperture sizes ranged from 2.25 to 8.75 µm in the left pulmonary ligaments and from 2.50 to 12.50 µm in the right pulmonary ligaments. The densities of the apertures ranged from 2 to 9 per mm(2) in the left pulmonary ligaments and from 2 to 18 per mm(2) in the right pulmonary ligaments. However, no significant differences were found regarding the aperture size (p=0.359) and density (p=0.438) between the left and the right pulmonary ligaments. CONCLUSIONS: Our study revealed that apertures exhibit structural adequacy as lymphatic stomata on the surface of the pulmonary ligament, thereby providing evidence that lymphatic stomata are present in the adult human pleura.

Ultrastructure of lymphatic stomata in the tunica vaginalis of humans.

Lymphatic stomata are small openings of lymphatic capillaries on the surface of the mesothelium that lines the serous cavity and have the function of active absorption. They play an important role in physiological and pathological conditions. The cavity of the tunica vaginalis is a typical serous cavity of the testis, but the lymphatic stomata of the tunica vaginalis of humans have never been reported. Here, we studied their ultrastructure by scanning and transmission electron microscopy. The submesothelial connective tissue with foramina was investigated after the mesothelial cells were digested using NaOH solution. We found the lymphatic stomata in cuboidal mesothelial cell regions of the parietal layer of the tunica vaginalis of humans with a diameter of about 1-2 µm. Sometimes, closed lymphatic stomata could be observed. Our study is the first to report the existence of lymphatic stomata of the tunica vaginalis of humans. We found that the tunica vaginalis cavity is connected with the lymphatic system through the stomata, which might provide a morphological basis for the drainage of hydrocele and tumor metastasis of the tunica vaginalis of humans.

Prevención laparoscópica de la hernia paraestomal mediante técnica de Sugarbaker modificada con malla compuesta (Physiomesh ®) / Parastomal hernia prevention through laparoscopic modified Sugarbaker technique with composite mesh (Physiomesh ®)

La elevada incidencia de la hernia paraestomal y la controversia en su reparación hacen que su prevención sea un área de intensa investigación. El objetivo del presente artículo es describir la técnica de Sugarbaker modificada con una nueva malla para la prevención de una hernia paraestomal, utilizando un abordaje laparoscópico (AU)

The high incidence of parastomal hernia and the controversy surrounding its repair make its prevention an area of intense research. The aim of this article is to describe the modified Sugarbaker technique with a new mesh for the prevention of parastomal hernia using a laparoscopic approach (AU)

Problema de pele em paciente estomizada: relato de caso / Skin problems in a stomized patient: a case report

Objetivo: Relatar o caso vivenciado na prática de enfermagem, no manejo de complicações de pele periestoma,e avaliar as mudanças clínicas obtidas após a utilização de protetores cutâneos. Relato de caso: O estudo foi desenvolvido em uma paciente estomizada de 57 anos, cuja pele periestoma apresentava extensa dermatite periestomal com aspecto brilhante, altamente exsudativa, irritativa e dolorosa, em que o dispositivo para estomia mantinha-se adaptado por menos de 24 horas. Conclusão: Após o manejo dos protetores cutâneos, houve evolução satisfatória em relação à lesão periestomal e no emocional, o que resultou no fechamento da ileostomia.

Objective: To report a case experienced in nursing practice regarding the management of peristomal skin complications, as well as to evaluate the clinical changes obtained after the use of skin protectors. Case report: this study was developed in a patient with stoma 57, whose skin had extensive peristomal dermatitis, glossy, highly exudative, irritating and painful, who had a device installed for ostomy adapted forless than 24 hours. Conclusion: After the management of skin protectors, there was satisfactory progress in relation to peristomal and emotional injury, which resulted in the closure of the ileostomy.

Strumosis peritoneal: estudio de extensión con 99mTc-pertecnectato / Peritoneal strumosis: an extension study with 99mTc-pertecnectate

Presentamos el caso de una paciente de 35 años, nuligesta, con antecedentes de quistectomía ovárica bilateral hace 3 años por un teratoma monodérmico tipo struma ovarii en ovario derecho y quiste hemorrágico en ovario izquierdo. En revisiones periódicas se observa crecimiento progresivo de la tumoración anexial izquierda por lo que se le realiza una nueva laparoscopia y ante los hallazgos se le practica una quistectomía de ovario izquierdo, salpinguectomía derecha y exéresis de múltiples implantes peritoneales. El diagnóstico anatomopatológico fue de struma ovarii izquierdo y strumosis peritoneal. Posteriormente se le realiza rastreo corporal total con 99mTc-pertecnetato para detectar otros implantes peritoneales y SPECT-TAC para localizarlos anatómicamente. Esta exploración ayudó a tomar una decisión terapéutica(AU)

