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PubMed1991

Correlative light and electron microscopic observations on ectopic neurons in the cerebellum of dreher mutant mouse.

The structure of ectopic neurons in the cerebellum of dreher mutant mouse was investigated by correlative light and electron microscopic observations. Tissue blocks were fixed in buffered aldehyde and embedded in a mixture of 2-hydroxypropyl methacrylate, Quetol 523, and methyl methacrylate. Sections at 0.4-0.5 microns in thickness were examined by electron microscopy after observation under a light microscope. By comparing the electron images with those of light microscopy in the same sites, the structures of ectopic cells were confirmed. Ectopic Purkinje cells were arranged with cell bodies that contained an oval, spherical or wrinkled nucleus without deep invagination and the thin layers of endoplasmic reticulum at the perinuclear regions. Granule cells were ectopically matured in the external granular layer and within the cluster at the cortical region. This method provides a useful procedure for understanding structures of the cerebellar neurons of the mutant.

Animals↗

PubMedDate not supplied

Ectopic pancreas and the islet cell dysmaturational syndrome.

Two cases of ectopic pancreas are described in the setting of the islet cell dysmaturational syndrome. Microscopic and immunostaining studies revealed both lesions to be composed of primarily (80 percent to 90 percent) islet tissue with nuclear hyperchromasia and probable depletion of immunoreactive insulin in one case. Persistent hyperinsulinemic hypoglycemia required a second laparotomy with resection of ectopic pancreas in one case. Awareness of the phenomenon led to successful identification and resection of ectopic islet tissue on first surgery in a subsequent case. Ectopic pancreas is a relatively common developmental pancreatic anomaly, and knowledge of its potential contribution to life-threatening hypoglycemia may obviate the need for multiple surgeries in some cases of islet cell dysmaturational syndrome.

Choristoma↗

PubMed1990

Cystosarcoma phyllodes arising synchronously in right breast and bilateral axillary ectopic breast tissue.

Pathologically involved ectopic breast tissue is not commonly encountered. There have been, however, intermittent reports of involvement of ectopic breast tissue by many of the same benign and malignant processes that occur in normally located breast tissue. This article records what, to our knowledge, is the first case of cystosarcoma phyllodes arising in ectopic breast tissue of the axillary regions and is the second reported case of three primary cystosarcoma phyllodes arising synchronously. A review of the available literature pertaining to ectopic breast tissue and multiple cystosarcoma phyllodes is also presented.

Axilla↗

PubMed1989

Efficacy and safety of flecainide in patients with stable ventricular ectopic beats. Multicenter trial of the Italian Study Group on the Electrophysiology of Arrhythmias.

The aim of this multicentre study, carried out by the Italian Study Group on the Electrophysiology of Arrhythmias (GISEA) in 60 Italian Cardiology Centres on 260 patients, was to assess the efficacy and the safety of flecainide in the treatment of stable hyperkinetic ventricular arrhythmias (greater than 100 ventricular ectopic beats/hour per day). The stability of the arrhythmia was verified using 24 hour Holter recordings allowing for a spontaneous variability of less than 20%. All the patients belonged to class NYHA I or II. Flecainide was administered in 2 x 100 mg/day doses and if the efficacy criteria, checked by the Holter on the 6th day, were not met the dose was increased to 2 x 150 mg/day. After a further Holter recording on the 11th day, therapy continued until the 31st day when the final recordings were carried out. The study protocol was completed by 249/260 pts. (95.7%). Due to violation of the protocol which included lack of basal stability of the arrhythmia 69/249 pts. (28%) were excluded. The 69 excluded patients were not considered for the efficacy evaluation, but entered for safety considerations. Only 16/180 (8%) of the qualified pts. were drop-outs. In the remaining 164 patients considered in the final evaluation, flecainide proved to be effective in 122 patients (74%) with a greater than 80% reduction of ventricular ectopic beats. In 118/131 patients (90%) there was a greater than 75% reduction in the couples and suppression of non-sustained ventricular tachycardia. The flecainide plasma levels were, on average, within the therapeutic range and could be correlated to dose level. The total incidence of adverse effects was 15% and the most frequent extracardiac ones were of a neurologic type. Proarrhythmic effects were observed in only 3/249 patients. This multicenter study in pts. with greater than 2400 ventricular ectopic beats/day confirms that flecainide is effective in the treatment of hyperkinetic ventricular arrhythmias including complex ones and that it is well tolerated in patients in a good NYHA functional class. Moreover this study emphasizes the serious problem of the individual variability of ventricular ectopic beats which requires the application of rigorous selection criteria for the correct execution of the trial as was done in this study.

