The aim of the study was to describe and depict the spatial arrangement of the colon microcirculatory bed as a whole. Various parts of the large intestine and terminal ileum were harvested from either cadaver or section material or gained peroperatively. Samples were then injected with India ink or methylmetacrylate Mercox resin for microdissection and corrosion casting for scanning electron microscopy. The results showed that extramural vasa recta ramified to form the subserous plexus, some of them passing underneath the colon taeniae. Branches of both short and long vasa recta merged in the colon wall, pierced the muscular layer and spread out as the submucous plexus, which extended throughout the whole intestine without any interruption. The muscular layer received blood via both the centrifugal branches of the submucous plexus and the minor branches sent off by the subserous plexus. The mucosa was supplied by the mucous plexus, which sent capillaries into the walls of intestinal glands. The hexagonal arrangement of the intestinal glands reflected their vascular bed. All three presumptive critical points are only gross anatomical points of no physiological relevance in healthy individuals. Neither microscopic weak points nor regional differences were proven within the wall of the whole large intestine. The corrosion casts showed a huge density of capillaries under the mucosa of the large intestine. A regular hexagonal pattern of the vascular bed on the inner surface was revealed. No microvascular critical point proofs were confirmed and a correlation model to various pathological states was created.

Colonic ischaemia after abdominal aortic grafting is a severe complication. Late detection of transmural ischaemia will result in a high mortality rate. No simple specific methods are available to detect the early stage. The aim of this pilot study was to detect and monitor sigmoidal ischaemia after aortic surgery with a new endoluminal sigmoidal probe, based on pulse oximetry. Twelve patients with sigmoidal ischaemia were included, the endoluminal probe being introduced into the sigmoid at least 25 cm proximal to the anal verge. It is shown that with this method, mucosal and transmural ischaemia can be graded and differentiated. Patients who showed no wave-form had transmural ischaemia; those with mucosal ischaemia showed reliable wave-forms with oxygen saturation from 40-85%. Colonic ischaemia after aortic grafting can be detected by endoluminal pulse oximetry but the clinical outcome will only improve by early detection in the preclinical stage.

To observe the branching site of the rat gastric submucosal arteriole toward the mucosal capillary network, we used vascular corrosion casting, scanning electron microscopy (SEM) and transmission electron microscopy (TEM), under various conditions, including the normal state, water immersion restraint stress for 24 h, ethanol-induced ulcer and administration of low and high doses of noradrenaline. In normal rats, the branching site of the submucosal arteriole toward the mucosa was slightly narrowed, as seen in the cast observations. The SEM and TEM observations revealed that this narrowing was due to the presence of the so-called "intra-arterial cushion". In the restraint stress rats, this narrowing was increased. TEM and direct SEM observation of the intraarterial cushion showed much the same findings. In the noradrenaline administered rats, similar changes were observed but not so in the rats with an ethanol-induced ulcer. Arterio-venous-anastomoses (AVA) were not observed in the submucosa, under any of the conditions used. We suggest that the submucosal intra-arterial cushions occurring at the branching sites of the submucosal arterioles may play an important role in regulating blood flow to the gastric mucosa.

1. The distribution of superior mesenteric arterial flow was investigated by radioactive microspheres. The small intestine received 83% of the flow ((85 ml/min)/100 g intestine) and flow was uniform along the length of the small intestine.2. The intestinal wall was separated into 3 layers-muscle, submucosa and mucosa. The muscle received (8 ml/min)/100 g intestine and the combined submucosa and mucosa (77 ml/min)/100 g intestine.3. The distribution of microspheres between the mucosa and submucosa depended on the size of the microspheres; the smaller the spheres, the more were found in the mucosa. It also depended on the state of the vascular bed; if microspheres were given during an infusion of vasopressin, a subsequent infusion of isoprenaline resulted in movement of some of the spheres from the submucosa into the mucosa.4. Histological studies after India ink injection showed few capillary-sized vessels but many large vessels in the submucosa. Capillary-sized vessels arose close to the junction with the mucosa and passed into the mucosa.5. These and other data suggest that the intestine consists of two parallel-coupled sections, one to the muscle and the other through the submucosa to the mucosa. The vessels in the submucosa are in series with those in the mucosa and submucosal shunts do not exist. Redistributions of flow between mucosa and submucosa cannot therefore occur during stimulation of the sympathetic nerves or infusions of drugs such as noradrenaline or adrenaline.6. When microspheres are used in pharmacological investigations on distribution of blood flow in organs, controls to validate the method for the particular areas being studied are essential. If the vessels in the areas studied are in series rather than in parallel, the method is invalid.