We report the case of a 35-year-old nulliparous woman, with a previous history of ovarian cystectomy diagnosed 3 years earlier due a struma ovarii type of monodermal teratoma in the right ovary and a hemorrhagic cyst in the left ovary. Progressive growth of the left adnexal mass was observed in the periodic medical check-ups. Due to this, a second laparoscopy was performed and, based on the findings, a left ovarian cystectomy, right salpingectomy and resection of multiple peritoneal implants were carried out. The pathology diagnosis was left struma ovarii and peritoneal strumosis. A whole body and SPECT/CT scan with 99mTc-pertechnetate was performed to detect possible peritoneal implants. This study helped to make the therapeutic decision(AU)

Dialogue study. Evaluación de la calidad de vida y de la piel periestomal del paciente ostomizado con el nuevo dispositivo SenSura / Dialogue study. To evaluate the quality of life and peristomal skin ostomy patient with the new device Sensura

En el año 2006, Coloplast comercializó en distintos países europeos un nuevo dispositivo para ostomías llamado SenSura. El presente informe de la investigación clínica incluye exclusivamente los resultados de la subpoblación incluida en España, como parte de un estudio internacional, en el que participaron numerosos países como Dinamarca, Estados Unidos, Canadá, Australia, Polonia, Países Bajos, Francia, Eslovaquia, Alemania, Reino Unido, Italia, Islandia, Japón, República Checa, Portugal, España, Corea del Sur y Argentina. Objetivos y variables de estudio. El propósito principal es evaluar la experiencia práctica con este dispositivo, en condiciones normales de uso, con especial atención al estado de la piel y a la calidad de vida. El objetivo principal es la evaluación de la calidad de vida a través del Cuestionario de Calidad de Vida llamado «Stoma QoL». En cuanto a los objetivos secundarios encontramos el estudio de la correlación entre calidad de vida y el estado de la piel periestomal. Otros son la evaluación del dispositivo utilizado habitualmente por el paciente en el momento de entrar en el estudio, así como el dispositivo SenSura y el registro de acontecimientos adversos a lo largo de todo el proceso. Diseño del estudio. Se trata de un estudio abierto, longitudinal, internacional, no comparativo y post-comercialización. El período de estudio para cada paciente es de seis a ocho semanas +/– cuatro días, incluyendo una visita inicial y otra final. La población del estudio consiste en personas portadoras de una colostomía o una ileostomía. Metodología. En España participaron un total de 10 centros, para un total de 131 pacientes. En el presente informe únicamente se presentan resultados correspondientes a nueve centros y un total de 123 pacientes. El motivo es que el último centro comenzó el estudio con un retraso considerable. Los pacientes correspondientes a éste, junto con el resto de centros en España, serán incluidos en el próximo informe de investigación clínica internacional. Herramientas de medición. Stoma-QoL (Cuestionario de calidad de vida para personas ostomizadas). OST (Ostomy Skin Tool) Instrumento para la evaluación de la piel periestomal. Resultados. En cuanto a la calidad de vida, en la visita basal nos encontramos con una media de 59 sobre 100 (SD= 8,8), mientras que en la visita final del estudio, la puntuación media obtenida ha sido de 59,6 sobre 100 (SD= 9,3), aunque los resultados definitivos con respecto a esta variable se presentarán en el informe global, dado que no se ha alcanzado población suficiente en España para el análisis de esta variable. El estudio reveló una mejora significativa en el estado de la piel periestomal al final del mismo, medida a través de la herramienta OST (Ostomy Skin Tool). En cuanto a la evaluación del dispositivo SenSura, se registró una mejora significativa con respecto a la aparición de fugas de efluente, así como del resto de ítems evaluados en relación con el dispositivo(AU)

