[In memoriam Gerhard Wolf-Heidegger, 29 December 1910--31 July 1986].
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Anatomy↗
Biomedical subjects
W Lierse
Publications and source records attributed to W Lierse.
[Histochemical and ultrastructural studies on anti-edematous and radiation-protective action of 0-(beta-hydroxyethyl)-rutosides on the rat brain after single irradiation. 2. Histochemical study on carbohydrate metabolism and acid phosphatase activation].
The disturbances of the carbohydrate metabolism and the activation of acid phosphatases with and without protection by O-(beta-hydroxyethyl)-rutoside (HR) were studied in irradiated rat brains by means of the light microscope. The histochemically demonstrable deposition of glycogen and acid mucopolysaccharides serves as a criterion for a reversible lesion of the irradiated cerebral tissue. The extent of local activation of repair processes following to irradiation can be determined by the quantity of acid phosphatases in the lysosomes. For the dose range of 1 to 5 Gy, HR seems to exert a protective effect on the cellular metabolism of the irradiated cerebral tissue shown by a slight decrease of glycogen and mucopolysaccharide deposits compared to the untreated animals. However, when exceeding a threshold dose of 10 Gy, the deposition of carbohydrates in the HR group is strongly increased. A slightly increased activity of acid phosphatases induced by HR can be supposed at best for the dose range of 5 to 7.5 Gy. If the dose is even more increased, the reverse effect found in the carbohydrate metabolism, too, and an increased activation of acid phosphatases in the control group will be observed. This unexpected reversion of the protective effect could be related to the assumed inhibitory effect of HR on the ATPases and thus on the anaerobic part of glycolysis or to a breakdown of the cell interaction system of endothelial cells, glia cells, and neurons.
Acid Phosphatase↗
[Histological and morphometric research on rhabdomyosarcoma in the rat after irradiation and microwave hyperthermia].
Cellular effects of a combined treatment with X-rays (15 Gy) and local microwave hyperthermia (43 degrees C, 60 min) on the tumor tissue of the rhabdomyosarcoma R1H of the rat were studied with light and electron microscopy. The results were compared with the cell reactions obtained after X-rays (15 Gy) alone. The histological results and the morphometric data show that the time course of cell damage changes individually with the treatment applied. After radiation alone a cell oedema occurs within some days. After a combined treatment, however, a marked cell oedema and cell lysis is already observed after 24 hours. An intensive shrinking of the cell nuclei is found at day 6th, attended with pyknosis, karyolysis and cell fragments in the extended extracellular area. In comparison with radiation alone the processes of repair and repopulation in the R1H tissue are remarkably delayed after a combined treatment.
Animals↗
Myocutaneous vascular territory of the thoracoacromial artery. A topographical and morphometric study of the arterial vascularization of the pectoralis major myocutaneous flap.
In order to clarify the vascularization of the pectoralis major muscle by the pectoral branch of the thoracoacromial artery, morphometric investigations and selective injection studies of the vessel were performed. A comparison with the anatomical orientation points clinically used for locating the vessel and its course confirms that the origin of the artery is at a constant spot at half the sternoacromial distance; the main vessel axis, however, deviates considerably from the clinically used acromioxiphoid axis in lateral direction. The lumen of the thoracoacromial artery has a range of more than 150% of the smallest vessel. Atherosclerotic alterations are not the reason for this variety but only an additional handicap for the vessel capacity. Two types of muscle-perforating arteries were found, and the cutaneous area of blood supply was defined.
Acromion↗
[Phrenico-esophageal membrane: anchoring of the terminal esophagus and cardia at the diaphragm].
The esophageal hiatus lies in the muscular part of the diaphragm. The hiatus transmits, in addition to the esophagus, the vagus nerves, the esophageal blood vessels and connective tissue. The connective tissue binding the esophagus to the diaphragm has been termed the phrenico-esophageal membrane. Its strongest part derives from the inferior diaphragmatic fascia, extends some distance above the diaphragm to attach to the adventitia of the esophagus. The variations of the attachments have been described in detail. The importance for the surgical treatment of mobilisation and a supplementary suture of the lower esophagus are discussed.
Cardia↗
[The ligament system of the spleen and its significance for surgical interventions].
The anatomy of the splenic ligaments was examined in twenty cadavars. Histologic sections were taken from ten. In one of these twenty cases the entire ligamentous structure was studied by serial sections using a polarizing light microscope. There are four principal ligaments of the spleen: the gastrosplenic ligament, the colicosplenic ligament, the phrenocolic ligament and the phrenosplenic (splenorenal) ligament. There are two portions to the gastrosplenic ligament. In the upper portion where the spleen is very close to the stomach, the collagen fibers appear more dense. The term splenorenal ligament is vague. This is because there are three structures between the spleen and the kidney besides the peritoneal layer: collagenous tissue with fat (pararenal fat), the prerenal fascia and a fat capsule (perirenal fat). The vascular anatomy is of interest. Running through the gastrosplenic ligament are small branches from the short gastric and left gastroomental vessels. The colicosplenic ligament receives little branches from the left gastroomentalic vessels and the lower pole vessels. The other ligaments have mainly venous vascularisation which can develop into a collateral network within splenomegaly. The direction of the collagen fibers in the splenic ligaments is important. In all the ligaments most of the fibers come from two directions: laterocranial to mediocaudal and mediocranial to laterocaudal. Splenic capsular tears are a recognized complication of upper abdominal surgery. This is because traction in the mediocaudal direction during gastric and colon surgery and in the mediocranial direction during gastric surgery is oriented in the same direction as the collagen fibers in the splenic ligaments and thus tears the splenic capsule.
