[The functional anatomy of the pharynx, esophagus and trachea in adults and newborn infants].
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Deglutition↗
Biomedical subjects
W Lierse
Publications and source records attributed to W Lierse.
[Ultrastructure of the substantia spongiosa of the femur head and talus].
The results of the SEM examination of the zone between the cartilage and the spongeous substances are described precisely. For the first time, W. Lierse examined the 'tensulae' of calcium-collagen lamellae by light microscopy. The examination of this zone was initiated by the fact that the hydrodynamic flow can take place in the calcified zone of the cartilage which is filled with synovial fluid and that the calcified zone adheres to the subchondral substantia corticalis. The subchondral corticalis is characterized by funnel-like indentations with a high number of calcium-collagen and chondrocyte 'tensulae' which are up to now uncounted. The special aim was to locate the separation of the space of adipose and arterial supplies.
Calcium↗
[The anatomy of the pelvis].
The pelvis consists of the sacrum, the ossa coxae, and additionally the ligaments between these bones. According to mathematical calculations the bony structure as well as the arrangement of ligaments result in optimal engineering principles, i.e. maximal strength is achieved by minimal principles, i.e. maximal strength is achieved by minimal material. The muscles inside the pelvis are covered by a fascial layer. The latter represents a continuation of the abdominal transversal fascia which extends to the pelvic floor. The connective tissue fibres around the pelvic viscera interweave with those of the pelvic floor and laterally with the connective tissue around vessels and nerves. Connective tissue around the neurovascular sheaths is nearly transversely arranged and forms the lateral ligaments of bladder, uterus or prostate gland and the rectum. Several vertically arranged connective tissue ligaments accompany either the superior rectal artery and hypogastric nerves or the ureter and the ovarian vessels. Therefore, the lymphatic fluid of the pelvic organs passes the aortic lymph nodes and/or to the lateral pelvic wall along the branches of the internal iliac vessels.
Humans↗
[The arterial supply of the cervical vertebral body in newborns].
The cervical vertebral column is mainly supplied by both vertebral arteries. A regular ladder pattern of arteries is on the dorsal plane as well as on the ventral plane of the cervical vertebral bodies, opposite to the thoracal and the lumbar area of the vertebral column with only a dorsal ladder pattern of arteries. The cervical arterial anastomoses are built by the segmental arteries of the vertebral arteries, in the back of the cervical vertebral bodies by the arteriae canalis vertebralis anteriores and in the front by the rami anteriores (corporum vertebrarum). The thyrocervical and the costocervical trunks are an additional blood supply especially to the ventral anastomoses. A loss of a segmental artery may have no effect because of the good anastomoses. Some decades of aa. nutriciae come in the vertebral body from all sides, but only 2 up to 4 rr. centrales anteriores and 2 rr. centrales posteriores join in the middle of the vertebral body. There are parallels to the arterial blood supply of the thoracal and the lumbar vertebral bodies. The longitudinal ligaments are supplied by both ladder patterns of arteries.
Cervical Vertebrae↗
[The arterial supply of the thoracic and lumbar spine in newborns].
The major arteries supplying the vertebral column are definite. The branching arteries of these trunks are variable. The posterior intercostal arteries and the lumbar arteries have an ascending, descending or horizontal course. In accordance with the literature, we found large, arched anastomoses between the rami ascendentes and the rami descendentes arising from the rami canalis vertebralis anteriores on the dorsal plane of the vertebral bodies. There are also nearly horizontal junctions between the rr. ascendentes of both sides. We found junctions on the front of the thoracolumbar vertebral column at the end of the arteries. On the dorsal plane of the vertebral body 2 arteriae centrales posteriores originate from the rr. ascendentes. They run to the centre of the vertebral body. On the ventrolateral plane of the vertebral body 2 or 3 aa. centrales anteriores can be found. These 4 or 5 arteries join in the middle of the vertebral body. The blood supply of the thoracal and lumbar vertebral bodies does not differ essentially. Vessels come especially from lateral in the intervertebral disc. We suggest to name such a vessel ramus disci intervertebralis. The posterior longitudinal ligament is mainly supplied by the junction between the rr. ascendentes of both sides and the anterior longitudinal ligament by the aa. nutriciae in the thoracal and the lumbar area.
Arteries↗
[Morphologic findings in dilated cardiomyopathy and their relation to hemodynamics and catecholamine concentrations in the plasma and myocardium].