In 2006, Coloplast launched in several European countries a new device for ostomy care called Sensura. This clinical research report includes only the results of the subpopulation included in Spain as a part of an international study, involving many countries such as Denmark, United States, Canada, Australia, Poland, Netherlands, France, Slovakia, Germany, UK, Italy, Iceland, Japan, Czech Republic, Portugal, South Korea and Argentina. Objectives and study variables. The main purpose of the study is to evaluate the experience with Sensura, under normal conditions of use, with special attention to skin condition and quality of life. The main objective of the study is to evaluate the quality of life, through Quality of Life Questionnaire called «Stoma QoL». A secondary objective, is to study the correlation between quality of life and the peristomal skin condition. Other Secondary objectives include the evaluation of the patient's current device at the time of entering the study, and by the other hand, the device Sensura and safety evaluation throughout the study. Design study. The study was designed as an open label, non-comparative, multi-national Post Market study. The study period for each patient is 6 to 8 weeks +/– 4 days, which includes an initial visit and a final visit. The study population included people who carry a colostomy or ileostomy. Methodology. Regarding Spain, a total of 10 sites participated and included a total of 131 patients. This report only presents results for nine sites and a total of 123 patients. The reason is that the last participating site began the study with a considerable delay. The remaining subjects included in this site together with the other centers in Spain and the other participating countries will be included in the final international report, that will present the overall results. Measurement tools. Stoma-QoL (Quality of Life Questionnaire for people with an ostomy). OST (Ostomy Skin Tool) instrument for the assessment of peristomal skin. Results. As for the quality of life, at baseline we found a mean of 59 out of 100 (SD = 8.8), while the final study visit, mean score was 59.6 out of 100 (SD = 9.3), although the final results on this variable will be presented in the global report, since since it has not reached sufficient population in Spain for the analysis of this variable. The study revealed a significant improvement in the peristomal skin condition at the end of the study, measured by the tool OST (Ostomy Skin Tool). Regarding the evaluation of the SenSura device, there was a significant improvement related to the appearance of leakage of effluent, as well as other items evaluated in relation with the device(AU)

Recent advances in the research of lymphatic stomata.

Lymphatic stomata are small openings of lymphatic capillaries on the free surface of the mesothelium. The peritoneal cavity, pleural cavity, and pericardial cavity are connected with lymphatic system via these small openings, which have the function of active absorption. The ultrastructure of the lymphatic stomata and their absorption from the body cavities are important clinically, such as ascites elimination, neoplasm metastasis, and inflammatory reaction. The lymphatic stomata play an important role in the physiological and pathological conditions. Our previous study indicated for the first time that nitric oxide (NO) could regulate the opening and absorption of the lymphatic stomata. It could decrease the level of free intracellular calcium [Ca(2+)] through increasing the cyclic guanosine monophosphate (cGMP) level in the rat peritoneal mesothelial cells, thus regulating the lymphatic stomata. This process is related with the NO-cGMP-[Ca(2+)] signal pathway. In this review, we summarize the recent advances in understanding the development and the function of the lymphatic stomata. The ultrastructure and regulations of the lymphatic stomata are also discussed in this review.

Cell signal transduction mechanism for nitric oxide regulating lymphatic stomata and its draining capability.

We have previously demonstrated that nitric oxide (NO) is involved in the regulation of the lymphatic stomata. However, the related mechanisms are still unknown. The present study was designed to test the hypothesis that NO-cyclic guanosine monophosphate (cGMP) -mediated cytosolic Ca(2+) concentration ([Ca(2+)]i) signaling may contribute to the regulation of the lymphatic stomata and lymph drainage. Using trypan blue as a tracer, the effects of NO-cGMP-Ca(2+) signal cascade on the lymphatic stomata and lymph absorption were examined by means of scanning electron microscopy. Then, the role of NO in cGMP and [Ca(2+)]i of rat peritoneal mesothelial cells (RPMCs) was measured by radioimmunoassay and a confocal laser scanning microscope. Our results showed that NO-donor spermine/nitric oxide complex (Sper/NO) could broaden the opening area of the lymphatic stomata and enhance lymph absorption in a dose-dependent manner. These NO-mediated changes could be blocked by 1H-[1,2,4] oxadiazolo [4,3-a] quinoxalin-1-one (ODQ), a specific inhibitor of soluble guanylyl cyclase, and mimicked by calcium channel blocker nifedipine. Furthermore, Sper/NO enhanced the cGMP level and lessened [Ca(2+)](i) in RPMCs, which was completely abrogated at the presence of ODQ. Nifedipine induced an immediate and marked decrease of [Ca(2+)](i) in the RPMCs, which was not attenuated by addition of Sper/NO, indicating that the Sper/NO-cGMP signaling system induced [Ca(2+)](i) change was related to the L-type voltage-gated calcium channel in the RPMCs. Our results suggest that NO enlarges the opening area of the lymphatic stomata to strengthen the lymph drainage of tracer by means of NO-cGMP-[Ca(2+)]i signal transduction pathway in the RPMCs.

