Dobbie J W, Anderson J D
Mesothelial and Peritoneal Research Centre, Lister Research Laboratories, University Department of Surgery, Edinburgh Royal Infirmary, Scotland.
Perit Dial Int. 1996 Sep-Oct;16(5):488-96.
To determine the ultrastructure, relative density, and location of lamellar bodies in the various regions, structures, cells, and intercellular matrix in normal human peritoneum; to carry out engineering analysis of the role of lamellar structures in serosal lubricancy and deduce what effect this system may have on the process of peritoneal dialysis.
Five samples of normal human parietal peritoneum obtained at elective operation were fixed in a tannic acid-glutaraldehyde mixture and submitted to examination by transmission electron microscopy. Detailed analysis using reconstruction of serial electron micrographs and tracings of montages were employed in determining location, and disposition, density, and geometric patterns of lamellar bodies in all levels of the peritoneal membrane.
Lamellar profiles were found in greatest density enmeshed in surface microvilli and in mesothelial cytoplasm. Lamellar bodies were frequently observed capping the external portion of mesothelial junctional complexes, and within intercellular junctions. Lamellar bodies were also encountered in macrophages, both in the peritoneal cavity and submesothelial tissue, and also in fibroblasts. Lamellar bodies were present in low density in the matrix ground substance of submesothelial connective tissue, in blood vessel walls between smooth muscle, in endothelial cell cytoplasm, and in vascular lumina.
Three-dimensional analysis of lamellae on mesothelial surfaces indicates that an arrangement of constantly changing microscopic spheres and cylinders would act at "ball and roller bearings" among the microvilli for the lubrication of opposing surfaces. The entrapment of fluid in lamellar bubbles, which in normal peritoneum fill the microvillous layer, would, if maintained in peritoneal dialysis, constitute a stagnant layer of considerable stability and inertia.
确定正常人腹膜各区域、结构、细胞及细胞间基质中层状体的超微结构、相对密度和位置；对层状结构在浆膜润滑中的作用进行工程分析，并推断该系统对腹膜透析过程可能产生的影响。
选取择期手术获取的5例正常人壁腹膜样本，用鞣酸 - 戊二醛混合液固定，进行透射电子显微镜检查。采用连续电子显微镜图像重建和蒙片追踪进行详细分析，以确定腹膜各层中层状体的位置、分布、密度和几何图案。
在表面微绒毛和间皮细胞质中发现层状结构的密度最高。经常观察到层状体覆盖间皮连接复合体的外部以及细胞间连接处。在腹膜腔和间皮下组织中的巨噬细胞以及成纤维细胞中也发现了层状体。在间皮下结缔组织的基质、平滑肌之间的血管壁、内皮细胞质和血管腔中，层状体的密度较低。
对间皮表面薄片的三维分析表明，不断变化的微观球体和圆柱体排列将像“滚珠和滚柱轴承”一样作用于微绒毛之间，以润滑相对的表面。在正常腹膜中充满微绒毛层的层状泡中截留的液体，如果在腹膜透析中得以维持，将构成一个具有相当稳定性和惯性的停滞层。
