Reaction of the vasa nervorum of the facial nerve during stimulation with neurotransmitters.
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Acetylcholine↗
Biomedical subjects
E Seifert
Publications and source records attributed to E Seifert.
[Neurogenic inflammation and area of involvement of the facial nerve of the rat].
Antidromic electrical stimulation of sensory nerves produces vascular hyperpermeability, plasma protein extravasation and oedema. The initial phase of this inflammatory reaction is induced by the release of the neuropeptides CGRP, SP and NKA; the later phase is induced by mast cells. In previous investigations we were able to show that the facial nerve of the rat contains CGRP, SP and NKA as well as mast cells. The same mechanism--increased vascular permeability--plasma extravasation--oedema--is thought to be part of the pathogenesis of Bell's palsy. Hence, we tried to produce neurogenic inflammations in the facial nerves of six adult Wistar rats. To assess plasma extravasation we used Evans blue, a dye which binds to serum albumin, according to the method described by Brokaw and White (1992). Having cut the facial nerve distal of the stylomastoid foramen we induced a neurogenic inflammation by the application of an electrical stimulus to the distal part of the nerve. In comparison to the contralateral, non-stimulated side, we recognized that the inflammatory reactions were limited to the area of the skin innervated by the posterior auricular nerve. So far, we can transfer this "neurogenic inflammation model" the well-known relationship between nerves and inflammatory reactions to this limited area innervated by the facial nerve.
Animals↗
Innervation of epi- and endoneurial compartments of rat facial, vagus and sciatic nerves as studied by double-labeling immunofluorescence.
The mediators of axon terminals innervating the blood vessels and connective tissue compartments of rat peripheral nerves (facial, vagus and sciatic nerve) were investigated by means of double-labeling immunofluorescence. Sympathetic noradrenergic/neuropeptide-Y-immunoreactive axons innervated epi- and endoneurial arterial blood vessels; noradrenergic fibers without neuropeptide Y immunoreactivity terminated in the endoneurium between the axons of the main nerve trunk. Presumably sensory nerve terminals immunoreactive to substance P/calcitonin gene-related peptide supplied epi- but not endoneurial arteries and arterioles, and ran freely in the endoneurial space. Axons immunoreactive to vasoactive intestinal peptide innervated epineurial blood vessels of the facial and vagus nerve but were absent from the vasa nervorum of the sciatic nerve. The findings are in line with the concept, based upon previous pharmacological experiments, of a tonic constrictory and dilatory innervation of vasa nervorum. However, as judged from the distribution patterns of the neurochemically distinct axonal populations, vascular segments of different connective tissue compartments (epi- versus endoneurial) and body regions (sciatic versus cranial nerves) are differentially addressed by each of these axonal populations. This might have implications for the development of region-specific neuropathies.
Animals↗
[Intramural pseudodiverticulosis of the esophagus with candidiasis involvement].
We report on a 55 year old female patient suffering from weight loss. On endoscopy we found an Esophageal Intramural Pseudodiverticulosis (EIP) with Candidiasis. This case report wants to discuss this rare benign disease and its diagnostic and therapeutic approach.
Candidiasis↗
[Blood supply to the facial nerve].
At the present time there is no final explanation for the etiology of Bell's palsy. The theory of pathophysiology involving a combined primary and/or secondary ischemia is now well-accepted. As such, it is supposed that there is a dysfunction of the blood vessels which supply the nerve. This is followed by a hyperpermeability and transudation which lead to edema of the nerve and compression of the blood supply. The vicious circle starts and the final result is facial paralysis. The blood supply of the facial nerve has been described previously in the literature, although there have been no experimental investigations on in vivo perfusion of the nerve. In the present study we evaluated the percentage of those vessels perfused among the total blood vessels found in facial nerves of Wistar rats. Animals were examined after i.v.-injections of Evans blue dye, with perfused vessels demonstrable under a fluorescence microscope. Forty-eight hours later, the same tissue section was stained by indirect immunofluorescence and the primary antibody used was directed against myosin of non-muscle sources. This antibody cross-reacted with myosin of vascular endothelial cells and thus allowed identification of any existing blood vessels. More than 90% of the immunostained vessels were labeled with the dye, showing that almost all vessels were perfused.
