A macroanatomical and histological study of the uropygial gland in the white stork (Ciconia cicionia) / Un estudio macroanatómico e histológicos de la glándula uropigial de la cigüeña blanca (Ciconia cicionia)

The present study was aimed at the macroanatomical and histological investigation and the demonstration of the structural characteristics of the uropygial gland in the white stork. The uropygial gland of two adult male white storks constituted the material of the study. It was determined that the gland was situated subcutaneously in between the caudal aspect of the lumbosacral bone and the first coccygeal vertebrae. The gland was composed of two lobes, which displayed an oval appearance when viewed from above and resembled a water drop when observed medially. Tuft of feathers were present on the caudal margin of each lobe. The present study revealed that the uropygial gland of the white stork is a simple tubular gland, which discharges its secretion into the lumen by a holocrine mode. Each lobe, possessed centrally located large cavities and a main excretory duct and displayed the presence of externally situated "peripheral tubules" and interiorly situated "central tubules". These secretory tubules, which composed the parenchyma, were separated by connective tissue septa referred to as "trabeculae", and released their secretion into a centrally located lumen. The wall of the secretory tubules was comprised of four layers, referred to as the germinative, intermediary, secretory and degenerative layers. The silver-staining procedure demonstrated that the stroma of the uropygial gland did not contain reticulum fibres. The anatomy and histology of the gland has been examined in few avian species. Up to date, this study is the first to describe the histological and anatomical peculiarities of the uropygial gland in white stork. The results acquired hereby will surely contribute to further studies to be conducted on the related area.

El estudio tuvo como objetivo la investigación anatómica e histológica de la glándula uropigial de la cigüeña blanca, junto con demostrar las características estructurales de ella. El material del estudio estuvo constituido por glándula uropigial de dos cigüeñas blancas adultas macho. Se determinó que la glándula se encuentra vía subcutánea entre la parte caudal del hueso lumbosacro y las primeras vértebras coccígeas. La glándula se compone de dos lóbulos que muestran un aspecto ovalado, vista desde arriba y se asemejan a una gota de agua cuando se observa en sentido medial. Un penacho de plumas estaba presente en el margen caudal de cada lóbulo. El presente estudio reveló que la glándula uropigial de la cigüeña blanca es una glándula tubular simple, que descarga su secreción al lumen de un modo holocrino. Cada lóbulo posee una gran cavidad de ubicación céntrica y un conducto excretor principal, además muestra la presencia de "túbulos periféricos" situados exteriormente y "túbulos centrales "situados interiormente. Estos túbulos secretores que componen el parénquima, estaban separados por tabiques de tejido conectivo denominado "trabéculas", y liberan su secreción en una luz central. La pared de los túbulos secretores se componen de cuatro capas: germinativa, intermedia, secretora y degenerativa. La tinción de plata demostró que el estroma de la glándula uropigial no contienen fibras reticulares. La anatomía e histología de esta glándula se ha examinado en algunas especies de aves. Hasta la fecha, este es el primer estudio en describir las particularidades histológicas y anatómicas de la glándula uropigial de la cigüeña blanca. Los resultados obtenidos contribuirán a llevar a cabo nuevos estudios relacionados en el área.

Fístula quiloperitoneal en gestante a propósito de un caso: resumen / Quiloperitoneal fistula pregnant about a case: summary

El sistema linfático corresponde a una amplia red de capilares y vasos distribuidos por todo el organismo, que convergen a nivel del tórax a una estructura única mayor, el conducto torácico, el cual drena su contenido a la circulación venosa a nivel de la vena subclavia izquierda. La fístula quilosa se define como la perdida de linfa desde los vasos linfáticos, típicamente acumulado en la cavidad abdominal y/o torácica, ocasionalmente manifestada como una fístula externa. (120) El tratamiento conservador de la fístula quilosa está recomendado en la mayoría de los pacientes y va a estar determinado por las fístulas con gasto elevado que causan alteraciones fisiológicas tempranas, por lo que el tratamiento debe ser agresivo. Las fístulas quilosas de origen tumoral son de difícil manejo, el tratamiento es más exitoso si estas se presentan luego de un trauma o cirugía. Para mejorar la efectividad del tratamiento conservador, se ha sugerido asociar a las medidas antes señaladas el uso de somatostatina o sus análogos. El tratamiento quirúrgico es abordado cuando la terapia conservadora falla (40%).99 Se presenta el caso de femenina de 39 años, proveniente del Estado Nueva Esparta, sin antecedente patológicos conocidos, IV gesta, III para a quien se le realizo cesárea de emergencia a las 34 semanas por feto con poli hidramnios y al abordar cavidad abdominal hay la presencia de liquido de aspecto lechoso del cual obtienen 3000cc aprox., extraen el feto el cual estaba en condición estable, revisan cavidad abdominal sin evidenciar patología. Es egresada en condición estable, y consulta a los 7 días por aumento de volumen abdominal. En vista de esto es referida a nuestro centro donde se realizan diversos estudios como laboratorio que solo reportó anemia (Hb 10), marcadores tumorales (alfa feto proteína, Ca 19-9, CEA) negativos, pruebas especiales para descartar trastorno de coagulación resultaron negativos...

