Profuse Blood Supply Research Articles

Vascular Supply of the Cerebral Cortex is Specialized for Cell Layers but Not Columns

The vascular supply to layers and columns was compared in macaque primary visual cortex (V1) by labeling red blood cells via their endogenous peroxidase activity. Alternate sections were processed for cytochrome oxidase to reveal "patches" or "blobs," which anchor the interdigitated column systems of striate cortex. More densely populated cell layers received the most profuse blood supply. In the superficial layers the blood supply was organized into microvascular lobules, consisting of a central venule surrounded by arterioles. Each vessel was identified as an arteriole or venule by matching it with the penetration site where it entered the cortex from a parent arteriole or venule in the pial circulation. Although microvascular lobules and cytochrome oxidase patches had a similar periodicity, they bore no mutual relationship. The size and density of penetrating arterioles and venules did not differ between patches and interpatches. The red blood cell labeling in patches and interpatches was equal. Moreover, patches and interpatches were supplied by an anastomotic pial arteriole system, with no segregation of blood supply to the two compartments. Often a focal constriction was present at the origin of pial arterial branches, indicating that local control of cortical perfusion may be accomplished by vascular sphincters.

Incomplete Superficial Palmar Arch – Clinical Significance

The hands receive profuse blood supply by superficial and deep palmar arches (SPA & DPA), though both arches are constituted by radial and ulnar arteries, variations are constantly observed in SPA. During routine dissections we observed unilateral incomplete SPA being formed by superficial branches of radial and ulnar arteries in the right hand of an old male cadaver. These two arteries remained independent without anastomosis forming incomplete arch. The superficial branch of radial artery supplied the thumb and radial side of index finger by its two branches - the arteriaprincepspollicis and arteriaradialisindicis. Normally these two branches are given by radial artery but here they are given by a branch of radial artery. The presence of an incomplete SPA as in this case is a potential danger in RA harvesting for CABG. Variations in the SPA play a key role in microvascular surgical procedures of hand, RA interventions and arterial graft applications.

Bilateral sciatica secondary to mass lesions in the gluteal muscles

The MRI revealed well-demarcated solid masses in the left gluteal muscles and the right piriformis muscle showing significant contrast enhancement. Both sciatic nerves were surrounded by the tumor masses, their fibers being thickened with no enhancement with contrast medium (black arrows in Fig.1 in ‘‘Question”). Multicentric intramuscular mass lesions suggest metastasis, leukemia, lymphoma, and sarcoidosis. When patients have a history of cancer, metastasis is supported by clinical and radiological findings. The diagnosis was confirmed via needle biopsy. Although skeletal muscles comprise nearly 50% of the total body mass and have a profuse blood supply, metastatic involvement is quite rare, which is unexplained. It may be related to contractile activity, high tissue pressure, the accumulation of lactic acid, local changes in pH, or oxygenation. The frequency of muscle metastases is reported as 0.8% to 16% in necropsy studies, lung carcinomas being the most usual source. The most commonly involved muscles

Endometriosis: an immune condition resembling Crohn’s disease?

1.1. Anorectal disease in pregnancy is both directly and indirectly affected by specific anopelvirectal changes of pregnancy prenatally, with delivery and with changes of involution postpartum.2.2. The relationship of the anorectum and the pelvirectum is shown both anatomically and physiologically to the pelvis and genital organs in the non-pregnant state, during pregnancy and postpartum. This particularly relates to knowledge gained recently of their levator ani components from the levator ani structurely and functionally, and particularly relates to the profuseness of blood supply to the anopelvirectum with its profuse collateral blood supply throughout the pelvis.3.3. It has been shown that the work of Courtney on the anatomy of the pelvic diaphragm and anorectal musculature, now applied both anatomically and physiologically, demonstrates that the anorectum cannot be considered as an organ distinctly anorectal, but should be considered as an organ both pelvirectal as well as anorectal and as part of the levator ani. The levator ani assumes a vital part in the act of defecation as well as of childbirth which is anopelvirectal. Here pelvirectally is the area where a profuse blood supply to the rectum occurs.4.4. Specific anorectal and pelvirectal changes in pregnancy are outlined.5.5. Accompanying mechanical, hormonal and secretory changes affecting the gastrointestinal tract and directly or indirectly affecting specific anopelvirectal changes are outlined.6.6. Hemorrhoids and pruritus of anorectal and perigenital type have a high incidence during pregnancy. Other anorectal diseases have a low incidence.7.7. A new concept of the etiology of hemorrhoids and a new classification thereof is given. This is based on our knowledge of the profuse collateral blood supply in the pelvis to the ano rectum and pelvirectum and is also based on known accepted facts of the etiology and classification of varicose veins elsewhere than the anorectum.8.8. Anorectal disease in pregnancy, other than cancer, ulcerative colitis and postpartum communicating fistulas, such as rectovaginal fistula, are discussed in detail and new concepts of their presence or absence in pregnancy and their management as related to pregnancy changes, and to the pregnancy itself, are considered in each instance.

