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PubMed1977

A reversed jejunal segment interposition as feeding gastrostomy.

Permanent feeding gastrostomies are needed for prolonged alimentation in some patients with foregut obstruction. The usual gastric flap or tube may be limited in patients with previous gastric surgery or with a small stomach. In these patients, interposition of a short, vascularized jejunal segment between the anterior wall of the stomach and the outside may be valuable. Periodic intubation is easy. Tested initially in dogs and then applied to selected patients, we have not seen ulcers, regurgitation, soiling, pain, or other complications.

Animals↗
PubMed1977

Origin, destination and mapping of tritocerebral neurons of locust.

The connectivities of the tritocerebrum of locust (Locusta migratoria L., Schistocerca gregaria (Forsk.)) were studied histologically and by means of cobalt chloride infusion. Its neuropil consists partly of fibers which traverse the tritocerebrum and areas consisting of neuropilar agglomerizations ("glomeruli"). The following direct connections between the tritocerebrum and other regions were observed: connections to 1) dorsal and lateral brain regions (mushroom body, optic lobe), 2) the ventral nerve cord, 3) the stomatogastric nervous system (here the protocerebrum and the subesophageal ganglion are also involved in these connections), 4) the retro-cerebral glands (corpora cardiaca, corpora allata), and 5) muscles of the foregut.

Animals↗
PubMed1976

[Thymic carcinoid. Case report and review of the literature (author's transl)].

A case of a primary thymic carcinoid tumour of a 32 year old male is reported, and the previously published 25 cases are reviewed. The neoplasms occur in adults, predominantly in males: they are located in the anterior or antero-superior mediastinum. The only sufficient treatment is the surgical excision; through radiotherapy may be indicated in some cases, too. The tumour is characterized by the formation of rosettes, ribbons and garlands; sheet-like or medullary areas, and large clusters with central necrosis. The tumour is positive for the Grimelius argyrophil silver stain. Ultrastructurally numerous dense-core "neurosecretory" granules are observed. The formal pathogenesis is similar to that of carcinoid tumours of other locations; particularly of those arriving from derivates of the foregut, respectively from the APUD cell system. At present it cannot be decided whether this particular tumour of the thymus represents an autochthonic thymic carcinoid or simply a teratoma with a differentiation in one direction in the sence of a simplified teratoma.

Adrenocorticotropic Hormone↗
PubMed1978

Topogenesis of the anterior intestinal port. Microkinematographic investigations on chick embryos.

Morphogenetic movements of the anterior intestinal port of in vitro growing chick embryos were recorded in stages 5--12 by means of microkinematography. Anterior intestinal port moves between stages 7 and 12 by 1.02 mm caudally, while the cranial end of the head migrates by 0.45 mm cranially. Rate of descensus, which is high during stages 7--9, decreases continually, approaching 0 in stage 12. The results are discussed in connection with the formation of intestinal port and of foregut.

Animals↗
PubMed1979

Protein transmission in the intestine of the newborn lamb: the involvement of acid and alkaline phosphatase activity.

The localization of acid phosphatase activity was differentiated from that of alkaline phosphatase in the foregut of the newborn lamb by light and electron microscopy. The examination of samples from fed and unfed lambs indicated the presence of alkaline phosphatase activity in endocytic vesicles originating from the brush-border. These vesicles, associated with protein absorption, were particularly numerous in fed lambs and occurred throughout the cytoplasm of the enterocytes. Acid phosphatase activity was absent from vesicles in the apical cytoplasm but it was localized in most sub-nuclear vesicles, also in the Golgi apparatus and the lysosomes of macrophages. The sub-nuclear vesicles were often observed in close proximity to the lateral and basement membranes of the enterocytes, also in continuity with the intercellular space. It is suggested that these results indicate the mechanism for transmission of brush-border and lysosomal enzymes, along with the immunoglobulins, into the lymph of the newborn lamb.

Acid Phosphatase↗
PubMed1977

Segmental dilatation of the ileum.

Three new cases of congenital segmental dilatation of the ileum are presented and added to 12 cases of segmental dilatation found in the literature. The aspect of the condition which is of particular interest is the presence in 3 of the dilated segments of heteroplastic foregut derivatives of unusual varieties. The etiology of the condition is discussed; it does not appear to be a single distinct pathological entity.

