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PubMed2002

Skin manifestations of internal malignancy.

This article concentrates on the major signs and syndromes that are associated with internal malignancies in the geriatric population. Included are cutaneous metastases, ectopic adrenocorticotropic hormone-producing syndromes, and disorders arising from APUD cell tumors. The major paraneoplastic disorders of dermatomyositis, generalized pruritus, Bazex's syndrome, and acanthosis nigricans also are discussed. Also included are Bowen's disease of skin; arsenical toxicity; and the Peutz-Jeghers', Gardner's, and Torre's syndromes, which are indicative of systemic or organ-related carcinogens.

Acanthosis Nigricans↗
PubMed1982

Inhibition of amiloride-sensitive sodium conductance by indoleamines.

To examine a possible role of indoleamines in the regulation of epithelial sodium absorption, the effect of serotonin (5-hydroxytryptamine) and several derivatives on electrolyte transport was measured in vitro in the baboon bronchus and in the trachea and colon of sodium-deficient rats. Serotonin, melatonin (N-acetyl-5-hydroxytryptamine), and harmaline (1-methyl-7-methoxy-3,4-dihydro-beta-carboline) inhibited sodium transport in all three preparations in a similar manner to the natriuretic agent amiloride. In all three epithelia, sodium absorption via the amiloride-sensitive pathway constitutes a substantial portion of total electrolyte transport, measured as the amiloride-sensitive short-circuit current. Thus 25 microM amiloride inhibited the short-circuit current 21% in the rat trachea, 63% in the baboon bronchus, and 90% in the rat colon. Serotonin, melatonin, and harmaline inhibited the amiloride-sensitive portion of the short-circuit current from the luminal side of the epithelium. The inhibition was rapid, requiring only seconds, and maximal inhibition by serotonin was identical to that by amiloride. When sodium was omitted from the luminal solution, the short-circuit current was reduced a similar amount, suggesting that sodium absorption was being inhibited by both amiloride and the indoles. The IC50 value for amiloride was 50 nM in the baboon bronchus and 500 nM in the rat colon. In contrast, the IC50 value for serotonin was 0.4 mM in the baboon bronchus and 8 mM in the rat colon. These results, together with the wide distribution of amine-precursor-uptake-and-decarboxylation (APUD) cells in the respiratory and intestinal tract, suggest that certain indoleamines could play a role as local regulators of fluid and electrolyte transport. For example, in the airways, indoleamines may be one of the factors involved in regulation of the depth of the periciliary fluid layer.

Amiloride↗
PubMed1975

Ectopic apudocarcinomas and associated endocrine hyperplasias of the foregut.

Foregut endocrine polypeptide-secreting APUD cells (Amine-Precursor-Uptake and Decarboxylation), in their embryologic migration from neural crest to foregut may become "arrested" in the mesoderm or in other ectopic locations. They may become hyperplastic, adenomatous or malignant. Eight illustrative patients are reported. One patient had "pancreatic hyperparathyroidism" with hypercalcemic crises, pancreatic apudocarcinoma, normal parathyroids, biologically active parathormone, but inert immunochemically to the usual parathyroid antisera. Two had gastrin-secreting malignancies in the mesoderm. Remission after excision, but eventual recurrence of the syndrome due to islet cell hyperplasia required total gastrectomy. One patient had a gastric corpus apudocarcinoma found prospectively with hypergastrinemia which required excision of the tumor. One patient had acromegaly with hypergastrinemia and antral gastrinosis treated by pituitary irradiation, One patient had the antral or intermediary type of the Zollinger-Ellison syndrome with moderate hypergastrinemia, duodenal ulcer and antral gastrinosis, treated by vagotomy and antrectomy. One patient had hyperparathyroidism with antral gastrinosis, treated by parathyroidectomy. One patient had malignant Zollinger-Ellison syndrome and developed associated thyroid parafollicular cell hyperplasia and parathyroid chief cell hyperplasia, treated by total gastrectomy and multiple endocrine excisions. These investigative observations demonstrate ectopic loci and associated hyperplasias which support the concept of migration and bizarre potentiality of polypeptide-secreting cells of the foregut.