Animals↗
[Reconstruction of oral cavity and oropharyngeal defects with a pure muscle-fascia flap].
As a rule carcinomas of the oral cavity and oropharynx are not diagnosed in early stages. Surgical resections of these tumors including margins of safety invariably result in large defects. At present, one-stage flap techniques are preferred for reconstruction, as exemplified by pectoralis major myocutaneous flaps and free revascularized jejunum grafts. The skin island of the myocutaneous flap is underlayed by fat tissue as a sliding surface. Temporary sutures are necessary but have the disadvantage of producing a convex configuration. This shape compromises anatomical reconstruction of the oral cavity and oropharynx. Robertson et al. in 1985 demonstrated an alternative method for a muscle-fascia flap from the pectoralis major muscle. In comparison to the temporalis muscle-fascia flap, the pectoralis muscle-fascia flap is associated with a lesser incidence of complications. Although it is still too early to conclude their definitive use, their application in some cases is now being questioned because of such factors as reduced time of anesthesia.
Carcinoma, Squamous Cell↗
[Lansoprazole--profile of a new proton pump inhibitor].
Lansoprazole, a new proton pump inhibitor, selectively inhibits the H+/K(+)-ATPase. Its inhibitory effect on basal and gastrin stimulated gastric acid secretion is equal to omeprazole and stronger than that of H2-receptor antagonists. Healing rates concerning gastric and duodenal ulcers and refluxesophagitis are significantly higher compared to H2-receptor antagonists and at least comparable to omeprazole. Regarding pilot studies in H. pylori eradication therapy, lansoprazole in combination with various antibiotics is expected to show good eradication rates. Considering its excellent safety and interaction profile lansoprazole is effective and safe in treating acid related disorders.
2-Pyridinylmethylsulfinylbenzimidazoles↗
[Prevention of gastrointestinal stress lesions].
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Anti-Ulcer Agents↗
Endoscopic and bioptic diagnosis of malignant non-Hodgkin's lymphoma of the stomach.
Experience in the endoscopic and bioptic diagnosis of malignant non-Hodgkin's lymphomas of the stomach in 66 patients is reported all of which were B cell lymphomas originating in the mucosa associated lymphoid tissue (MALT) type. Two types of tumor could be differentiated by their appearance on endoscopy (two patients had both types). An exophytic type (n = 24) was easily recognized as malignancy on endoscopy and the diagnosis confirmed by endoscopic biopsy (mean of 1.2 endoscopic-bioptic examinations). It could be classified according to the Palmer classification; 50% were low-grade malignancies and 50% high-grade malignancies. Resection (n = 17) showed wall penetration beyond the muscularis propria in 70%. An infiltrative type (n = 44) was difficult to diagnose by means of endoscopy and biopsy (mean of 2.9 endoscopic-bioptic examinations); in one case a histological diagnosis could only be established on surgery. A classification system is suggested for this type (I--elevated, II--flat, III--cavitated). Most of these lymphomas were low-grade malignancies (77%), and limited to the mucosa and submucosa (79% of 34 resected cases). It is concluded that attention should be paid especially to the infiltrative type of gastric lymphoma which is difficult to diagnose and to differentiate from other gastric conditions such as ulcers and erosions, but which is most often found at an early stage and has a better prognosis. Complete tumor resection (R0) was achieved in 49 of 51 patients undergoing surgery (96%).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Neuropeptides in the facial nerve of the rat].