Adult↗
PubMed1976

The cell coat of Crithidia fasciculata.

A prominent filamentous and granular cell coat is associated with the plasma membrane of haptomonads of Crithidia fasciculata attached to the cuticular lining of the hindgut of Anopheles gambiae. This surface material is completely absent from morphologically identical haptomonads from the mosquito foregut and from rosettes in culture. On the basis of these observations, it is suggested that cell coat formation is dependent on suitable environmental conditions. A cytochemical staining technique indicates the presence of carbohydrates in (a) the cell coat, (b) the outer leaflet of the plasma membrane of haptomonads from all locations and (c) small cytoplasmic vesicles and multivesicular bodies in all haptomonads. It is suggested that these cytoplasmic organelles represent stages in the intracellular pathway for material ingested by pinocytosis rather than elements involved in surface coat formation.

Animals↗
PubMed1976

Nonfunctioning argyrophilic tumor (APUDoma) of the hepatic duct: simplified methods of detecting biogenic amines in tissue.

This report documents a foregut endocrine neoplasm in an unusual location, the main hepatic bile duct, and describes simplified methods of detecting similar endocrine tumors. Formaldehyde fume-induced fluorescence (FIF) is a quick, specific method to demonstrate biogenic amines. FIF combined with histochemical procedures showing abundant alpha-glycerol phosphate dehydrogenase and esterases indicates the neural crest origin of these and related neoplasms. Amine precursor uptake and decarboxylation (APUD) is a significant marker of these cells and gives them their name.

Adult↗
PubMed1975

Sites of organic acid production and pattern of digesta movement in the gastrointestinal tract of geese.

Sixteen geese were used to assess the movement of fluid and particulate digesta through their gastrointestinal tracts and to determine the diurnal variation in organic acid levels for the various segments of the tract. Fluid (polyethylene glycol and chronium-labeled ethylenediaminetetraacetic acid) and particulate markers (2 and 5 mm long) were administered with the meal. Animals were killed at given intervals after the administration of markers. The gastrointestinal tract was divided into nine segments for measurement of markers, pH, volatile fatty acids (VFA), and lactic acid contents. The data indicated a rapid evacuation of fluid marker from the foregut (crop, ventriculus, and proventriculus), while particulate markers were retained for extended periods of time. Retention of fluid marker was observed only within the cecum. Retrograde movement of particulate marker was demonstrated from the duodenum to ventriculus and proventriculus. Retrograde movement of fluid marker was observed from the cloaca to the colon, cecum, and distal third of the small intestine. However, particulate marker showed no retrograde movement in these segments of tract. Highest VFA levels were observed in the cecum. Retention of digesta and production of VFA within the colon were less than those noted for the dog, pig and pony. Lactic acid comprised less than 10% of the organic acids present in the gastrointestinal tract and were at their highest levels in the proximal and mid small intestine.

Animals↗
PubMed1977

Sites of organic acid production and patterns of digesta movement in the gastrointestinal tract of the rock hyrax.

The rock hyrax, smallest of the present day ungulates and a near relative of the elephant, has a gastrointestinal tract of such complex nature that it may be considered ccomparable to both the simple and complex stomach mammals, and also to birds. They have a stomach to body weight capacity equal to that of sheep. But for all its complexity, the passage of ingesta is reasonably rapid. However, there are three major sites of digesta retention and microbial fermentation of the ingested material. The cranial stomach provides the first major site of fermentation with VFA levels comparable to those observed in the rumen (125-145 mM/liter). Quantities of lactic acid are also produced in the foregut where the pH may vary from 2 to 5.5. The ingested particulate material is exclusively retained in the cranial half of the stomach for 4 hours after consumption, and partially retained in the entire stomach for greater than 24 hours. The mid-gut sacculation provides the second major site of fermentation with the retention of the digesta in this gut segment for up to 16 hours. The two ceca provide the third site. Concentrations of VFA in these latter two gut segments approaches 80 mM/liter, while the near stable and neutral pH corresponds to the absence of lactic acid production.

Animals↗
PubMed1978

Cyclic changes in the osmolality and electrolyte composition in the gastrointestinal tract of the rock hyrax.