Adenoma↗
PubMed1978

Bronchial carcinoids and hormonal disorder.

The relationship between bronchial carcinoids and hormonal disorder is reviewed in the light of a study of 24 patients with carcinoid tumors of the bronchus. In this series, two patients presented with manifestations of the polyendocrine disorder. The common origin of carcinoid tumors and other APUD cells from neural crest ectoderm provides a common denominator in the association of carcinoid tumors of the bronchus and adenomas, or carcinoma of associated endocrine organs.

Adenoma↗
PubMed1979

The carcinoid tumour.

Carcinoid tumours are by no means rare. The wide range of sites in which they occur is explained by their origin from APUD cells of the neural crest. These cells migrate to all parts of the alimentary tract during embryonic life, and ultimately are found as well in various gut derivatives such as the respiratory, pancreatic and biliary systems. On the basis of a series of 31 carcinoid tumours seen at the Royal Prince Alfred Hospital in a five-year period, the distinctive clinical and histological features of carcinoids of foregut, midgut and hindgut origin are reviewed. Diagnosis, treatment and results are discussed, and recommendations regarding management of the patient with a carcinoid tumour are given.

Adolescent↗
PubMed1980

Bronchial carcinoid metastatic to skin. Light and electron microscopic findings.

This case report illustrates the value of ultrastructural examination of an undifferentiated carcinoma mestastatic to skin. In this patient, ultrastructural study of a cutaneous nodule demonstrated cytoplasmic neurosecretory granules characteristic of an amino precursor-uptake and decarboxylation cells (APUD) tumor and supported the diagnosis of metastatic bronchial carcinoid. Additional nine cases of bronchial carcinoids metastatic to skin are also briefly reviewed.

Bronchial Neoplasms↗
PubMed1989

Acetylcholine in neurons and paraneurons: a histochemical study.

Several years ago we proposed a method for the localization of acetylcholine in the cholinergic nerve terminals. The method is based on a rapid precipitation of quarternary ammonium cations (such as acetylcholine or choline) by molybdic or tungstic heteropolyanions (such as phosphomolybdic acid, phosphotungstic acid and silicotungstic acid). The insoluble salts formed can be directly visualized under the electron microscope. In the synaptic vesicles, acetylcholine was localized as point-like precipitates, while the membranes were well preserved. Since these fixations are based on a rapid ionic interaction, the term "ionic fixation" was proposed. The ionic fixation performed on motor end-plates in various physiological conditions, provided different forms of cytochemical precipitates of acetylcholine (point-like, spot-like, diffuse or laminar). In contrast with the numerous physiological and neurochemical investigations into the acetylcholine mechanism of neurons, very little is known about paraneurons. The historical evolution of paraneuron research, more or less bound to that of the sympathetic paraganglion and of the APUD cells may explain this lack of results. In certain physiological conditions, acetylcholine can be revealed in paraneurons and seems to reflect a plasticity of the cells, as already observed in sympathetic ganglion cells. This paper further overviews the cholinergic mechanisms of exocrine secretory cells. The presence of a high cholinesterase activity exist in most of these exocrine cells, as far as we could verify. In addition to cholinesterase activity, the presence of acetylcholine, probably related to exocrine cell metabolism, was investigated with our histochemical method.

Acetylcholine↗
PubMed1992

[Pheochromocytoma--basic and clinical analyses].

