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M C DeRuiter

Publications and source records attributed to M C DeRuiter.

30 records · Page 2Linked to original sources
PubMed1996

Anatomical basis of autonomic nerve-preserving total mesorectal excision for rectal cancer.

Total mesorectal excision with autonomic nerve preservation for rectal cancer is based on the anatomy of the mesorectum and of the pelvic autonomic nerves. Cadaver dissections were performed to describe the relationship between these structures. Between the rectum and the sacrum a retrorectal space can be developed, lined anteriorly by the visceral leaf and posteriorly by the parietal leaf of the pelvic fascia. The hypogastric nerve runs anterior to the visceral fascia, from the sacral promontory in a laterocaudad direction. The splanchnic sacral nerves originate from the sacral foramina, posterior to the parietal fascia, and run caudad, laterally and anteriorly. After piercing the parietal layer of the pelvic fascia, approximately 4 cm from the midline, the sacral nerves run between a double layer of the visceral part of the pelvic fascia. The relationship between the hypogastric nerves, the splanchnic nerves and the pelvic fascia was comparable in all six specimens examined.

Autonomic Nervous System↗
PubMed1996

Onset of elastogenesis and downregulation of smooth muscle actin as distinguishing phenomena in artery differentiation in the chick embryo.

During development, the arterial system is grossly divided into elastic and muscular vessel types. Apart from local environmental factors, it has been suggested that vascular smooth muscle cell origin (mesoderm or neural crest) is involved in this, as yet poorly understood, arterial differentiation. We describe differentiation of the thoracic arterial system in the chick embryo, using immunohistochemical techniques staining for muscle-specific actin, vinculin and desmin and histological staining to visualise elastin. The initial developmental stages of the vessel wall in all arteries appeared to be highly similar, with all arteries showing peri-endothelial actin and vinculin staining. Major alterations did not occur until the start of elastogenesis, which coincided with complete loss of actin staining from the proximal part of the great arteries. Later in development, however, actin was re-expressed in a subpopulation of medial cells, which also expressed vinculin and desmin. Concomitantly another, nonmuscular, cell type became evident in the great arteries. Transient loss of actin expression and segregation of very distinct cell populations occurred only in vessels prone to elastic development and known to receive a neural crest contribution. In contrast, arteries that developed a muscular phenotype never lost the initially acquired peri-endothelial actin expression. We also show a significant difference in the organisation of elastic fibres between elastic vessels that contain neural crest derivatives and those that do not. The ductus arteriosus still presents as an enigma in the sense that it is the only part of the pharyngeal arch complex that develops a muscular phenotype.

Actins↗
PubMed1995

In normal development pulmonary veins are connected to the sinus venosus segment in the left atrium.

BACKGROUND: Classic theories describe that the common pulmonary vein develops as an outgrowth from either the sinus venosus or atrial segment. Recent studies show that the pulmonary veins are connected to the sinu-atrial region before its differentiation into a sinus venosus and atrial segment. METHODS: The development of the sinu-atrial region with regard to the developing common pulmonary vein and the growth of the atrial septum was investigated in avian embryos, using both scanning electron microscopy and immunohistochemistry. Embryos ranging between stage HH12 and HH28 were incubated with QH-1 that recognizes quail endothelial cells and precursors, HNK-1, that appears in this study to detect the myocardium of the sinus venosus, or with HHF-35, being specific for muscle actins. Also vascular casts of the heart were produced by injecting prepolymerized Mercox into the vascular system. RESULTS: In preseptation stages the common pulmonary vein drains into the left part of the sinus venosus, that is clearly demarcated by the sinu-atrial fold and HNK-1 expression. During atrial septation the left part of the sinus venosus, in contrast to the right part, loses its HNK-1 antigen from stage HH23 onwards, while at the same time the sinu-atrial fold in the left atrial dorsal wall flattens and disappears. From stage HH25 onwards HNK-1 expression is restricted to the right part of the sinus venosus, which contributes to the right atrium. The myocardial atrial septum never expresses the HNK-1 antigen, suggesting that the septum is of atrial origin. DISCUSSION: It appeared that the sinus venosus does not only contribute to the sinus venarum of the right atrium, but also to the left atrium.