The occurrence of peptidergic nerve fibres containing substance P (SP), calcitonin gene-related peptide (CGRP), vasoactive intestinal peptide (VIP) and neuropeptide Y (NPY) in the cerebral arteries and arterioles is well known. NPY is a vasoconstrictor, while SP, CGRP and VIP induce cerebrovascular dilatation. Vascular dysregulation of the vasa nervorum of the facial nerve is believed to be a central factor in the pathogenesis of Bell's palsy. Hilger's theory of the primary and/or secondary oedema which is followed by the vicious circle is generally accepted. It was our aim to describe the occurrence and distribution of neuropeptides in the blood vessels of the facial nerve. We examined the facial nerves of 6 male Wistar rats using the indirect immunofluorescence technique. There is not only a characteristic distribution of the neuropeptides in different parts of the facial nerves, but there are also beaded axons of sensory nerve fibers, which are localised freely in the endoneurium. These SP and CGRP containing beaded axons which densely innervate the nerve in the bony canal, are capable of inducing an oedema by neurogenic inflammation. Our findings suggest that there must be a vascular regulation in the facial nerve which is controlled by various neuropeptides.
Animals↗
[Transient insulin-dependent diabetes mellitus with alpha-interferon therapy in chronic active hepatitis].
Since alpha-interferon has been introduced an efficient therapy of chronic active hepatitis has become available for the first time. Among some of the treated patients, however, alpha-interferon therapy causes typical side effects. Fever, chills, loss of weight, fatigue as well as arthralgia, myalgia, loss of concentration and hematologic side effects have to be mentioned in particular. We report the occurrence of a diabetes mellitus under alpha-interferon therapy. The metabolic disorder gradually normalized after 3 weeks of antidiabetic treatment, although the interferon medication had been continued. We consider this disorder to be an effect caused by the alpha-interferon. The underlying mechanism might be an insulin resistance or an autoimmunologic defect. For that reason, when administering alpha-interferon, we recommend regular analyses of the blood sugar level during the regular patient monitoring.
Alanine Transaminase↗
Spatial control of the gap gene knirps in the Drosophila embryo by posterior morphogen system.
The gap genes of Drosophila are the first zygotic genes to respond to the maternal positional signals and establish the body pattern along the anterior-posterior axis. The gap gene knirps, required for patterning in the posterior region of the embryo, can be activated throughout the wild-type embryo and is normally repressed from the anterior and posterior sides. These results provide direct molecular evidence that the posterior morphogen system interacts in a fundamentally different manner than do hunchback and bicoid, which are responsible for anterior pattern formation.
Animals↗
Long-term results of treatment of malignant non-Hodgkin's lymphoma of the stomach.
Our experience with 66 endoscopic-bioptic diagnosed malignant non-Hodgkin's lymphomas (NHL) showed that in most of them (57 of 66 patients) a tumor stage IE or IIE was present. All 57 primary gastric lymphomas were B-cell-lymphomas arising from the mucosa-associated lymphoid tissue (MALT). After curative primary gastric resection in stage IE and IIE the 5-year survival rate was 81%, and the 5-years lymphoma-related survival rate was 88%. These results are superior to those reported in the literature. The following two points are probably of importance for improving the prognosis: early diagnosis made possible by better knowledge of the infiltrative-flat type of tumor growth (38 out of 57 patients, including 23 cases in which infiltration was limited to mucosa and submucosa = "early lymphoma"), and extensive preoperative staging. The infiltrative-flat type, which is difficult to diagnose endoscopically, usually shows low-grade malignancy on histology (76%; in early lymphoma 83%) and has an excellent prognosis when submitted to surgery. In our experience the question as to whether additional treatment by chemotherapy and/or radiotherapy improves the prognosis of NHL of the stomach remains unanswered and further studies are needed.
Combined Modality Therapy↗
[Using endoscopy in peptic lesions of stomach and duodenum].
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Biopsy↗
[Evaluating the effectiveness of chemotherapy in patients with head-neck tumors using positron emission tomography (PET scan)].
