The role of psychophysiological factors in disorders of oesophageal function.
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The innervation of the human spleen was investigated by the fluorescence method for adrenergic nerve fibers (52 cases) and the enzyme histochemical method for cholinergic nerve fibers (27 cases). The spleens examined were removed by laparotomy chiefly for gastric cancer. Adrenergic nerve fibers were demonstrated at the medioadventitial junction and the media in the trabecular arteries, whereas they occurred at the medioadventitial junction in the central and penicillar arteries. They were not found in the trabecular and pulp veins and venules, sheathed capillaries, avascular trabeculae, white and red pulp, and capsule. Nerves containing only a few adrenergic fibers and nerves without adrenergic fibers occurred close to the trabecular arteries. It was also demonstrated that nerves close to the trabecular arteries contain cholinergic fibers. The present study first verifies histochemically that the human spleen is innervated doubly by adrenergic and cholinergic nerve fibers.
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Using the Acetylcholinesterase (AChE) tecnique applied to light and electron microscopy, was observed that the lymph vascular wall shows very few and inconstant AChE-positive fibers. The cholinergic fibers run prevalently longitudinal in the perivascular connective tissue, only brief segments show a loose network. The results are discussed and compared with blood vessels innervation.
A 9-year-old boy presented with symptoms and signs of marked postganglionic cholinergic autonomic dysfunction manifested by bilateral internal ophthalmoplegia, impaired secretion of tears and saliva, lack of gastrointestinal motility, atony of the bladder, generalized absence of sweating, and hypertension. Clinical and pharmacological studies confirmed that the abnormalities were restricted mainly to the postganglionic cholinergic autonomic system and showed evidence of postdenervation supersensitivity to parasympathomimetic drugs. The patient was treated in the early phase of his illness by the administration of carbachol, and eventually he made a slow and partial spontaneous recovery. Histoimmunofluorescent studies on a skin biopsy specimen suggested an autoimmune origin for his disease, with IgG antibodies being produced against postganglionic cholinergic autonomic fibers.
The autonomic innervation of the rat ventral prostate was studied in an attempt to evaluate the role of innervation in the normal function of the gland. Specific histochemical methods for both catecholamines (the formaldehyde-induced fluorescence method, FIF) and acetylcholinesterases (the Gomori-Koelle thiocholine method) were used. The neuro-effector contacts were studied by electron microscopy using both 3% glutaraldehyde and 3% potassium permanganate (KMnO4) as fixatives. It was found that the rat ventral prostate receives dual autonomic innervation. Adrenergic fibers, which formed the majority of the nerves, were often seen in close contact with the smooth muscle cells around both the prostatic alveoli and secretory ducts. The non-adrenergic nerve fibers, which were fewer in number, did not form such intimate contacts with the muscle cells. No direct synapses with epithelial cells were detected.
Pineal glands were grafted under the kidney capsule of mature male rats for periods of 20, 40, 60 and 100 days. Each grafted gland was then excised and divided into two halves. One half was processed for conventional electron microscopy and the other was fixed in aldehydes and then incubated in a zinc-iodide-osmium tetroxide mixture at pH 4.4 (A-ZIO-4.4). During the forty days following the operation pinealocytes showed the typical ultrastructural features associated with cells with a high protein and/or peptide secretory activity. On the other hand, during this period, the number of granular vesicles decreased progressively. From day 40 on, the grafted pinealocytes lacked granular vesicles. During the second half of the experimental period the ultrastructure of the pinealocytes indicated that their secretory activity was considerably decreased. During the acute phase of the experimental period numerous structures regarded as the tip of growing axons as well as typical nerve fibres appeared around blood vessels and within the paren chyma of the grafted gland. In the transplanted tissue obtained 60 and 100 days after the operation the growth cones were scarce, whereas typical nerve endings became numerous. These endings contained small clear vesicles which reacted positively when the tissue was treated with A-ZIO-4.4. The secretory activity of the grafted pineal gland and the nature of the nerve fibres which innervate the graft are discussed.
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Compound 48/80 and polymyxin B elicited prompt and sharp increases in histamine output from the isolated guinea pig heart and had no effect on norepinephrine output. Dextran decreased histamine output without affecting norepinephrine output. Bradykinin increased both histamine and norepinephrine output; the histamine output increased only after a latent period. Stimulation of both left and right stellate ganglia increased norepinephrine output, but only right ganglion stimulation increased histamine output, after a latency. Stimulation of the right but not the left vagus nerve decreased histamine output first, then increased it moderately, the peak of which came later than norepinephrine release. It was suggested that histamine release following nerve stimulation and bradykinin was secondary to norepinephrine release. Isoniazid decreased the output of both histamine and norepinephrine. Aminoguanidine increased histamine output but decreased norepinephrine output.
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Historical developments concerning salivary myoepithelial cells have been outlined and structural features of the cells have been described. Evidence from structural and functional studies supports the belief that myoepithelial cells usually have a dual innervation by parasympathetic as well as sympathetic nerves, and impulses from both types of nerve cause the cells to contract. Functional assessment using salivary flow phenomena and intraluminal pressure changes have been used to determine, so far as is possible, the effects of myoepithelial contractions. In some instances tissues have been examined structurally after such experimental procedures. These investigations indicate that salivary myoepithelial activity 1. Speeds up the outflow of saliva 2. Reduces luminal volume 3. Contributes to the secretory pressure 4. Supports the underlying parenchyma 5. Helps salivary flow to overcome increases in peripheral resistance. However, beyond a certain point, this may lead to sialectatic damage of striated ducts with increase in glandular permeability. Myoepithelial activity may also help to expel parenchymal cell contents in certain instances.
Mechanisms of possible pathophysiological importance in primary dysmenorrhea are discussed. Hyperactivity of the myometrium with accompanying uterine ischemia is considered to be of central importance in the causation of pain. Prostaglandins seem to be involved to a large extent in the development of the myometrial hyperactivity. Other mechanisms of possible importance such as ovarian hormones, cervical factors, vasopressin, nerves, and psychological factors can well act ultimately through prostaglandin release but an action directly on the myometrium and blood flow may also occur.
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