A variety of vasoactive substances including biogenic amines, neuropeptide Y, somatostatin, enkephalin, ACTH, corticotropin-releasing hormone, growth hormone releasing hormone, vasoactive intestinal peptide, calcitonin, and atrial natriuretic factor have been extracted from intra-adrenal and extra-adrenal pheochromocytomas in men. Some of them appear to play an important role for the development of hypertension or clinical serious symptoms. However, informations on the molecular forms of other substances in pheochromocytomas are still limited, and precise amount of the peptides or hormones in the tumors has not yet been quantitated. Numerous in vitro or in vivo studies of this documented neoplasm over the years have been reviewed in this manuscript. Clinical analyses of early diagnosis, localization diagnosis, treatment of multiple endocrine neoplasia, preoperative and operative treatments are also evaluated in this paper. These informations will probably provide additional evidence for the multi-secretory APUD cells of neural crest origin and will contribute the therapy in patients with pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed2000

[Efficiency of endobronchial laser therapy in patients with chronic bronchitis].

Clinical effectiveness of endobronchial laser therapy (EBLT) was studied in 18-56-year-old patients with chronic bronchitis (CB) running for 2-18 years. A parallel luminescent and histochemical tests measured histamine, serotonin and catecholamines in bronchial mucosa. It was found that alveolar macrophages, lymphocytes and mucus of CB patients contain significantly higher amounts of histamine and serotonin though low amounts of catecholamines than those of healthy subjects. Levels of monoamines in alveolar macrophages, lymphocytes, neutrophils, mast and APUD cells, mucus in of CB patients correlated with the disease phase, duration, features of endobronchitis, bronchial obstruction and severity of respiratory insufficiency. EBLT produced a positive effect on CB course and bronchial mucosa bioamines. It was superior to conventional therapy in lowering of histamine and serotonin in alveolar macrophages, lymphocytes and mucus as well as in raising catecholamines.

Adolescent↗
PubMed2002

[Primary malignant melanoma of the small intestine--a case report].

Small bowel neoplasms are very rare and can be found in 1-2% of all gastrointestinal tumors. Most of them have metastatic origin. Malignant melanoma is the most common tumor metastatic to the GI tract. Primary malignant melanomas arising from the small intestine are very rarely but therefore are some case reports in the literature. Some authors stated that melanomas are never primary in the intestinal tract. Others try to explain the primary etiology. The most famous theory for its origin is the APUD cell concept. When a small bowel tumor is suspected, enteroclysis is the most useful imaging study. Herein we report the case of a primary malignant melanoma of the small bowel.

Adult↗
PubMed2002

[Bronchial reactivity and mucosal bioamines as criteria for acute bronchitis becoming chronic].

AIM: To study bronchial reactivity and sensitivity with consideration of histamine, serotonin and catecholamines concentration in bronchial mucosa in patients with acute bronchitis (AB) as possible criteria of its becoming chronic. MATERIAL AND METHODS: Before the treatment 116 patients with verified AB were examined using inhalation provocative tests (IPT) with histamine, serotonin and obsidian in increasing doses. Also, external respiration function was studied. IPT were repeated after the course of treatment. RESULTS: 87 of 116 AB patients exhibited high bronchial sensitivity and reactivity to inhalations of histamine, serotonin, obsidian. In parallel, there was a rise in the levels of histamine and serotonin and a fall in the level of catecholamines in bronchial mucosa (alveolar macrophages, lymphocytes, neutrophils, mast and APUD-cells). Changes in monoamines concentration in bronchial mucosa were relevant to activity of bronchial inflammation and the presence of obstructive syndrome. CONCLUSION: Persistent bronchial hyperreactivity to inhalations of histamine and obsidian along with high histamine levels and low level of catecholamines in alveolar macrophages, lymphocytes and mucus is a criterion of bronchitis transformation to chronic one.

Acute Disease↗
PubMed2003

Carcinoid tumors of the gastrointestinal tract. A review and the Duke University institutional overview.