Animals↗
PubMed1995

Intracardiac blood flow patterns related to the yolk sac circulation of the chick embryo.

Intracardiac flow patterns during heart development were studied by injection of india ink into the yolk sac circulation of chick embryos at Hamburger-Hamilton stages 10 to 17. We injected india ink into a small venule or capillary, carefully preventing application of overpressure to the vascular system, and recorded the intracardiac route by video. From stage 12 onward, blood flow was laminar, and separate intracardiac currents were visualized. The yolk sac was divided into a left and a right half. Blood coursed through each half in concentric loops, ranging from the marginal sinus to the sinus venosus. This parallel array persisted within the heart. Bilateral to the embryo, two lateral regions arose that extended wedge-like within each half, resulting in six equally sized yolk sac regions at stage 16. The process of heart looping was not accompanied by a change in flow pattern. However, developmental changes of the yolk sac circulation were reflected in alteration of the intracardiac flow pattern. From stage 16 onward, the intracardiac flow pattern was no longer determined by the left- or right-hand side of the yolk sac but by bilateral anterior, lateral, and posterior regions of the yolk sac. Blood from the lateral regions of the yolk sac was preferentially distributed to the head. The results show that in preseptation stages a relatively stable flow pattern is present. We suggest that alterations in blood flow could influence the process of normal heart development.

Animals↗
PubMed1994

The restricted surgical relevance of morphologic criteria to classify systemic-pulmonary collateral arteries in pulmonary atresia with ventricular septal defect.

Now that systemic-pulmonary collateral arteries are used for unifocalization in patients with pulmonary atresia and ventricular septal defect, the question arises whether morphologic criteria of these collateral arteries could help to provide better results. In an attempt to classify the morphologic features of systemic-pulmonary collateral arteries, we studied 31 heart-lung autopsy specimens with pulmonary atresia and ventricular septal defect. The course of the systemic-pulmonary collateral arteries (origin, branching pattern, and connections with systemic and central pulmonary arteries) was related to their histologic characteristics. The results show that systemic-pulmonary collateral arteries cannot be classified according to their course related to the trachea and the main branches of the bronchi. The histologic features of these collateral arteries vary along their course to the lungs. Nearly all systemic-pulmonary collateral arteries contain a muscular or a musculoelastic segment. One type of collateral artery (complex loop anastomoses) is completely muscular and resembles a bronchial artery. Nutritive branches (bronchial arteries) arise from all histologic types of systemic-pulmonary collateral artery segments. The size and number of intimal proliferations in muscular, elastic, and musculoelastic segments did not differ significantly. In 29 of 31 cases a ductus arteriosus did not coexist with large collateral arteries (two cases unknown). It is concluded that a classification of large systemic-pulmonary collateral arteries based on morphologic features results in a highly variable system, which does not facilitate decisions for the suitability of these arteries for unifocalization procedures. The variability of the systemic-pulmonary collateral arteries corresponds with the recent embryologic finding that during development, collateral artery formation is possible during extended periods.

Adolescent↗
PubMed1993

Early formation of the vascular system in quail embryos.