Adolescent↗

PubMed1989

Induction of active zones at ectopic neuromuscular junctions in the frog.

To examine de novo differentiation of the active zone, ectopic neuromuscular junctions were studied in adult frog muscles. Ectopic junctions induced by excising the original endplate region and implanting the nerve to an endplate-free site were examined by light and electron microscopy 4 weeks-1 year after operations. The earliest time point at which ectopic junction formation was detected with freeze fracture was 6 weeks postoperation, when clusters of active zone particles were observed scattered across the nerve ending. Subsequently, short active zones (6-10 weeks postoperation, length mean = 0.36 +/- 0.24 microns) composed of the characteristic 2 double rows of particles are detected. Before junctional folds are observed with freeze fracture, many active zones are parallel to each other and to the long axis of the nerve. The average angle 6-10 weeks postoperation is 27 degrees +/- 23 degrees. Even during these early stages of formation, active zones are functional. As time passes, active zones attain a more typical, perpendicular orientation (12-18 weeks postoperation, mean = 62 degrees +/- 24 degrees) and also increase in length (mean = 0.69 +/- 0.45 microns). However, even after 1 year, the orientation (angle, mean = 70 degrees +/- 22 degrees) and the length (mean = 0.78 +/- 0.63 microns) of active zones at ectopic junctions are still not well correlated with active zones at normal junctions (normal active zone angle mean = 85 degrees +/- 5 degrees, length mean = 1.00 +/- 0.57 microns).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1987

Ectopic pituitary and hypothalamic hormone syndromes.

The pathophysiology and diagnosis of ectopic hormone syndromes are discussed, and a classification of hypothalamic and pituitary ectopic syndromes is provided. Ectopic hypothalamic syndromes resulting from tumor elaboration of GRH, GnRH, CRF, and SRIF and ectopic pituitary hormone hypersecretion of GH, PRL, and TSH are reviewed comprehensively. A practical approach to the clinical work-up and management of these newly described disorders is provided.

Hamartoma↗

PubMed1987

[Treatment,in girls, of ectopic ureters, due to duplication, using reimplantation of the single pathological ureter into the bladder].

Mostly the ectopic ureter belongs to the upper pole in urinary tract duplications. In the pelvis, the two ureters are clearly separated. The only dissection of the ectopic ureter is in no case dangerous for the ureter of the lower pole. Therefore the reimplantation of the ectopic ureter can be performed separately. This only reimplantation of the ectopic ureter has been performed 9 times, without any mortality nor morbidity. The scar is almost invisible and the child is cured without any risk for the upper pole and saving the whole of the renal parenchyma. If the upper pole is functional, which happened in 1/4 of the cases, this technique is the best way and the less dangerous to recovery.

Adolescent↗

PubMed1978

Gastrin-producing cells in ectopic gastric mucosa of developmental and metaplastic origins.

Immunocytochemical techniques using antigastrin antibody were employed to localize G cells in ectopic gastric mucosa of metaplastic and congenital origins and to compare their distribution with that in normal gastric mucosa. Five examples of Barrett's esophagus, 8 Meckel's diverticula, and 2 small bowel duplications were studied. Although G cells were absent in the gastric mucosa from all cases of Barett's esophagus, four Meckel's diverticula and one small bowel duplication contained G cells. In all instances of congenitally derived ectopic gastric mucosa where G cells were demonstrable, the gastric mucosa showed areas of antropyloric differentiation, whereas in the remaining cases the ectopic gastric mucosa was exclusively of the body-fundic type. It is concluded that the presence of G cells within ectopic gastric mucosa of Meckel's diverticula and small bowel duplications in foci of antropyloric differentiation reflects their developmental origin, whereas the absence of G cells in Barrett's esophagus is in keeping with its metaplastic derivation.

Choristoma↗

PubMed1986

[Ectopic hormone production].

Ectopic hormone production by tumors is one particular form of paraneoplasia. Syndromes caused by inappropriate ectopic secretion of hormones or biologically active molecules with hormone-like effects may help to detect the presence of a tumor or its localization, and in monitoring the efficiency of therapy. Ectopic hormone production is difficult to demonstrate unequivocally. The pathogenesis remains unknown but may be elucidated in the near future by research into the pathogenesis of tumors at the molecular level. The tumors most frequently associated with ectopic hormone production are bronchogenic and pancreatic carcinomas, carcinoids, and thymomas.