In 72 patients with dilated cardiomyopathy the degree of morphological alterations were studied by transvenous endomyocardial biopsy. These findings were correlated to the clinical status, left ventricular ejection fraction, and to the catecholamine concentrations in plasma and myocardium. Muscle fiber diameter was negatively correlated to ejection fraction (r = -0.3, p = 0.02) and to the volume fraction of mitochondria (r = -0.32, p = 0.001). Between plasma norepinephrine concentration and ejection fraction a significant negative correlation was found (r = -0.37, p = 0.001). In contrast, myocardial norepinephrine concentration was positively correlated to ejection fraction (r = 0.25, p = 0.04). Between myocardial norepinephrine concentration and muscle fiber diameter a negative correlation was found (r = -0.46, p = 0.004). Patients with an EF of less than 30% and an EF of greater than 45% could be differentiated with an accuracy of 79%, when muscle fiber diameter, plasma norepinephrine concentration, and the density of capillary vessels were entered into a multi-variant analysis. In conclusion, dilated cardiomyopathy is associated with morphological alterations and alterations in plasma and myocardial catecholamine concentrations. Patients with highly reduced ventricular function could be best identified by the combined assessment of plasma catecholamine concentration, muscle fiber diameter, and density of capillary vessels.
Adult↗
[Histologic vascular changes in the area of microanastomoses in preoperative irradiation].
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Anastomosis, Surgical↗
[Anterior approach to the cervical vertebrae and the location of the recurrent laryngeal nerve].
It is well known that the recurrent laryngeal nerve is often damaged during or following an anterior approach to the cervical vertebral column. Reports in the literature suggest that the right-sided approach gives rise to more complications of the recurrent nerve than the left-sided approach and that the right recurrent nerve is in a less protected position. There are also studies addressing the risks involved in the right-sided and the left-sided approach and suggesting the opposite conclusion. In our study, the position of the recurrent nerve was found to be variable and even to be different on the right and left sides in the same person. In 44.6% of cases (45 of 101) the recurrent nerve was found to be have an intermediate course (at the dorsal edge of the trachea or in the sulcus between trachea and esophagus) on both sides. The recurrent nerve was in an anterior position (lateral of the ventral two-thirds or the dorsal one-third of the trachea) in 50.5% (51 cases) on the left and in 49.5% (50 cases) on the right. A posterior position (lateral to the esophagus) of the recurrent nerve was found in 4.9% (5 cases) on the left and in 5.9% (6 cases) on the right. All combinations are possible. The position of the recurrent nerve cannot be inferred from its position on the opposite side. The right-sided or the left-sided approach cannot be preferred on the basis of the position of the recurrent nerve.(ABSTRACT TRUNCATED AT 250 WORDS)
Cervical Vertebrae↗
[Epithelium and anal glands in rectal pouches and fistula. Histologic studies of swine with congenital anal atresia].
The epithelial coating of the rectal pouch and fistula was studied morphologically in 33 newborn piglets with high and low forms of anal atresia and was found to be similar to the epithelial coating of the anal canal in normal piglets: the typical epithelium of the rectum changed its character into transitional epithelium at the region of the internal sphincter which surrounded the fistulae in all animals. In the caudal part of the fistula the transitional epithelium was followed by squamous epithelium. Only in male piglets with deformities and recto-urethral fistulae no squamous epithelium was found. In these cases transitional epithelium covered all parts of the fistula and the region of the internal sphincter. Anal glands were found in all animals, with or without anorectal malformations. They always invaded the internal sphincter. According to our morphological studies the fistula in anorectal malformations represents an ectopic anal canal.
Anal Canal↗
Three-dimensional arrangement of dense connective tissue around the human major duodenal papilla. Including the ampullary region and the distal choledochal duct.
Directionally arranged dense connective tissue fibres were investigated in 21 specimens of the major duodenal papilla. Specimens were examined using a stereoscope, polarization microscopy and serial histological sections at three different planes. Directionally arranged dense connective tissue fibres spread in a deltoid pattern from the orifice of the major duodenal papilla and its intraduodenal part to the circular duodenal musculature. Connective tissue fibres crossing at different angles form a texture from the orifice of the major duodenal papilla to the distal choledochal duct. The functional significance of the dense connective tissue fibres, e.g. for the muscular system in the investigated area, is discussed as well as possible reasons for gallstone impactions.
Ampulla of Vater↗
Histochemical alterations in the adult rat brain after X-ray irradiation: effects of O-(beta-hydroxyethyl)-rutosides.
X-ray-induced tissue damage in the brain of adult rats was investigated in the presence or absence of O-(beta-hydroxyethyl)-rutosides (OHR; active agents of Venoruton, Zyma-Blaes, München, FRG). Histochemical methods were used for the detection of glycogen (periodic acid-Schiff), acid mucopolysaccharides (Hale) and acid phosphatases (Gomori) by light microscopy. The tissue alterations were reduced after drug application in the dose range between 5 and 7.5 Gy (300 kV, 12 mA). Exposure of the animals to higher irradiation doses (10, 20 Gy) led to an inversion of the drug effect, now exerting pronounced tissue injury. For a possible explanation we discuss the inhibitory influence of rutosides (e.g. OHR) on the glycolytic pathway. Hence, a vital energy source of brain tissue could be impaired by the drug after reaching a threshold of 10 Gy.
Acid Phosphatase↗
Bioconstruction of the extrahepatic biliary duct system in minipigs. Comparing normal condition with experimental obstruction.