Collagen↗
The internal sphincter in anorectal malformations: morphologic investigations in neonatal pigs.
The knowledge of sphincter anatomy in anorectal malformations is still inadequate and contradictory. Therefore, morphologic investigations were carried out in 33 neonatal piglets with congenital anal atresias. Of the 24 male animals 12 had high anomalies with a rectourethral fistula. The remaining 12 piglets had low anomalies; in nine cases we were able to demonstrate an anocutaneous fistula. Of the nine female animals, six had high anomalies with a rectovaginal fistula. The three female piglets with low anomalies had an anovestibular or an anocutaneous fistula. In all animals we could demonstrate a normal internal sphincter, which surrounded the proximal part of the fistulae. The position of the internal sphincter therefore depended on the localization of the fistula orifice into the rectal pouch. This differed greatly. The form of the internal sphincter also differed greatly. Sometimes the muscle had the form of a tube or an acute-angled funnel as in healthy piglets. However, mostly the internal sphincter was spread out wide and had the form of a disc or a flat dish. The proximal region of the fistulae in anal atresias has most features of a normal anal opening: (1) it is surrounded by an internal sphincter, (2) the rectal pouch in the region of the internal sphincter as well as the fistulae are hypoganglionotic, (3) the proximal fistula region is lined by transitional epithelium, and (4) it contains anal glands. We, therefore, consider that the fistula should be designated as an ectopic anal canal. The most important result was the demonstration of a normal internal sphincter even in high and intermediate anomalies of anal atresias.(ABSTRACT TRUNCATED AT 250 WORDS)
Anal Canal↗
Angioarchitecture and blood supply of micro- and macrometastases in human livers. An anatomic-pathological investigation using injection-techniques.
The histological and stereoscopical appearance of the metastatic vascular tree was examined in a series of 23 human metastatic livers using injection techniques. All metastases showed an abnormal 'construction-concept' of vascularization, never imitating the normal angioarchitecture of the liver parenchyma. 17 of 22 arterial injected livers contained hyper-, and 5 hypovascularized metastases. Two main types of hypervascularized metastases could be detected: a central type with blood supply via a main arterial 'hilus-like' branch, and a peripheral type with multiple arterial vessels infiltrating from the metastatic surrounding. Of 13 livers injected via the portal vein, 11 showed a portal supply of the metastases. Portal tumor thrombi were a frequent finding, possibly indicating a retrograde portal local tumor spread within the liver. No larger branches of the hepatic vein could be found in any metastases which were injected via the hepatic veins; all showed typical signs of compression, displacement and destruction. Micrometastases were found in the direct surroundings of almost half of all macrometastases. Up to a size of 100-200 microns they appeared to be mainly supplied by sinusoidal blood. With continuing growth, newly built capillaries could be shown in the direct surroundings of some of the micrometastases.
Arteries↗
[Morphologic studies in swine with anal atresia].
33 piglets with anorectal malformations were investigated histologically. 24 animals were male, 9 female. 18 piglets had high deformities with recto-urethral, respectively recto-vaginal fistulas. 15 animals had low deformities. In all animals we were able to demonstrate a sphincter internus muscle and a sphincter externus muscle. The sphincter internus muscle was localised around the fistula. These fistulas also had other characteristics of a normal anal opening.
Anal Canal↗
Microvascular architecture of the mucosa of the gastric corpus in man.
Vascular casts of human gastric mucosa of the corpus area were studied by scanning electron microscopy and compared with vertical and horizontal series of semithin sections of perfusion-fixed corpus mucosa. The submucosal arteries give off short and long arterioles. The short arterioles branch into a basal capillary network reaching from the basis to the isthmus of the gastric glands. The long arterioles pass through the lamina propria without ramifications and supply a second, apical capillary layer reaching from the base to the top of the gastric pits. Anastomoses connect both capillary layers. Dense, convoluted capillaries at the mucosal surface encircle the gastric pits. Both capillary layers drain into venules at the level of the gastric pits. Below, on their way to the submucosal plexus, the venules do not receive any further capillary tributaries. In the examined tissue no arteriovenous anastomoses could be identified. A microvascular architecture with two capillary layers is presented, which guarantees a luxurious oxygenation throughout all layers of the gastric corpus mucosa in man. These findings are in contrast to previous descriptions of human corpus mucosa, where only one capillary layer, reaching from the base to the top of the corpus mucosa, has been identified.