Gastric wall abscess presenting as a submucosal tumor: Case report

Suppurative gastritis is a rare disorder; about 500 cases have been reported, the majority during the preantibiotic era. 1 Iwakiri Y Kabemura T Yasuda D Okabe H Soejima A Miyagahara T et al. A case of acute phlegmonous gastritis successfully treated with antibiotics. J Clin Gastroenterol. 1999; 28: 175-177 Crossref PubMed Scopus (45) Google Scholar The rarity of suppurative gastritis is thought to be caused by the profuse blood supply to the stomach and the bactericidal effect of gastric acid. 2 Farman J Dallmand S Rosen Y. Gastric abscess, a complication of pancreatitis. Am J Dig Dis. 1974; 19: 751-758 Crossref PubMed Scopus (9) Google Scholar Pathogenic mechanisms include direct invasion by microorganisms and hematogenous spread from a distant source. The mortality rate ranges from 92% to 37%, specific symptoms are lacking in most cases, and the diagnosis is frequently delayed until laparotomy. 1 Iwakiri Y Kabemura T Yasuda D Okabe H Soejima A Miyagahara T et al. A case of acute phlegmonous gastritis successfully treated with antibiotics. J Clin Gastroenterol. 1999; 28: 175-177 Crossref PubMed Scopus (45) Google Scholar , 3 Seidel RH Burdick JS. Gastric leiomyosarcoma presenting as a gastric wall abscess. Am J Gastroenterol. 1998; 93: 2241-2244 Crossref PubMed Google Scholar According to the extent of the disorder, suppurative gastritis is classified into diffuse and localized types. The diffuse or phlegmonous type is more common and involves the entire stomach with inflammation spreading to all layers from the submucosa. Emphysematous gastritis is a subtype of phlegmonous gastritis and may be caused by gas-forming organisms. The localized, or wall abscess, type occurs less commonly and frequently involves the antrum or pylorus. 4 Murphy JF Graham DY Frankel NB Spjut H. Intramural gastric abscess. Am J Surg. 1976; 131: 618-621 Abstract Full Text PDF PubMed Scopus (22) Google Scholar Because the mucosa appears intact in most cases of gastric wall abscess, it is necessary to differentiate this lesion from other submucosal lesions including tumors. 5 Will U Masri R Bosseckert H Knopke A Schonlebe J Justus J. Gastric wall abscess, a rare endosonographic differential diagnosis of intramural tumors: successful endoscopic treatment. Endoscopy. 1998; 30: 432-435 Crossref PubMed Scopus (25) Google Scholar

Intestinal Anastomosis

Primary healing by accurate apposition is considered the ideal for epithelial wounds, and intestinal anastomoses should be no different. However, most anastomotic techniques do not aspire to accurate realignment and consequently depend on secondary healing. Most intestinal anastomoses heal uneventfully because of the relatively profuse blood supply of the bowel and the fact that the process of healing is hidden within the abdomen. Intestinal anastomoses heal in a series of overlapping phases: • lag phase (days 0–4), in which the acute inflammatory response clears the wound of debris • phase of fibroplasia (days 3–14), in which fibroblasts proliferate and immature collagen is laid down • maturation phase (day 10 onwards), in which collagen remodels. Intestinal anastomoses have little intrinsic resistance to distension and longitudinal distraction is weak until collagen deposition is established. Extrinsic support is required during the lag phase to maintain tissue continuity. The surgeon's role is to provide support (usually by inserting sutures or staples), and to ensure optimal conditions for subsequent healing. Although anastomotic technique is the single most important determinant of outcome, a number of other factors affect healing (Figure 1); if these combine to make the risk of anastomotic failure high, the wisdom of performing an anastomosis should be questioned.

Involvement of Pineal Indoles and Polypeptides with the Neuroendocrine Axis

This chapter discusses the involvement of pineal indoles and polypeptides with the neuroendocrine axis. The number of endocrine organs that the pineal gland influences is truly remarkable. Most, if not all, of the hormones derived from the anterior pituitary gland are modulated by pineal secretions. Furthermore, many of the extra-pituitary regulated endocrine glands are also under control of this multipotent epithalamic structure. Because of its profuse blood supply, several investigators predicted an endocrine role for the pineal gland at a time during which it was unpopular to do so. The question of the specific pineal substance(s) responsible for the gonad-regulating capability of the pineal obviously remains unanswered. The indoles may act on the brain where they modify monoamine or catecholamine metabolism while the polypeptides may act on the anterior pituitary in a manner similar to the action of other polypeptides, the hypothalamic releasing factors.