The lymphatic system represents a vast network of capillaries and vessels distributed throughout the body, which converge at the thoracic cavity to a largest single structure, the thoracic duct, which drains its contents into the venous circulation to the left subclavian vein. Chylous fistula is defined as a loss of lymph from the lymphatic vessels, typically accumulated in the abdominal cavity and/or cage, occasionally manifested as an external fistula. (120) Conservative treatment of chylous fistula is recommended in most patients and shall be determined by high output fistulas causing early physiological changes, so treatment should be aggressive. Tumoral chylous fistulas are difficult to manage; treatment is more successful if these appear after trauma or surgery. To improve the effectiveness of conservative treatment, it has been suggested to associate the use of somatostatin or its analogs with the above mentioned measures. Surgical treatment is addressed when conservative therapy fails (40%). We present a case of a 39 years-old female, from the state of Nueva Esparta - Venezuela, with no known medical history, GESTA IV, III who underwent emergency cesarean section at 34 weeks due to fetus with polyhydramnios. When approaching the abdominal cavity they found a milky fluid of which they obtained 3000cc approx.; they took out the fetus which was in stable condition and examined the abdominal cavity without evidence of any pathology, whatsoever. She was discharged in stable condition, and comes back to consult at 7 days after due to increased abdominal volume. For this reason, she was referred to our center where several studies are made, such as laboratory studies which only reported anemia (Hb 10), tumor markers (alpha fetoprotein, Ca 19-9, CEA) negative, special tests to rule out clotting disorder were negative; negative immunological profile (ANCA, ANA, AMA, AML), CT Scan of the chest-abdomen and pelvis which concluded...

Linfangiogénesis en el cáncer y su papel en la diseminación metastásica / Cancer lymphangiogenesis and its role in metastasic dissemination

Es bien sabido que existen diferentes patrones de metástasis dependiendo del tipo tumoral. Por ejemplo, la diseminación metastásica de los carcinomas es vía linfática preferencialmente, las células neoplásicas llegan a los ganglios linfáticos regionales a través de vasos linfáticos aferentes preexistentes o capilares linfáticos de nueva formación; en cambio, en los sarcomas la vía principal es a través de los vasos sanguíneos. Estos patrones metastásicos han sido utilizados durante muchos años por los clínicos y cirujanos para la etapificación y resección tumoral, particularmente en cáncer de mama. Recientemente este conocimiento ha sido aplicado para la detección y resección del ganglio centinela. El sistema linfático drena el líquido intersticial de los tejidos y lo reincorpora al sistema sanguíneo; además, forma parte de la defensa inmune del huésped y en condiciones patológicas induce diferentes tipos de linfedema y participa en la invasión y metástasis. El estudio de la linfangiogénesis permaneció aletargado por muchas décadas y no es sino hasta los últimos años que se han descrito mecanismos biomoleculares y marcadores específicos, los cuales actualmente se están utilizando para estudiar el proceso de diseminación tumoral y metástasis. Existe una tendencia hacia la aplicación clínica de este conocimiento molecular en la clínica para estimar el significado pronóstico de los tumores, así como para desarrollar estrategias terapéuticas específicas.

It is well-known that there are different tumor-type-dependent metastatic patterns. For example, in carcinomas metastatic spread is preferentially via the lymphatic system by which they reach regional lymph nodes through pre-existent afferent lymph vessels and/or newly formed lymph capillaries; while in sarcomas the favored pathway is through bloodvessels. These metastatic patterns have been used for many years by clinicians and surgeons for staging and tumor resection, particularly in the case of breast cancer. Recently this knowledge has been applied to detection and resection of sentinel lymph nodes. The lymphatic system drains the interstitial fluid from tissues and reincorporates it into the blood flow; in addition, it forms part of the host's immune defense and in pathological conditions, induces different types of lymph edema and participates in tumor invasion and metastasis. Although, the study of lymphangiogenesis was stagnated for several decades, it was not until a few years ago that biomolecular mechanisms were discovered and many specific markers are now in use to study the process of tumor dissemination and metastasis. There is a tendency to utilize molecular knowledge in clinical settings for grading and estimating prognostic significance of tumors as well as to develop specific therapeutic strategies.