Adult↗
[The hypoganglionic and aganglionic high pressure zone of the anterior esophagus (the esophageal opening) and its special blood supply (angiomuscular sphincter closure].
At the mouth of the oesophagus there is an aganglionic zone similar to that in the anorectal organ of continence. This is part of the system of permanent closure. Since the musculature at the oesophageal entrance is arranged in a screw-like fashion the aganglionic zone lies obliquely to the longitudinal axis of the oesophagus. Closure at the oesophageal entrance is further supported by a kind of corpus cavernosum similar to that in the rectum. In this pharyngeal corpus cavernosum blood is drained between the muscular fibres and their contraction prevents its drainage, thus facilitating the closure of the musculature. The constrictor pharyngeus muscle takes a similar course as does the puborectalis which leads to a bend in the anal canal. Thus also at the entrance to the gastrointestinal tract an arterial angiomuscular system of closure exists in the center of which an aganglionic segment is conspicuous.
Adult↗
[Anterior cruciate ligament reflex (LCA reflex)].
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Electromyography↗
Morphological and morphometric studies of cerebellar fissuration and myelination in mice with trisomy 19.
The fissuration and myelination in cerebella of trisomy 19 mice and of chromosomally balanced control animals on postnatal days (PD) 2, 5, 10, 12, and 15 were analyzed morphologically and morphometrically. In trisomy 19 mice, an increasing fissuration lag with a fissuration pattern and sequence identical to those of the control animals was found. The nuclear volume density of the trisomic glia cell in the neocerebellar commissure also developed like that of control mice, with an increase shortly before and parallel to the beginning of myelination and with a decrease in its further course. The trisomic axons and myelin sheaths were normally structured but axonal growth and myelination in the neocerebellar commissure were retarded. The quantitative relations of the assumed axon/glia interactions were similar to those of the control animals. The fissuration and myelination in the cerebellum of trisomy 19 mice did not seem to be pathologically changed but seemed to be differently retarded. On PD 15, a myelination lag of less than 5 days but a fissuration lag of nearly 10 days was found. This observation and the assumption of a differently retarded growth of the cerebellar cortex compared with cerebellar subcortical regions lead to the suggestion that the trisomy might result in a progressively asynchronous and disproportional development of different CNS structures.
Animals↗
[Vascularization of liver metastases: a corrosion cast study].
22 livers with multiple metastases from different primaries were injected with acrylate resin and examined stereoscopically. All metastases had developed an individual pattern of vascularization. The metastases of 8 out of 12 livers injected via the portal vein showed a distinct blood supply by the portal vessels. In all 16 livers with arterial hypervascularized metastases the development of pathological tumor vessels could be demonstrated. All metastases of the same liver showed an identical pattern of vascularization. Larger branches of the hepatic vein always were displaced by the growing tumor. It was impossible however to infer from the vascularization pattern of the metastases to the primaries. The clinical relevance of these anatomical findings will be discussed.
Blood Vessels↗
[The peritoneum. Anatomical bases].
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Humans↗
[Anastomoses between the segmental arteries of the liver and phrenicohepatic arterio-arterial anastomoses].
A corrosion - cast anatomical study was performed on human livers. At first arterio-arterial anastomoses between the inferior phrenic arteries and branches of the main hepatic artery were investigated. Secondly, arterial communications between the right and left hepatic artery are described. 1. The anatomical-functional study of phrenico-hepatic anastomoses gives new detailed information on the arterial blood supply of the liver out of the phrenic arteries. These collaterals are a consistent finding. By far the largest part of the phrenicohepatic anastomoses is derived from the right inferior phrenic artery. The superior and posterior segments receive most of the anastomoses. In about 10% of our cases we succeeded in filling almost the whole arterial system of the liver by injecting the inferior phrenic arteries. 2. There are three anastomotic pathways from the right hepatic artery to the left: the so-called portal anastomoses (hilar anastomoses), translobar vessels, and the capsular arteries.
Adult↗
The perirectal fascia: morphology and use in staging of rectal carcinoma.
A revised anatomy of the perirectal fascia is proposed based on more than 2,000 CT examinations of the lower pelvis. CT examination showed that the perirectal fascia completely encloses the "capsula adipose rectalis" within the subperitoneal space and separates the perirectal compartment from the "pararectal connective tissue." The accuracy of CT in preoperative staging of rectal carcinoma was also demonstrated. It is concluded on the basis of 155 preoperative CT examinations of rectal carcinoma that CT staging is superior to Mason's clinical staging scheme, although routine staging by CT is not justified because slight perirectal tumor spread and lymph node metastasis cannot be predicted accurately.
Carcinoma↗
[Cause of pulmonary disorder following sclerosing therapy].
In order to elucidate pulmonary changes after sclerotherapy of esophageal varices animal experiments were performed. Polidocanol was injected into the submucosa of the distal esophagus and into a branch of the pulmonary artery. The submucous infiltration of the lower esophagus often causes congestive pulmonary alterations near the injection area. The subsequent disturbances of gas exchange as well as the negative inotropic effect of Polidocanol demands therapy in a number of cases.
Animals↗