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[Digestive system neoplasms originating from the autonomic nervous system. Diagnostic, therapeutic and prognostic issues].

The gastrointestinal autonomic nerve tumors (GAN tumor) are uncommon stromal tumors of the intestinal tract and retroperitoneum. The distinction of GAN tumors from other gastrointestinal stromal tumors is based on electron microscopic findings. However further study of additional cases is needed to fully characterize both their gross and microscopic features and to further characterize the natural history of such tumors. In the present study we report two cases of GAN tumor that arose from the stomach and small intestinal with different prognostic evolution in two patients of 73 and 65 years old. They were both treated by surgery, but only one case was successful. In addition patient 1 aged 73, died 11 months after surgical treatment with liver metastases on CT. scan. Patient 2, is clinically well five years after surgical treatment.

Aged↗
PubMed2001

Cytoarchitecture of the bronchiolar wall in the rat lung: scanning electron microscopic studies.

The cytoarchitecture of rat bronchiolar walls was directly visualized from the adventitial side by scanning electron microscopy after removal of collagen and elastic fibers with a KOH-collagenase digestion method. The bronchioles were surrounded by cord-shaped smooth muscle fibers, which ran circularly to the long axis of the bronchiolar tree. Branches of the bronchial artery were located outside the bronchiolar smooth muscle layer, ran toward the periphery, gave off smaller branches one after another, and finally formed capillary networks both inside and outside the smooth muscle layer. Collecting venules arising from the capillary network ran independently of arterioles, but were gradually accompanied with arterioles as they became thickened. Peripheral nerves covered with a perineurial sheath were also present outside the bronchiolar smooth muscle layer; they gave off branches toward the periphery, and finally entered the bronchiolar smooth muscle layer. Lymphatic vessels were sometimes found at the bifurcation of bronchioles. These findings provide important basic data on the structure and functions of the bronchiolar wall.

Animals↗
PubMed2000

[Anatomical basis of autonomic nerve-preserving radical resection for rectal cancer].

OBJECTIVE: To clarify anatomical basis of autonomic nerve-preserving radical resection for rectal cancer. METHOD: Of 10 cadavers, 4 were male and 2 female. Four had hemisected pelvis in the mid-sagittal plane without damaging the retrorectal anatomy. All stages of each dissection were recorded photographically. RESULTS: Hypogastric nerves were identified. The superior hypogastric plexus is the direct extension of the aortic plexus below the aortic bifurcation. It lies immediately behind the peritoneum and descends over the anterior surface of the 5th lumbar vertebra in the retroperitoneal tissue. The superior hypogastric plexus ends by bifurcating into the right and left hypogastric nerves. The two hypogastric nerves diverge from each other at about the level of the sacral promontory and run down and forward along the walls of the pelvis in the lamina of the pelvic fascia closest to the peritoneum. Both of them are strong fibres with white-grey and reticular appearance and well located just below and close to the aortic bifurcation. And after bifurcation each of them also gives rise to several branches. But it is difficult to identify the pelvic splanchnic nerves in complete samples. In mid-sagitted samples they take origin from the second to fourth sacral ventral rami just after the sacral nerves have emerged from the pelvic sacral foramina. They always form plexus at the lateral ligament and are crossed by middle rectal artery. CONCLUSIONS: It is not very difficult to preserve the hypogastric nerves to spare functions in resection for rectal cancer to the anatomical knowledge of the pelvic autonomic nerves. When the pelvic splanchnic nerves are to be preserved, dissection must be cautious at the level of the lateral ligment on the side of nerve-preservation. The operation should be performed near the rectum as close as possible to achieve functional preservation.

Autonomic Pathways↗
PubMed1993

Effect of metoclopramide on muscle sympathetic nerve activity in humans.

For determining the effect of the activation of the central cholinergic system on the sympathetic nervous system, we measured muscle sympathetic nerve activity (MSNA) together with heart rate and blood pressure before and after an intravenous injection of metoclopramide. Immediately after metoclopramide injection, short-term increases in MSNA and heart rate followed a transient decrease in blood pressure, suggesting that increased sympathetic nerve activity may result from the unloading of arterial baroreceptors. Approximately 7 min after injection, MSNA and heart rate were again notably increased, followed by an increase in blood pressure. This late increase in MSNA may result from central activation of the sympathetic nervous system, but not as a result of the unloading of arterial baroreceptors. The results of this study suggest that metoclopramide activates the sympathetic nervous system by mediating the central cholinergic system in humans.

Adult↗
PubMed2003

Glucagon-like peptide-1-responsive catecholamine neurons in the area postrema link peripheral glucagon-like peptide-1 with central autonomic control sites.

Glucagon-like peptide-1 (GLP-1) released from the gut is an incretin that stimulates insulin secretion. GLP-1 is also a brain neuropeptide that has diverse central actions, including inhibition of food and water intake, gastric emptying, and stimulation of neuroendocrine responses characteristic of visceral illness. Both intravenous and intracerebroventricular administration of GLP-1 receptor (GLP-1R) agonists increase blood pressure and heart rate and induce Fos-like immunoreactivity (Fos-IR) in autonomic regulatory sites in the rat brain. The area postrema (AP) is a circumventricular organ and has been implicated in processing visceral sensory information. GLP-1Rs are densely expressed in the AP, and peripheral GLP-1R agonists induce Fos-IR in AP neurons to a greater degree than intracerebroventricular administration. Because the AP lacks a blood-brain barrier, we hypothesized that the AP is a key site for peripheral GLP-1 to activate central autonomic regulatory sites. In this study, we found that many tyrosine hydroxylase (TH)-containing neurons in the AP expressed GLP-1Rs and Fos-IR after intravenous GLP-1R agonists. Furthermore, intravenous but not intracerebroventricular GLP-1R agonists induced TH transcription in the AP in vivo. In addition, GLP-1R agonists directly activated TH transcription in an in vitro cell system. Finally, we found that GLP-1-responsive TH neurons in the AP innervate autonomic control sites, including the parabrachial nucleus, nucleus of solitary tract, and ventrolateral medulla. These findings suggest that catecholamine neurons in the AP link peripheral GLP-1 and central autonomic control sites that mediate the diverse neuroendocrine and autonomic actions of peripheral GLP-1.

Animals↗
PubMed2003

[Exercise therapy for chronic heart failure].

Increased mortality and impaired exercise tolerance is the two major clinical problems in patients with chronic heart failure(CHF). In addition, for many years, bed rest has been recommended for patients with CHF. However, in the last decade, exercise training has been shown to improve exercise capacity, quality of life, and event-free survival in patients with CHF. Furthermore, exercise training improves autonomic nerve function and vascular endothelial function in these patients. Based on these lines of evidence, clinical practice guidelines of exercise therapy for CHF have recently been published. More effort should be made to establish the optimal exercise prescription and to increase the implementation of exercise training as a non-pharmacologic therapy for CHF.

Autonomic Pathways↗
PubMed2002

[Opioid mechanism of regulation of the autonomic and motor functions in rabbits].

In rabbits, effects of s.c. administration of met-enkephaline (MET) and stimulation of hypothalamic nuclei upon vegetative and motor functions are similar and involve changes of the breathing rate, heart rate, and diminishing of the motor component of orienting responses. MET acts mainly upon cardiac parameters. Administration of naloxone eliminates the MET effect upon the vegetative and motor parameters. The role of opioid mechanism in regulation of the brain's visceral-motor function regulation, is emphasized.

Animals↗