[Effects of nitric oxide on peritoneal lymphatic stomata and lymph drainage via NO-cGMP-Ca2+ pathway].

To study the cell signal transduction mechanism of nitric oxide (NO) on the peritoneal lymphatic stomata and lymph drainage in the rat, cGMP content were measured by a commercially available radioimmunoassay kit, and the [Ca(2+)](i) were observed by a confocal laser scanning microscope in the cultured peritoneal mesothelial cell. Animal experiment was practiced to study the effect of NO-cGMP-Ca(2+) pathway on the lymphatic stomata and lymph absorption. The results showed that: (1) Sper/NO increased cGMP of the rat peritoneal mesothelial cell (RPMC) in a dose-dependent manner (P<0.01) compared to the control group. This effect was blocked by 1H-[1,2,4] oxadiazolo [4,3-a] quinoxalin-1-one (ODQ) (P<0.05), a specific inhibitor of soluble guanylyl cyclase (sGC). The level of [Ca(2+)](i) in single RPMC decreased by adding Sper/NO (P<0.05). Pretreatment with ODQ for 10 min blocked the Sper/NO-induced decrease in [Ca(2+)](i). L-typed calcium channel blocker nifedipine induced an immediate and marked decrease in [Ca(2+)](i) (P<0.05).. After [Ca(2+)](i) reached a balance again, adding Sper/NO could not change [Ca(2+)](i) (P>0.05). (2) Sper/NO increased the area of the stomata (P<0.01) and the quantity of the tracer in a dose-dependent manner (P<0.05) compared to the control group. Pretreatment with ODQ significantly inhibited Sper/NO-induced change of lymphatic stomata and lymph drainage (P<0.01). Nifedipine increased the opening area of the lymphatic stomata (P< 0.01) and the concentration of absorbed trypan blue of the diaphragm (P<0.05). Sper/NO could not make a further change in the samples pretreated by nifedipine (P> 0.05). The results indicate that NO can decrease [Ca(2+)](i) in the RPMC through the NO-cGMP pathway. This procession is related with the L- type voltage-gated Ca(2+) channel. NO enlarges the opening area of the lymphatic stomata and enhances the lymph drainage of tracer by NO-cGMP-[Ca(2+)](i) pathway.

Effects of nitric oxide on peritoneal lymphatic stomata and lymph drainage via NO-cGMP-Ca2+ pathway / 生理学报

To study the cell signal transduction mechanism of nitric oxide (NO) on the peritoneal lymphatic stomata and lymph drainage in the rat, cGMP content were measured by a commercially available radioimmunoassay kit, and the [Ca(2+)](i) were observed by a confocal laser scanning microscope in the cultured peritoneal mesothelial cell. Animal experiment was practiced to study the effect of NO-cGMP-Ca(2+) pathway on the lymphatic stomata and lymph absorption. The results showed that: (1) Sper/NO increased cGMP of the rat peritoneal mesothelial cell (RPMC) in a dose-dependent manner (P<0.01) compared to the control group. This effect was blocked by 1H-[1,2,4] oxadiazolo [4,3-a] quinoxalin-1-one (ODQ) (P<0.05), a specific inhibitor of soluble guanylyl cyclase (sGC). The level of [Ca(2+)](i) in single RPMC decreased by adding Sper/NO (P<0.05). Pretreatment with ODQ for 10 min blocked the Sper/NO-induced decrease in [Ca(2+)](i). L-typed calcium channel blocker nifedipine induced an immediate and marked decrease in [Ca(2+)](i) (P<0.05).. After [Ca(2+)](i) reached a balance again, adding Sper/NO could not change [Ca(2+)](i) (P>0.05). (2) Sper/NO increased the area of the stomata (P<0.01) and the quantity of the tracer in a dose-dependent manner (P<0.05) compared to the control group. Pretreatment with ODQ significantly inhibited Sper/NO-induced change of lymphatic stomata and lymph drainage (P<0.01). Nifedipine increased the opening area of the lymphatic stomata (P< 0.01) and the concentration of absorbed trypan blue of the diaphragm (P<0.05). Sper/NO could not make a further change in the samples pretreated by nifedipine (P> 0.05). The results indicate that NO can decrease [Ca(2+)](i) in the RPMC through the NO-cGMP pathway. This procession is related with the L- type voltage-gated Ca(2+) channel. NO enlarges the opening area of the lymphatic stomata and enhances the lymph drainage of tracer by NO-cGMP-[Ca(2+)](i) pathway.