The relation between vascular development and translocation of the splanchnic mesodermal layers was studied in presomite to 20-somite quail embryos by scanning electron microscopy. In addition, serially sectioned embryos were stained immunohistochemically with monoclonal antibodies (alpha QH1 or alpha MB1) specific for endothelial and hemopoietic cells. By the formation of the foregut the anterior borders of the two splanchnic mesodermal layers of a presomite embryo are translocated to the lateral and ventral sides of the foregut and fuse in the ventral midline of a 4-somite embryo. Meanwhile the splanchnic mesoderm differentiates into a splanchnic mesothelial layer and a plexus of endothelial cells, facing the endoderm. From 4 somites onward the foregut is covered by a single endothelial plexus. At first the endothelial precursors bordering the anterior intestinal portal and those in the area of the ventral mesocardium lumenize, subsequently giving rise to the endocardium of the heart tube. Hereafter, the pharyngeal arch arteries and the dorsal aortae develop from the remaining precursors. During formation of the pharyngeal arches, the pharyngeal arch arteries maintain their connections with the splanchnic plexus through the developing ventral pharyngeal veins. After disappearance of the dorsal mesocardium, the midpharyngeal endothelial strand, which is a longitudinal strand of proendocardial cells, remains connected to the foregut. This strand will contribute to the formation of the pulmonary venous drainage into the left atrium. A bilateral accumulation of cardiac jelly developing between the promyocardium and proendocardial plexus only suggests that the heart develops from two tubes. The proendocardial layer, however, is not divided by the ventral mesocardium but initially forms just one endocardial heart tube.

Animals↗
PubMed1993

Development of the pharyngeal arch system related to the pulmonary and bronchial vessels in the avian embryo. With a concept on systemic-pulmonary collateral artery formation.

BACKGROUND: The literature is ambiguous as to the question of the developmental background of systemic-pulmonary collateral arteries. These are found in combination with various congenital heart malformations such as pulmonary atresia. From a clinical point of view, it is of interest to know whether we are dealing with the persistence of transient embryological vessels such as ventral segmental arteries or parts of pharyngeal arch arteries or with the prenatal or postnatal recruitment of the bronchial vasculature that normally supplies the lung. This study of the embryology of the extrapulmonary and intrapulmonary vasculature aims at a better understanding of the variations in origin, course, branching pattern, and histology of collateral arteries. METHODS AND RESULTS: Serial sections of quail embryos ranging between stage HH11 and stage HH28 were incubated with a monoclonal antibody (alpha MB1) against endothelial cells and their precursors. Additional series of chick embryos were injected with india ink to study the lumenized vascular patterns. A splanchnic plexus consisting of endothelial cells and precursors is present around the foregut before the lung buds develop. This plexus expands and gives rise to the pharyngeal arch arteries, the ventral pharyngeal veins, the pulmonary vessels, and the bronchial vessels, including the intrapulmonary vessel network. During two subsequent periods, the splanchnic plexus is transiently connected to the systemic arteries and veins. The bronchial arteries and veins develop in the second period from these transient vessels. The expansion and extension of the splanchnic plexus to many organs during the formation of the bronchial vessels explains the varying course and branching pattern of the bronchial vasculature. CONCLUSIONS: These results show that we are not dealing with two or more individual vascular systems that contribute to the developing vessels of the lungs but with one vascular plexus that normally gives rise to the pulmonary and bronchial vasculature but has the potential to give rise to other systemic-pulmonary connections.

Animals↗
PubMed1992

The development of the myocardium and endocardium in mouse embryos. Fusion of two heart tubes?

The formation of the single heart tube by hypothetical fusion of two separately developed heart tubes is re-investigated, because this intricate process is ambiguously and often incompletely described. To gain a better insight into this problem ten mouse embryos ranging from 7.5 to 8.5 days of development (presomite to 6 somites) were serially sectioned (1 micron) and reconstructed graphically. Twenty mouse embryos of comparative ages, were studied by scanning electron microscopy. Two large embryonic mesodermal compartments, derived from the primitive streak, extend rostrally on either side of the embryonic axis, and meet in front of the buccopharyngeal membrane. In each compartment a coelomic cavity develops, splitting the mesoderm into a splanchnic and somatic layer. The splanchnic mesoderm differentiates into a layer of cuboidal splanchnic mesothelial cells (promyocardium) and a subjacent plexus of elongated endothelial cells (proendocardium). Before the 1-somite stage the left and right splanchnic mesoderm are separated in front of the buccopharyngeal membrane by a thickening of the yolk sac endoderm. The splanchnic mesoderm then fuses, forming a single horseshoe-shaped heart primordium consisting of a promyocardial layer and a subjacent vascular plexus. Until the 2-somite stage both coelomic cavities remain separated by a bilayer of squamous somatic mesothelial cells ('mesocardium'). The plexus of endothelial cells that forms the proendocardium, also seems to be the source of the lining of the vitelline veins, the pharyngeal arch arteries and the dorsal aortae. The relatively close adherence of endoderm to the medial part of the horseshoe-shaped heart primordium, combined with a bilateral accumulation of cardiac jelly, is suggestive of a double heart tube. However, promyocardium and proendocardium are both translocated as one horseshoe-shaped layer, thus fusion of the left and right parts of the heart primordium does not occur.

