History and Recent Progress in Carotid Body Studies

This chapter describes the history of the carotid body (CB) and the subsequent research on its structure and function. The chronological development of ideas about its anatomical structure as a ganglion, the first descriptions of its glandular nature as a ball of highly vascular tissue (glomus), the discovery of its neural crest origin and relevant embryological views as a true paraganglion toward a more conclusive understanding of its sensory nature as a chemoreceptor for chemical changes in blood have been consistently demonstrated. The knowledge of the CB neurochemistry, physiology and pathophysiology has progressed immensely in the past century and a large and compelling body of evidence for the presence of a neurogenic niche in the CB has accumulated over the last two decades, thus underlying its function and possibility for the development of cell replacement therapies.

Role of carotid and aortic bodies in mediating the increase in cardiac output during anoxemia

In 14 anesthetized dogs the inhalation of 5% oxygen in nitrogen for 2.5 min caused an increase in cardiac output, measured by the dye dilution technique (16.8% ±6.1 se). After surgical carotid-aortic chemoreceptor denervation, anoxemia still increased cardiac output (27.1% ±6.7 se). An effect of chemoreceptor denervation was the reduction of the control level of cardiac output. In the presence of a similar reduction of cardiac output by bleeding (innervated animal) anoxemia caused a greater increase in cardiac output than in the control preparation. The increase in cardiac output was accompanied by a decrease in total peripheral systemic resistance in the denervated state as compared to an increase in the innervated state. The increase in cardiac output during anoxemia was not prevented by complete spinal anesthesia. A possible cause for the increase in the denervated animal is a combination of the increase in venous return and fall in total systemic peripheral resistance.

[Pheochromocytoma of the left retroperitoneal paraganglion associated with torsade de pointes: a case report]

A 54-year-old woman developed torsade de pointes with secondary QT prolongation due to hypokalemia and hypomagnesemia. Her serum K and Mg levels were 2.5 mEq/l and 1.5 mg/dl, respectively. This electrolyte imbalance was due to intentional overdosing of metolazone. Attacks of torsade de pointes occurred three times in the intensive care unit and were corrected by intravenous lidocaine administration. Her serum K level was corrected using KCl infusion, restoring the normal QT interval. Routine computed tomography found a left retroperitoneal paraganglioma. Urinary and serum catecholamine examination revealed extremely high values of epinephrine and norepinephrine. The diagnosis was pheochromocytoma in the left retroperitoneal paraganglion. The tumor which was removed measured 70 x 65 x 60 mm in size. Microscopic examination revealed the characteristic patterns of pheochromocytoma.

Tumours of the adrenal gland and paraganglia

This classification is arranged in two parts in order to take into account the different origins, structures, and functions of the cortex and medulla. The tabular classification is a simplified version of that suggested for adrenal tumours in man, and includes cortical adenoma and carcinoma, phaeochromocytoma, chemodectoma, neurofibroma, ganglioneuroma and ganglioneuroblastoma, and neuroblastoma. A detailed functional classification is not given, since the hormonal activity of many adrenal tumours in animals is less well known than it is in man. Of the tumour-like lesions listed, cortical hyperplasia is particularly important in several species.

A glutaraldehyde/potassium dichromate tracing method for the localization and preservation of abdominal extra-adrenal chromaffin tissues

The present work introduces a method for the localization in situ of the abdominal paraganglia. After treating retroperitoneal tissue blocks with a near-neutral glutaraldehyde/potassium dichromate solution following routine glutaraldehyde perfusion, intra- and extraadrenal chromaffin tissues develop a pronounced brown color from the interaction of glutaraldehyde/potassium dichromate with amines. In this manner, visualization of the abdominal extra-adrenal chromaffin organs is enhanced at the same time that cellular ultrastructure is preserved. Subsequent examination of the dichromate-reacted tissues with the electron microscope confirms that they represent the amine-rich paraganglia. This method offers an effective alternative to extensive sampling of plastic-embedded blocks for localizing peripheral chromaffin tissue and has been used to define the exact distribution of abdominal paraganglia in the rabbit.

Functionig phaeochromocytoma of the organ of Zuckerkandl. The second case treated at Edendale Hospital

The second case of a functioning phaeochromocytoma of the organ of Zuckerkandl has been treated at Edendale Hospital. A young Black woman was admitted as a case of juvenile hypertension and a pre-operative diagnosis of a functioning phaeochromocytoma was made. The case, the importance of pre-operative preparation and the proposed follow-up are described.

THE CAROTID BODY: A PATHOLOGIST'S VIEW

A review of the literature on the histogenesis and function of the carotid body suggests that the results and the original interpretations of embryological, histological and histochemical investigations have not provided a convincing explanation of the origin of this structure. That the carotid body is developed from mesoderm and is a sensory organ (chemoreceptor) seems unlikely because of: morphological similarities between some of the carotid body tumours and certain tumours of peripheral nerves; certain electron microscopic similarities between the cells of carotid body and adrenal medulla; chromatographic demonstration of catecholamines in the human carotid bodies; and contradictory results of both animal experiments and clinical observations concerning function of this structure.It is concluded that the carotid body arises from ectoderm and should probably be classified as a gland of internal secretion, related to the adrenal medulla and other paraganglia.

Chromaffin cells, mast cells and melanin. I. The granular cells of the skin

Sections of human skin obtained from a variety of sites and from subjects of different ages have been examined. Mast cells, melanocytes and melanophores have been identified by the use of various staining procedures, but the 'chromaffin cells' reported by Adams-Ray & Nordenstam (1956) and Burch & Phillips (1958) have not been observed. The staining reactions of pressor amine-containing chromaffin cells are reviewed and contrasted with those of the granular cells of the skin.

Chromaffin cells, mast cells and melanin. II. The chromaffin cells of the liver capsule and gut in ungulates

Polymorphic cells whose granules give a positive chromaffin reaction have been identified in the liver capsule and gut of the ox, cow and sheep. These cells give a positive argentaffin and Schmorl's reaction in dichromate-fixed material, and fail to couple with alkaline diazonium compounds. These reactions are consistent with the presence of a catechol, and from the work of Bertler, Falck, Hillarp, Rosengren & Torp (1959) it would appear that they contain dopamine.

These chromaffin, dopamine-containing cells are, however, not a special type of cell but are tissue mast cells. Nuclear fast red (Herzberg) is not, as suggested by Falck, Hillarp & Torp (1959a, b), a specific stain for dopamine, but, when prepared with aluminium sulphate, it is specific for sulphated mucopolysaccharides.