Positron emission tomography (PET) demonstrates the qualitative and quantitative characteristics of multiple metabolic pathways. In a prospective study we evaluated the metabolism of glucose in the tumors of ten patients suffering from head and neck cancer before and after chemotherapy with cisplatin and 5-fluorouracil. Using 18-fluorodeoxyglucose (FDG), it was possible to show changes in tumor metabolism after chemotherapy. In general, chemotherapy reduced the volume of the primary tumor and the lymph nodes. There was a linear relation between the changes in metabolism and growth rate, but in a few patients the lymph nodes and the primary tumor showed a different metabolic reaction. With FDG metabolism and PET we were able to determine the response rate of the tumor in vivo before chemotherapy.
Antineoplastic Combined Chemotherapy Protocols↗
[Exercise and sports therapy for patients with head and neck tumors].
Important aspects in the aftercare of patients with cancer of head and neck can be realized by physical training in a sports group. The aftermath of operative therapy, e.g. loss of motion, imbalances of muscular activity or respiratory movements, can be reduced. The main importance of physical training in a group is the patient's reintegration in a social environment. Evaluating the quality of life of the individual patient we found that this method of psychosocial aftercare can improve subjective quality of life. Therefore, this conception of rehabilitation should not be missing in the aftercare of patients with malignant cancer.
Combined Modality Therapy↗
Adenoma and carcinoma of the duodenum and papilla of Vater: a clinicopathologic study.
In a retrospective study (1982-1990), 12 adenomas, 35 carcinomas of the papilla of Vater, and 21 duodenal adenomas were examined. All patients had endoscopicbioptic examinations (5-10 forceps biopsies, snare biopsy or forceps-biopsies after endoscopic sphincterotomy). Special attention was paid to malignant transformation of adenomas and of residual adenomatous tissue in surgical resected cancer. Follow-up data were gained by reexamination or questionnaires. In papillary adenomas, an adenocarcinoma was found in 30% at operation or by follow-up. In 41.2% of the operated cases, residual adenomatous tissue was found, more often in well-differentiated adenocarcinomas than in other histological types. A transformation from duodenal adenomas to adenocarcinomas was seen less frequently (9.5%). Therefore, the risk of malignancy in ampullary adenomas is greater than elsewhere in the duodenum. In eight of 11 patients (72.7%) with duodenal adenomas, one or more simultaneously developed colonic adenomas were found (in four cases a Gardner syndrome not known before). We conclude that there is strong evidence that most ampullary and duodenal carcinomas develop in preexisting adenomas, with an adenoma-cancer sequence similar to that accepted for colorectal carcinoma. This has to be kept in mind for diagnostic as well as therapeutic reasons. When either an adenoma of the ampulla or duodenum is diagnosed, colonoscopy is mandatory to find or exclude colonic adenomas. In patients with familiar adenomatosis, the duodenum and the papilla of Vater have to be examined endoscopically.
Adenocarcinoma↗
Gene expression mediated by cis-acting sequences of the Krüppel gene in response to the Drosophila morphogens bicoid and hunchback.
The initial expression of the gap gene Krüppel (Kr) occurs in a precisely bounded central region of the Drosophila blastoderm embryo. According to genetic analysis, the spatial limits of the Kr expression domain are controlled by the morphogenetic activities of the anterior organizer gene bicoid (bcd) and the anterior gap gene hunchback (hb). Using gene fusion analysis, we assayed for cis-acting sequences of the Kr gene which mediate transcriptional activation and localized gene expression in response to trans-acting factors. A 730 bp Kr control element drives gene expression in place of the endogenous Kr central domain. This cis-acting element, Kr730, is composed of bcd and hb responsive sequences. They map into regions of multiple hb and bcd protein in vitro binding sites. A 142 bp core fragment containing one low affinity hb and five medium to strong bcd protein binding sites drives gene expression in a Kr-like location in the centre of the embryo. Our results show that this fragment represents a target for the redundant activator/repressor system provided by the anterior morphogens bcd and hb.
Animals↗