The extrahepatic biliary duct system is subject to a particular bioconstruction to secure its bile transport function. The dominant structure of the bile duct wall is a network of collagen fibres harboring muscle-fibre bundles. The collagen fibres are virtually inelastic, volumes can be changed only by rearranging the network. The ducts show different spatial arrangements of the fibres causing different extents of dilatation during obstruction. Extreme dilatation might cause a rupture of the network, and deficient postoperative retonisation could be the result.
Animals↗
[Anatomy and pathophysiology of hemorrhoids].
The internal (hemmorrhoidal) plexus consists of two groups of veins separated by the musculus canalis ani. The submucosal group forms the zona hemorrhoidalis. A direct communication between arteries and veins is the characteristic sign of this functional part of rectal circulation. In the nutrient part, the arterioles divide into capillaries. The vessels of the zona hemorrhoidalis are wrapped in by a system of elastic fibers, which split with age. Common pathogenetic factors of hemorrhoids may involve the spasm of anal sphincters and the absence of elastic fiber support of the plexus.
Arteries↗
Changes in tumor vasculature under fractionated radiation-hyperthermia treatment.
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Animals↗
[The mesoduodenum].
In the present study an anatomical examination of ten bodies was made to describe the fixation of duodenum and pancreas to the posterior abdominal wall. It has become apparent that the shape of the posterior mesoduodenum of the first part of duodenum is rodlike. Due to the secondary retroperitoneal fixation between duodenum and pancreas a vascularized, wide-based borderline lamella remains in the area of second and third parts of the duodenum. The borderline lamella corresponds to the tela subserosa and strengthens Treitz fascia and Gerota fascia in the prerenal area. It covers the inferior vena cava, and is fixed to the adventitia of the abdominal aorta. The retroduodenopancreatical tissue forms a duodenopancreatical layer which contains its own vessels. Now it is possible to understand better the surgical importance of pancreatitis, retroduodenal haematoma and mobilization of duodenum and pancreas.
Abdominal Muscles↗
The vascularization of liver metastases. Histological investigation of gelatine-injected liver specimens with special regard to the vascularization of micrometastases.
The vascularization of 19 human livers with metastases was investigated using gelatine perfusion and resin corrosion techniques. (1) In 16 livers examined after injection via the hepatic artery hypervascular metastases were demonstrated in 12 cases, hypovascular in 4. (2) Injection via the portal vein showed that more than 50% of liver metastases had a distinct portal blood supply to the tumor periphery. In approximately one-third of cases the portal blood supply extended centrally. (3) Injection via the hepatic vein demonstrated venous drainage from peripheral areas of tumor in less than 30%, and from central areas in only 9%. Larger branches of the hepatic vein were not detected within metastases. (4) Tumor thrombi were seen within branches of the portal vein situated 1-1.5 cm from the tumor periphery in more than 50% of all liver metastases-suggesting the possibility of local hepatic retrograde tumor spread via the portal vein. (5) Central necroses were seen in hypervascular metastases only, mainly in tumors larger than 1-1.5 cm. (6) The incidence and vascularity of human hepatic micrometastases was investigated. Micrometastases were seen in close proximity to about 40% of the macrometastases. Metastases up to the size of 200 micron received their main blood supply via sinusoids. Neovascularization of tumors larger than 200 micron was demonstrated.
Gelatin↗
Vascularization of the myocutaneous latissimus dorsi flap. Injection study on the thoracodorsal artery.
This study reports on investigations of the thoracodorsal artery by injection studies. This artery has a long proximal extramuscular course before it enters the muscle. A consistent neurovascular hilum was found at a considerably constant location on the inferior muscle surface, 2-3 cm medial to its lateral edge and about 5 cm distal to the inferior scapular border. A constant branching pattern of the thoracodorsal artery into a lateral and a medial vessel stem was found. A high number of muscle-perforating arteries from a dense network in the cutaneous and subcutaneous layer. The thoracodorsal artery supplies the whole cutaneous area adjacent to the latissimus dorsi muscle plus a streak of about 2 cm at the medial and distal muscle borders. The presented anatomical landmarks are useful for locating the neurovascular hilum, and the intramuscular course of the thoracodorsal artery for exploration of the vessel by Doppler sonography or dissection. The length of the pedicle and the relatively big vessel gauge are good anatomical markers for the free transfer of a latissimus dorsi flap.
Humans↗
Qualitative investigation of the postnatal development of axon and nerve fiber calibers in the ventral roots of rats.
The postnatal development of the ventral spinal roots of rats was studied with optical microscopic and morphometric methods. Adult rats show a craniocaudal decrease of axon and nerve fiber diameters which cannot be detected in younger animals. The bimodal differentiation of the nerve fiber populations occurs between the 15th and 20th day. Myelinated nerve fibers show a g ratio of 0.6 for all examined age groups.
Animals↗