Humans↗

PubMed1977

Ectopic ossification after total hip arthroplasty. Predisposing factors, frequency, and effect on results.

In a statistical analysis of 398 consecutive patients with 507 total hip arthroplasties which was designed to identify factors predisposing to ectopic ossification and to determine the frequency of ossification and its effect on the results, it was found that male patients with considerable bilateral osteophytic osteoarthritis were statistically most likely to have ectopic ossification, especially if ossification had existed before arthroplasty consequent to previous surgery. Ectopic ossification which was first noted six weeks after total hip arthroplasty in 96 per cent of the cases did not change in amount thereafter, though the bone did mature. Both the range of motion of the hip and the function of the patient were affected by the ectopic bone during the first postoperative year, but after that only the range of hip motion was influenced.

Arthroplasty↗

PubMed1985

[Ectopic ureteral opening in four males: including a case of inverted Y ureteral duplication].

Four males with ectopic ureteral opening are reported herein. Case 1 was a 17 year old who complained of miction pain and macroscopic hematuria. Cystoscopy and radiological examinations showed left ectopic ureteral opening into the seminal vesicle associated with left renal agenesis. The left ureter and seminal vesicle were extirpated. Case 2 was a 21 year old who complained of lower abdominal pain. On physical examination, a child's head sized mass was palpable in the midline of the lower abdomen. Operation was performed under diagnosis of intrapelvic tumor, but the mass was cystic dilatation of left ureter which opened into the seminal vesicle. Case 3 was a 19 year old who complained of right CVA colic pain. On cystoscopy, the right ureteral orifice was absent. During the operation, right ureter was found to open into the posterior urethra. Case 4 was a 57 year old who complained of fever. Plain X-ray on the pelvic cavity showed a 82 X 10 mm calcified shadow. CT revealed a right ectopic ureteral opening into the posterior urethra with a ureteral stone in it. On cystoscopy, the right ureteral orifice was identified and pus discharge was observed to flow out of it. Operative exploration demonstrated that the right ureter was inverted Y duplication; one opened into the posterior urethra and the other into the trigone. Seventy nine males with ectopic ureteral opening and 3 with inverted Y ureteral duplication from the Japanese literature are reviewed briefly.

Adolescent↗

PubMed1979

Ectopic pregnancy as an etiologic agent in appendicitis.

The association of ectopic pregnancy and acute appendicitis has seldom been discussed in literature. This report presents 2 patients who had simultaneous right tubal pregnancies and acute periappendicitis. The cases reported here suggest the possibility that an ectopic pregnancy can produce an inflammatory reaction of the appendix. Ectopic pregnancy as an etiological stimulus for acute appendicitis is discussed. The advisability of examining the appendix at the time of surgery for pelvic disease, and performing an appendectomy at the same time, if pathology of the appendix is suspected, is emphasized. The use of elective appendectomy in surgery for ectopic pregnancy is reviewed.

Acute Disease↗

PubMed1984

Somatostatin induces ectopic activity fronts of the migrating motor complex via a local intestinal mechanism.

To study the peripheral effect of somatostatin in dogs a tiny Silastic catheter was implanted in an almost terminal branch of the mesenteric artery, providing blood supply to a jejunal segment of 5-10 cm. In 4 dogs one catheter was implanted, perfusing a small bowel segment about 60 cm below the angle of Treitz; in 3 dogs two catheters were implanted, perfusing two small bowel segments about 30 and 60 cm below the angle of Treitz. The catheter was kept open by continuous perfusion with a diluted heparin solution by means of a portable insulin infusion pump fixed to the animal's protection jacket. Small bowel motility was recorded electromyographically. Experiments were started 2 wk after surgery and were performed in conscious fasted animals. Control experiments using intraarterial saline perfusion showed normal migrating motor complexes in the perfused segment. Intraarterial perfusion of somatostatin (50-200 ng/kg X h) induced ectopic activity fronts, which always started just distal to the perfused segment and progressed down the small bowel at a normal propagation velocity. During the occurrence of ectopic fronts no activity fronts were observed in the small bowel proximal to the perfusion site. Apart from ectopic fronts, normal activity fronts, starting in the duodenum and passing the perfused segment, were also observed. The most proximal part of the jejunum was more sensitive to intraarterial somatostatin than the more distal jejunum. Intravenous infusion of the same doses of somatostatin had no effect. Somatostatin, therefore, seems to induce ectopic fronts via a local mechanism. We propose that somatostatin is able to relieve the intestine locally from an inhibitory mechanism that prevents the development of activity fronts.