Linfangiogênese e genética dos linfedemas: revisão da literatura / Lymphangiogenesis and genetics in lymphedemas: a review of the literature

O estudo do genoma humano propiciou recentes descobertas de genes e de complexos mecanismos de controle da linfangiogênese. Neste artigo esses conhecimentos são revistos, com suas implicações na embriogênese e desenvolvimento do sistema linfático e na etiopatogenia de diferentes formas e síndromes de linfedema hereditário. Algumas doenças linfáticas de transmissão genética e síndromes de aneuploidia são descritas nas suas características genotípicas e fenotípicas. Os avanços na compreensão do crescimento e desenvolvimento dos vasos linfáticos devem trazer novas alternativas terapêuticas nas linfangiodisplasias e no controle da disseminação linfática dos tumores.

Recent advances in the exploration and manipulation of the human genome provided new insights into the intricate genetics and control of lymphangiogenesis. Implications for embryogenesis and development of the lymphatic system and its role in some familial and aneuploid syndromes are reviewed, along with their genotypic and phenotypic characteristics. Increased understanding of growth and development of the lymphatic vessels may bring new therapeutic options for lymphatic angiodysplasias and control of the lymphatic spread of tumors.

Lymphangiogenesis: from the pig embryos to cancer: [review] / Linfangiogênese: de embriões de suínos ao câncer: [revisão]

The discovery and the comprehension of lymphatic vessels suffered several historical delays and setbacks. The inherent anatomical problems slowed down the precise identification of the lymphatic system during the development of medical science. Gasparo Aselli, an Italian surgeon and anatomist, was the first to describe the lymphatic vessels in 1627 (De Lacteibus sive Lacteis Venis). However, most original descriptions that report the morphology of the lymphatic system in different organisms were done during the 19th and the 20th centuries. The recent identification of specific lymphatic vasculature molecular markers allows a more accurate identification and characterization of the lymphatic system evolution in different organs, as well as its role in different pathological conditions, including cancer. This study summarizes the current understanding of lymphangiogenesis in tumour progression, as well as it presents a review of the promising data regarding the prognostic value of lymphatic density and the use of therapeutic lymphangiogenic molecules.

A descoberta dos vasos linfáticos e sua compreensão enfrentaram uma série de atrasos e dificuldades históricos. As inerentes dificuldades anatômicas retardaram a identificação precisa da rede vascular linfática durante o desenvolvimento da ciência médica. Gasparo Aselli, um anatomista e cirurgião italiano, foi o primeiro a descrever os vasos linfáticos, em 1627 (De Lacteibus sive Lacteis Venis). Entretanto, a maioria das descrições originais que relatam a morfologia do sistema linfático nos diferentes organismos foi realizada depois, entre os séculos XIX e XX. A recente identificação de marcadores moleculares específicos à vasculatura linfática permite agora identificação e caracterização mais acuradas da evolução da rede linfática nos vários órgãos e em diferentes situações, inclusive no câncer. Esta revisão resume o conhecimento sobre a linfangiogênese na progressão tumoral, bem como apresenta uma síntese dos dados mais promissores em relação ao valor prognóstico da densidade linfática e da utilização das moléculas linfangiogênicas como alvo terapêutico.

Características morfométricas do desenvolvimento do timo em cães / Morphometric characteristics of thymus development in dogs

O timo é um órgão de grande importância imunológica durante a vida fetal e o período neonatal. Ele é o precursor da linfopoiese e apresenta alta atividade linfopoiética, sendo também o maior órgão linfóide durante a vida intrauterina e até o nascimento. Neste estudo, os aspectoso morfológicos do desenvolvimento prenatal de timos de cães foram descritos em fetos de diferentes idades e sexos. Vinte e quatro fetos de cães domésticos, sem raça definida, machos e fêmeas, foram divididos em 4 grupos etários. O timo apresentou-se composto por dois lobos unidos por um tecido de conexão, com coloração rósea, localizados no espaço mediastinal cranial. A porção cranial estendeu-se pouco além do primeiro par de costelas. As células que formavam o parênquima do timo estavam bem organizadas. Agrega dos concêntricos chamados Corpúsculos de Hassal foram observados, envolvidos por uma delgada cápsula de tecido conjuntivo que é espessada por tecido adiposo. O tamanho dos vasos aumentou gradativamente com a idade dos fetos, sendo maior nos animais próximos ao nascimento. Os timos das fêmeas apresentaram maior volume (Vref) e dimensões de tamanho que nos machos.