The rock hyrax has been shown to have a very unusual and complex digestive tract. The gastrointestinal tract is comparable to that of the simple and complex stomach of mammals as well as to that of birds. Determinations of osmolality and electrolytes have been made in different sections of the gut of the hyrax. However, with the exception of the elevated potassium levels observed in the cranial stomach, the hyrax poses no unusual osmotic or electrolyte concentrations when compared to man or other mammals. The greater cation concentration and hypertonicity of the cranial stomach was largely accounted for by the elevated potassium load in this gut segment. Sodium and potassium comprised the major cations present throughout the gastrointestinal tract. Chloride was the major anion observed in the foregut; however, the electroneutrality of the mid and hindgut of the hyrax was primarily maintained by the presence of large concentrations of volatile fatty acids produced in these portions of the gut. Volatile fatty acid also accounted for the high anion concentration and hypertonicity of the cranial stomach.

Animals↗
PubMed1979

Sites of organic acid production and patterns of digesta movement in the gastro-intestinal tract of the raccoon.

Twelve raccoons were used to assess the movement of fluid and particulate digesta through their gastrointestinal tract and to determine the diurnal variations in organic acid levels for the various segments of the tract. Fluid and particulate markers were administered at the time of meal feeding. Animals were killed at given intervals after the administration of markers. The gastrointestinal tract was removed and divided into seven segments for measurement of markers, pH, volatile fatty acids (VFA) and lactic acid content. The results indicate a rapid transit of the digesta through the entire gastrointestinal tract, with a mean retention time of less than 24 hours for all fluid and particulate markers. Particulate markers up to 2 cm in length were passed rapidly, with limited retention within the tract, much unlike animals with greater gut complexity. The apparent requirements for gut complexity and digesta retention presumably necessary for digestion by gut microflora were not evident in the raccoon. However, even in the absence of these characteristics, microbial fermentation of the ingesta occurred, as evidenced by the levels of organic acids produced. Colonic VFA concentrations achieved levels comparable to levels observed in the ruminants' foregut and the large intestine of the pony. Lactic acid was found throughout the entire gastrointestinal tract.

Animals↗
PubMed1975

Transplantation of human cancers to nude mice and effects of thymus grafts.

Human cancers were transplanted to nude mice; a cell line originating in the foregut (distal stomach or first portion of the duodenum) produced exponential nonmetastasizing growth, preventable by prior thymus implantation. Implantation of thymuses into mice with established tumors resulted in increased animal survival and in four instances in complete regression of the neoplasm. Cell lines of pancreatic carcinoma and melanoma and surgical specimens of melanoma and of neoplasms from the pancreas and colon showed variable growth patterns in this system. Repeated attempts to transplant gastric adenocarcinoma were unsuccessful.

Adenocarcinoma↗
PubMed1979

Prospective evaluation of angiography in the diagnosis and management of patients suspected of having pancreatic cancer.

One hundred three patients suspected of having pancreatic cancer underwent celiac and superior mesenteric arteriography which was reported 'blind.' Final diagnosis, operative findings, and resectability of pancreatic cancers were correlated with angiography reports. Forty patients had pancreatic cancer. Thirty-seven of these underwent laparotomy, and 14 (37%) had resectable lesions. Sensitivity and specificity of arteriogrphy for pancreatic cancer were 72% (29/40) and 71% (45/63) respectively. Resectability was unrelated to the angiographic diagnosis. Nonresectability was related to an angiographic finding of definite tumor vessel (4/4), large-vessel encasement (14/7), and major venous pathology (8/11). Only the first of these was unique to pancreatic cancer. Hepatic metastases were detected in only six of 13 patients. Small-artery encasement, arterial occlusion, vessel displacement, and gallbladder distention were not indicators of diagnosis or extent of disease. Major anatomic anomaly of foregut vasulature was revealed in 25% of angiographic studies. Prior knowledge of such anomalies has important bearing on the operative approach to pancreatic resection. We conclude that angiography should be performed prior to laparotomy whenever a resectable pancreatic cancer is suspected from other investigations. When used prospectively, angiography is not a reliable diagnostic or prognostic tool for pancreatic cancer.

Adolescent↗
PubMed1979

Leishmania in phlebotomid sandflies. VII. On the taxonomic status of Leishmania peruviana, causative agent of Peruvian 'uta', as indicated by its development in the sandfly, Lutzomyia longipalpis.