Animals↗
PubMed1991

The development of the vascular system in quail embryos: a combination of microvascular corrosion casts and immunohistochemical identification.

Although vascular casts, obtained by injection with methacrylates, are frequently used to investigate the adult vascular system, little data are available for embryonic stages. In this paper we use Mercox in quail embryos in the period of 2 to 7 days after incubation. The microvascular corrosion casts were evaluated in the scanning electron microscope (SEM) with special attention to the development and remodelling of the large arteries and veins. Our results show that the remodelling of the large arteries and veins together with their developing tributary vessels can be visualized from very early embryonic stages onwards. However, complete replication of a developing vascular system depends on diameter and regularity of the lumen. In the stages investigated, the vascular lumen, even of the largest vessels, is still very irregular. Detailed cellular characteristics like nuclear impressions of endothelial cells, as often seen in adult material, were seldom found in the embryos. To examine whether blind-ending sprouts are completely or incompletely replicated in a developing vascular system, additional series of quail embryos were stained immunohistochemically with a monoclonal antibody (MB1) specific for endothelial and hemopoietic cells. It seems that a plexus consisting of endothelial precursors (endothelial cells lacking a lumen) is present in the developing organ before the formation of a lumen and assembly into vessels, which are connected to an adjacent artery or vein. Expansion of the vascular system may in part be due to incorporation of these endothelial precursors in the wall of existing vessels.

Animals↗
PubMedDate not supplied

Avoiding long-term disturbance to bladder and sexual function in pelvic surgery, particularly with rectal cancer.

Urinary and sexual dysfunction are common problems after rectal cancer surgery, and the likely cause is damage to the pelvic autonomic nerves during surgery. In recent years, attention has been focused on preserving the autonomic nerves through a technique which is usually combined with total mesorectal excision or radical pelvic lymphadenectomy. The autonomic nerves consist of the paired sympathetic hypogastric nerve, sacral splanchnic nerves, and the pelvic autonomic nerve plexus. We will demonstrate the anatomy of the pelvic autonomic nerves and the relation of these nerves to the mesorectal fascial planes, and review the medical literature on sexual and urinary dysfunction after rectal cancer surgery with and without autonomic nerve preservation.

Autonomic Nervous System↗
PubMedDate not supplied

Morphogenetic differences of secundum atrial septal defects.

It is generally considered that the development of secundum atrial septal defect (ASDII) or oval fossa defect is the result of excessive resorption of the embryological atrial septum primum, but this does not seem to explain all defects. We investigated 58 postmortem hearts with an ASDII and 22 normal hearts from patients ranging in age from 1 day to 49 years. The different structures of the oval fossa were examined. In 86% of the specimens, the defects were the result of a malformation of the valvula foraminis ovalis or embryological atrial septum primum, and in 14% an absent superior limbus (septum secundum) was the cause of the interatrial communication. The "septum primum" ASDs were divided into four subgroups based on the degree of deficiency of the septum primum and position of the ostium secundum within the septum primum. We conclude that the morphogenesis of ASDII is variable and both septum primum and septum secundum defects occur, which may be relevant in view of genetic studies that may lead to further differentiation of patients with and without genetically determined ASDIIs.

Adolescent↗