The thymus is an organ with great immunological relevance during foetus life and neonatal period, It is the predecessor of lymphopoiesis and shows high lymphopoietic activity, being also the largest lymphoid organ during intrauterine life and at birth. In this study, the morphological aspects of the prenatal development of dog thymus were described in foetus of different ages and sexes. Twenty-four foetus of mongrel domestic dogs, males and females, were divided into four age groups. The thymus presented two lobes linked by a rose-colored tissue connection that was localized in the cranial mediastinal space. The cranial portion protrudes slightly beyond the first pair of ribs. The cells that formed the thymus parenchyma were well organized. Concentric aggregates named Hassal corpuscles were observed, involved by a thin capsule of connective tissue thickened by adipose tissue. The vessels size gradually increased with the foetus age, being larger in animals that were closer to birth. The volume (Vref) and size parameters of female thymus were larger than in males.

Lymphatic transport of orally administered drugs.

Several therapeutic molecules such as lipophilic drugs and peptides suffer from the problems of low oral bioavailability. Improvement of their bioavailability and simultaneous prevention of the oral degradation of the prone molecules appears to be a challenge. Lymphatic system, which is responsible for the maintenance of fluid balance, immunity and metastatic spread of cancers, is also found to play a major role in the oral absorption of lipids and lipophilic drugs from intestine. The specialized structure of gut associated lymphoid tissue can be utilized as a gateway for the delivery of particulate systems containing drugs. Even though a large gap has existed in the field of lymphatic drug delivery, the introduction of a large number of lipophilic drugs and peptides has brought a renewed interest of research in this area. In this review, the mechanisms of intestinal lymphatic drug transport, approaches taken for the delivery of macromolecules, lipophilic and peptide drugs, biochemical barriers involved in intestinal drug absorption, and animal models used in the studies of intestinal lymphatic drug transport has been discussed.

Contribution of the thoracic duct to cardiac lymphatic drainage

In this study, we investigated the relationship between the thoracic duct and the lynphatics of the heart using retrograde dye (methilene blue) injection into the cross-clamped thoracic duct at the level of vertebra T5 in adult adavrs. Eighteen corpses (12 men), 6 women) were examined during autopsies. The thoracic duct opened into the left internal jugular vein in 10 cases (55.5 porcento), into the left subclavian vein in 4 cases (22.3 porcento), into the left venous angle in 3 cases (16.6 porcento), and into the left brachiocephalic vein in 1 case (5.6 porcento). there was cardiac staining (only in the epicardium) in 6 cases (33.3 porcento), with visualization of the surface lymphatics draining along the coronary arteries in the atria and ventricles, these results show that in the third of the cases, some cardiac lymph was drained via the thoracic duct and effective connections could be demonstrated.

Intrinsic lymphatics of the thymus in the rat: a detailed light and electron microscopic study using serial sections

The morphology and distribution of intrinsic lymphatics of the thymus gland of adult Swiss-Albino rats was studied by light and transmission electron microscopy. Lymphatic channels were traced, in serial semithin sections, progressively from the hilar region into the medullary region. The results show the presence of true lymphatic vessels in the connective tissue septa and close to blood vessels. When traced internally, these lymphatics were only identified in the cortico-medullary junction, to a lesser extent in the outer medulla, but never in the inner medulla or cortex. Afferent lymphatics to the thymus were not observed. Transmission electron microscopy, frequently showed concentric layers of small lymphocytes in the perivascular connective tissue spaces. Perivascular lymphocytes were smaller and more pachychromatic than those in the thymic parenchyma. They were enclosed by long mesenchymal/fibroblastic processes which formed a system of irregular "extra-lymphatic" channels or spaces located close to lymphatic vessels which contained many small lymphocytes closely resembling perivascular lymphocytes. These "extra-lymphatic" channels may be pre-lymphatic that may be concerned in the passage of thymocytes and interstitial fluid from the deep regions of the medulla to the nearest lymphatic in the perivascular connective tissue. This may provide an additional route for the migration of lymphocytes from the rat thymus gland supplementing the venous route. Further timed injection studies to trace the continuity of these "pre-lymphatic channels" will offer more precise results

Investigación anatómica de las vías linfáticas del recto y sus implicacias quirúrgicas / Anatomy research of lymphatic routes of the rectum