Action Potentials↗

PubMed1984

Use of an ectopic pelvic donor kidney for transplantation.

A case is presented in which an ectopic but otherwise normally functioning kidney was used for living related renal transplantation. The donor evaluation was complicated by nonvisualization of the ectopic kidney on intravenous pyelogram, presumably through an error in radiologic technique. Donor nephrectomy and transplantation of the recipient were performed uneventfully; the kidney had an ectopic arterial supply from the donor internal iliac artery which had to be anastomosed to the distal external iliac artery of the recipient because of the short vessels and short ureter. One year after transplantation, both donor and recipient are doing well with normal renal function. An ectopic kidney discovered in an otherwise healthy and willing donor should not preclude him from consideration.

Adult↗

PubMed1983

Ectopic ossification following total hip replacement in juvenile chronic arthritis.

Of twenty-one patients with juvenile chronic arthritis (seventeen with juvenile rheumatoid arthritis and four with juvenile ankylosing spondylitis) who had total hip replacement before the age of thirty years, thirteen patients (62 per cent) showed different degrees of ectopic ossification: nine (53 per cent) of the seventeen with juvenile rheumatoid arthritis and all four of those with juvenile ankylosing spondylitis. Human leukocyte antigen B5 was found with an increased frequency in the patients with ectopic ossification. Functional capacity was not impaired regardless of the severity of the ectopic ossification. As in patients with adult-onset disease, ectopic ossification after total hip replacement occurred with a higher frequency in the patients with juvenile-onset ankylosing spondylitis than in those with juvenile-onset rheumatoid arthritis.

Adolescent↗

PubMed1978

Repetitive ventricular ectopic activity in chronic ischaemic heart disease.

The characteristics of repetitive ventricular ectopic activity in 175 ambulatory patients after myocardial infarction are analysed. A total of 1 500 magnetic tape recordings were made on these patients over a period of up to 8 years. In the group of patients exhibiting few ectopic beats, i.e. less than 8/h, the incidence of ventricular salvoes and tachycardia was 9% and 4% respectively, whereas in the group exhibiting many ectopic beats, i.e. greater than or equal to 8/h, the incidence of ventricular salvoes and tachycardia was 60% and 30% respectively. Even though only 1 patient in the first group, exhibiting repetitive ventricular ectopic activity, died, in contrast to 10 in the second group, this is not of statistical significance. The coupling intervals between preceding normal sinus beats and beats which led to repetitive ventricular discharge were clustered between the shortest and the longest coupling intervals which did not lead to salvoes and tachycardia.

Adult↗

PubMed1982

The effect of indomethacin on para-articular ectopic ossification following total hip arthroplasty.

Three patients exhibiting Grade III para-articular ectopic ossification following bilateral hip arthroplasty were successfully treated by excision of the bone and small-dose, short-term indomethacin therapy. Based on these results, a preliminary study was performed to determine the effect of indomethacin used prophylactically in patients who were predisposed to ectopic ossification and were undergoing total hip arthroplasty. Of a retrospective control group of 24 hips with extensive bilateral osteoarthritis, 63% were found to develop ectopic ossification following arthroplasty compared to 17% of a similar group treated with indomethacin (p less than 0.001). The ectopic ossification in the indomethacin-treated group possibly was of lesser severity (Grade I) than that encountered in the control group.

Adult↗

PubMed1983

Transplantation of cricket sensory neurons to ectopic locations: arborizations and synaptic connections.

The cerci (abdominal sensory appendages) of crickets were transplanted to a leg stump after amputating the leg. Single identifiable cercal afferents were stained and found to regenerate into the host thoracic ganglia. A given neuron always arborizes in the same area of neuropil of the foreign ganglion and is distinctive in this property from other identified neurons. Taken as a whole, the results show that the afferents from the ectopic cercus are spatially ordered, the destination of a particular afferent within the ganglion being correlated with the location of its sensory cell body on the cercal surface. This is the case for the pro-, meso-, and metathoracic ganglion and the topography of these ectopic projections bears some resemblance to the normal projections found in the terminal ganglion. Thus the insect segmental ganglion seems to possess a set of markers which are interpretable by all afferent neurons, and this organization is repeated in each ganglion. The ectopic afferents make functional synaptic connections with intersegmental interneurons, one of which is described anatomically here. However, the ectopic afferents do not, as had previously been reported, make functional connections with the medial giant or lateral giant interneuron (the normal targets of cercal sensory neurons in the terminal ganglion).

Animals↗