The name Leishmania peruviana was given by Velez (1913) to the parasite responsible for a form of cutaneous leishmaniasis known as 'uta'; this disease occurs in the Peruvian Andes. Clinical similarities between uta and 'oriental sore', which is caused by Leishmania tropica of the Eastern Hemisphere, have, however, led to the suggestion that uta is simply due to L. tropica, which was introduced into Latin America by African slaves or European immigrants. Leishmania species are divisible into three distinct sections, according to their pattern of development in their natural (phlebotomine) vectors. One of these sections, the PERIPYLARIA, contains the subspecies of Leishmania braziliensis, and is characterized by parasites that undergo a phase of development attached to the wall of the hindgut (pylorus and ileum), in addition to multiplication in the midgut and subsequent invasion of the foregut. Such development is unknown in any other group of leishmaniae, including those groups of the section SUPRAPYLARIA, which includes parasites of the L. tropica complex. Three isolates of L. peruviana were studied in laboratory-bred sandflies, Lutzomyia longipalpis (Lutz & Neiva), and all showed consistent and prolific development of rounded or stumpy flagellates attached to the wall of the hindgut and, in some instances, growth of free, elongate promastigotes throughout the midgut. Development of both L. tropica and L. major, in the same insect, was restricted to massive development of free flagellates in the midgut, up to the cardial valve. From the behaviour of L. peruviana in the sandfly, its slow growth in hamster skin and the small size of its amastigotes, it is concluded that this parasite is (a) distinctly different from both L. tropica and L. major, and (b) closely related to subspecies of L. braziliensis within the section PERIPYLARIA. On this evidence it is also concluded that L. peruviana is indigenous to the American continent. The specific name is best retained for the time being (rather than L. braziliensis peruviana).

Animals↗
PubMed1976

Neuroendocrine embryology and the APUD concept.

In the Vertebrata the great majority of cells producing hormonal peptides belong to the APUD series and share its distinctive cytochemical and ultrastructural characteristics. According to the concept all members of the series are to be regarded as derivatives of neuroectoderm or of specialized (placodal) ectoderm. For most of the APUD cells this criterion is fulfilled in that their origin from neural tube, neural ridges or neural crest can be considered proven. Complete proof is not yet available for the APUD cells of the gastrointestinal tract and pancreas, and indeed much contrary evidence can be cited. Despite the latter, our embryological studies show: (1) that the hypothalamohypophyseal complex is wholly neuroectodermal; (2)that the chronology of neural crest dispersion is such that this tissue could be responsible for observed APUD cell contributions to the foregut; (3) that placodal ectoderm makes important contributions to pharyngeal pouch endocrine derivatives in birds and mammals; and (4) that the amphibian parathyroid gland is derived from the same layer of neural ectoderm as the hypothalamo-hypophyseal axis. Supporting immunocytochemical studies indicate that peptides belonging to the APUD series are more widely distributed than hitherto recognized and it is concluded: (1) that the whole of peptide endocrinology is neuroendocrinology; and (2) that the APUD cells, with a few cells hitherto regarded as being outside the series, form a third (Endocrine) division of the nervous system to add to the existing Somatic and Autonomic divisions.

APUD Cells↗
PubMed1977

Morphology and staining patterns of endocrine cell tumours in the gut, pancreas and bronchus and their possible significance.

We have studied 109 endocrine cell tumours of the gastrointestinal tract, pancreas and bronchus in terms of histological pattern and histochemical staining with immunocytochemical studies on seven tumours. As a result we believe that previous histological classifications need modification. 5-Hydroxytryptamine secreting tumours have a carcinoid (A1) pattern with, in some cases, an additional tubuloacinar element (A1A2) and definable histochemical reactions; well differentiated gastrinomas, insulinomas and glucagonomas are associated commonly, but not exclusively, with particular histological patterns and argyrophilia, but no such association exists for less differentiated tumours. This may be related to the synthesis of precursor hormones by less differentiated tumours. Mixed patterns are common, particularly in tumours of foregut derivation. Prospective studies planned to correlate histology, histochemistry, immunocytochemistry and ultrastructure are needed on all endocrine cell tumours.

Bronchial Neoplasms↗
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↗