Se presentan los resultados de un trabajo de investigación anatómica sobre las vías linfáticas del recto. Fue realizado sobre 36 fetos fallecidos con 7 o más meses de vida intrauterina. La masa de Gerota se inyectó separadamente en cada tercio del recto y en el canal anal. En el tercio superior del recto sólo se coloreó la vía linfática ascendente (vía de la mesentérica inferior). En los especímenes inyectados en el tercio medio e inferior del recto y en el canal anal, la masa de Gerota coloreó tanto la vía ascendente como la lateral (vía de la hemorroidal media). En dos ejemplares, inyectados en el tercio medio, además de las dos vías recién mencionadas, fue observado un fino canal linfático ascendiendo por el espacio retrorrectal hasta terminar en un ganglio localizado sobre el ala derecha del sacro. No se hallaron comunicaciones linfáticas entre el recto y los órganos genitourinarios ni tampoco con el grupo ganglionar inguinal

Tratamiento del carcinoma de ángulo esplénico del colon / Treatment of splenic flexure colon carcinoma

En este trabajo se presenta la experiencia con el carcinoma del ángulo esplénico del colon, se estudian sus particularidades y se considera si ellas pueden influir en la elección del procedimiento quirúrgico para su tratamiento. Se tratan 23 pacientes, 5,8 por ciento del total de operados por cáncer colorrectal en un período de 12 años. Presentaron obstrucción intestinal 7 (32 por ciento), cifra esta significativamente mayor que la que mostraron los tumores en otras localizaciones (p = 0,02). La mortalidad operatoria no fue significativamente mayor en los tumores del ángulo esplénico, comparados con otras localizaciones. Se considera conveniente realizar colectomías extendidas cada vez que sea posible y no se recomienda la resección del bazo y de la porción distal del páncreas en forma rutinaria, con el objeto de ampliar la resección linfática

Variaciones de las comunicaciones linfático-venosas en la fosa supraclavicular izquierda del hombre / Variations of the lymphatic-venous communications in the human left supraclavicular fossa

Considerando la importancia clínica y quirúrgica de las comunicaciones linfático-venosas, poco descritas en la región cervical, presentamos y analizamos variaciones de estas comunicaciones, las que fueron observadas después de la disección de la fosa supraclavicular izquierda de 34 cadáveres en la Disciplina de Anatomía Descriptiva y Topográfica de la Universidade Federal de Sao Paulo-Escola Paulista de Medicina, Brasil. Encontramos dos casos (5,9 por ciento) de vasos linfáticos que desembocaban en la vena subclavia izquierda, próximo del ángulo yúgulo-subclavio. En ambos casos, estaba presente el conducto torácico desembocando en el lugar habitual. Los estudios anatómicos de estas variaciones son importantes, ya que su conocimiento ayuda a evitar secuelas después de la realización de procedimientos quirúrgicos en la región cervical permitiendo, además, aportar detalles sobre las vías linfáticas de esa región

Capilares linfáticos en pulpa dental humana de dientes permanentes / Lymphatic vessels in human dental pulps of permanent teeth

Se han observado pulpas dentales humanas en dientes permanentes en un total de 580 piezas. Se presentan capilares linfáticos de tipo especial con elementos valvulares, termiando en extermo ciego, con calibres más amplios que los capilares sanguíneos, con paredes extremadamente finas, careciendo de eritrocitos en su luz, pero presentando escasos linfocitos. Se los ve acompañando a las venas en sus recorridos hacia el foramen apical y formando delicados plexos en zonas periféricas subodontoblásticas y central

Linfáticos da laringe / Lymphatics of the larynx

Realizamos 147 injeçöes de diferentes corantes e/ou contraste radiopaco, em 77 laringes de cäes a fim de se estudar os linfáticos da submucosa da laringe e suas eventuais vias preferencias de drenagem. Os corantess utilizados (Blue Patent V, Azul da Prússia e Tinta Nankin) e/ou contraste radiopaco (Hypaque) foram previamente injetados em regiöes topográficas selecionadas. O estudo foi realizado em cäes anestesiados ou recém-sacrificados, e em laringes extirpadas. A drenagem linfática foi também estudada em cäes submetidos a ligadura prévia de eferentes linfáticos aos linfonodos cervicais. Em laringes isoladas, o estudo dos linfáticos e suas vias de drenagem foi realizado sob lupa estereoscópica, antes e após a desidrataçäo e diafanizaçäo das peças. O autor descreve os caminhos descritos pelos linfáticos da submucosa da laringe até encontrar as vias de drenagem: via superior, via média e via inferior.