Carcinoid tumors are relatively rare neoplasms arising from the amine precursor uptake and decarboxylation (APUD) cells of the gastrointestinal tract and bronchial tree. Presenting symptoms vary by site of origin, and various modalities may be used to diagnose them. Initial treatment is surgical, with procedure depending upon site of origin. Several experimental therapies may be used in treatment of metastatic carcinoid tumors.

Antineoplastic Agents↗
PubMed1992

[Cushing syndrome in a neuroendocrine pancreatic tumor. Clinicopathologic case report].

A 59-year-old female patient with mild clinical features of a Cushing syndrome underwent surgery for a suspected hormonally active tumor of the left adrenal gland. Surprisingly, the adrenal gland was unremarkable, however, a tumor in the pancreatic tail was found. A left pancreatic resection with splenectomy resulted in curative removal of the tumor. The pathohistological examination of the tumor established the diagnosis of an ACTH-producing pancreatic carcinoid. Morphology and pathogenesis of pancreatic carcinoids which are tumors of the APUD-cell-system are discussed in detail.

ACTH Syndrome, Ectopic↗
PubMed1990

[The pathogenesis and morphogenesis of noninflammatory lung diseases in premature infants].

Studies of the morphofunctional status of the lungs in premature infants showed that the factors responsible for the immaturity of the bronchoalveolar tissue played a major role in the patho- and morphogenesis of noninflammatory conditions: atelectasis and hyaline membrane disease. Of special significance is inadequate differentiation of the alveolar parenchyma and blood-air barrier as well as the presence of large amounts of serotonin-containing APUD cells in the immature lungs. When released into the surrounding parenchyma under the influence of pathogenic factors, serotonin brings about the development of broncho- and vasoconstriction, microthrombosis, and increased permeability of the vascular walls, which induces the development of hyaline membrane disease in premature infants. The findings open up new possibilities for the elaboration of new prevention and therapy patterns in combating this condition.

Humans↗
PubMed1985

[Somatostatinoma of the liver].

A case report is given of a 45 year old patient, who had a tumor of the liver, pain in the upper abdomen and relapsing fever. Surgery was done and part of the liver was removed. On microscopic examination a somatostatinoma was found. The clinical symptoms of this very rare type of tumor, which belongs to the APUD cell system, is discussed as well as therapeutical implications.

Adenoma, Islet Cell↗
PubMed1988

[Carcinoid tumor of the ampulla of Vater. Morphology, diagnosis and therapy of a rare papilla tumor].

We report on a patient with a carcinoid tumour of the ampulla of Vater and review the 33 known cases of the literature with regard to clinical presentation, morphology and therapy. As it is apparent from the location of the tumour, obstructive jaundice, pancreatitis and nonspecific upper abdominal complaints are the most frequent symptoms. The ampullary carcinoid belongs histogenetically to the APUD cell system with the ability of multiple endocrine activity. The expression of somatostatin peptide and neuron-specific enolase are the most common histopathological findings. A systemic function of these hormones, however, has not yet been shown. For diagnostic purposes in surgical pathology we found synaptophysin and chromogranin A to be important markers. For surgical treatment, partial duodenopancreatectomy remains the current therapy of choise, if the tumour exceeds two centimeters in diameter.

Ampulla of Vater↗
PubMed1987

[Role of 131I-metaiodobenzylguanidine scintigraphy in the diagnosis of intestinal carcinoids].

Iodine-131 metaiodobenzylguanidine (131I-MIBG) is concentrated in a variety of neuroendocrine tumors, such as pheochromocytoma and neuroblastoma. Other neuroendocrine tumors from the APUD-cell system such as carcinoid tumors, may possess this uptake capability as well. We investigated 11 patients suffering from intestinal carcinoid with 131I-MIBG in order to determine the value of MIBG scintigraphy in these tumors. MIBG scans were positive in 5 out of 11 patients (45%). False-positive MIBG-scans did not occur. No correlation between MIBG uptake, clinical symptoms and urinary 5-HIAA level could be found.

3-Iodobenzylguanidine↗