A CASE OF CYSTADENOMA OF THE PANCREAS STUDIED BY SELECTIVE ANGIOGRAPHY.

Currently there is considerable interest in the specific use and value of angiography. At The New York Hospital it is used extensively since it provides diagnostic information which cannot be otherwise obtained and gives accurate and specific information for the surgeon. Recently the opportunity arose to study a patient with a large abdominal tumor which was found to be a cystadenoma of the pancreas. The pancreatic arteriogram aided the surgeon in defining the pathologic anatomy and thus helped to make its removal possible. Since cystadenoma of the pancreas is a rare tumor and the study was of such value in the management of this patient, the case report is being presented. A review of the literature reveals approximately 50 to 75 reported cases of cystadenoma of the pancreas (1, 9, 11). The tumor occurs predominantly in the female, with 66 per cent presenting before the age of fifty. The most common site is the body and tail of the pancreas (4, 5). The onset is usually insidious, and the growth may reach an enormous size. These tumors have a profuse blood supply (2) and may contain calcification either in the capsule or in the vascular stroma (1, 6, 7). Brunschwig (3) noted that in the past, because of their vascular nature, some of these tumors had been confused with angiosarcoma of the pancreas. Cystadenoma, therefore, lends itself very nicely to pancreatic arteriography. Case Report The patient was a 75-year-old white male who presented with gradual enlargement of the abdomen. There was a long history of ulcer disease, and he stated that in 1945, at the time of a gastroenterostomy, biopsy of a mass resulted in considerable bleeding. Unfortunately, these records are not available. Four years prior to the present admission he was admitted for intestinal bleeding, and a mass was clinically palpable. Since that time the growth progressively enlarged. No jaundice was observed. On the present admission there was a large mass on the right side of the epigastrium with transmitted pulsation. A systolic bruit was easily audible. The mass had ill-defined borders, was nontender, and extended 10 to 12 cm. below the right costal margin. Laboratory findings revealed normal serum amylase, bilirubin, proteins, and blood urea nitrogen. The fasting blood sugar was slightly elevated, as was the serum lipase. The intravenous cholangiogram showed a normal but markedly displaced common duct. A selective celiac and superior mesenteric arteriogram was obtained since it was thought to be of most value in this case Two yellow Ödman catheters were placed, one in the celiac axis and the other in the superior mesenteric artery, following percutaneous puncture of both femoral arteries via the Seldinger technic (10). Because of the distortion of the celiac axis it was not possible to maintain the catheter position during the entire study. The pancreatic arteriogram can be seen in Figures 1–2; 4–5.

Anorectal complications of pregnancy: Anatomic and physiologic changes of the anorectum and pelvirectum during pregnancy

1. 1. Anorectal disease in pregnancy is both directly and indirectly affected by specific anopelvirectal changes of pregnancy prenatally, with delivery and with changes of involution postpartum. 2. 2. The relationship of the anorectum and the pelvirectum is shown both anatomically and physiologically to the pelvis and genital organs in the non-pregnant state, during pregnancy and postpartum. This particularly relates to knowledge gained recently of their levator ani components from the levator ani structurely and functionally, and particularly relates to the profuseness of blood supply to the anopelvirectum with its profuse collateral blood supply throughout the pelvis. 3. 3. It has been shown that the work of Courtney on the anatomy of the pelvic diaphragm and anorectal musculature, now applied both anatomically and physiologically, demonstrates that the anorectum cannot be considered as an organ distinctly anorectal, but should be considered as an organ both pelvirectal as well as anorectal and as part of the levator ani. The levator ani assumes a vital part in the act of defecation as well as of childbirth which is anopelvirectal. Here pelvirectally is the area where a profuse blood supply to the rectum occurs. 4. 4. Specific anorectal and pelvirectal changes in pregnancy are outlined. 5. 5. Accompanying mechanical, hormonal and secretory changes affecting the gastrointestinal tract and directly or indirectly affecting specific anopelvirectal changes are outlined. 6. 6. Hemorrhoids and pruritus of anorectal and perigenital type have a high incidence during pregnancy. Other anorectal diseases have a low incidence. 7. 7. A new concept of the etiology of hemorrhoids and a new classification thereof is given. This is based on our knowledge of the profuse collateral blood supply in the pelvis to the ano rectum and pelvirectum and is also based on known accepted facts of the etiology and classification of varicose veins elsewhere than the anorectum. 8. 8. Anorectal disease in pregnancy, other than cancer, ulcerative colitis and postpartum communicating fistulas, such as rectovaginal fistula, are discussed in detail and new concepts of their presence or absence in pregnancy and their management as related to pregnancy changes, and to the pregnancy itself, are considered in each instance.