Nils-Otto Sjöberg

Origin and distribution of VIP (Vasoactive Intestinal Polypeptide)-nerves in the genito-urinary tract

SummaryVIP (Vasoactive Intestinal Polypeptide)-immunoreactive nerves were found throughout the genito-urinary tract of the cat; they were less numerous in the guinea pig and in the rat. In the cat, VIP nerves were particularly numerous in the neck of the urinary bladder and proximal urethra, in the uterine cervix and in the prostate gland. The nerves were found in smooth muscle, around blood vessels and in the connective tissue immediately beneath the epithelium. Ganglia were found below the trigonum area of the bladder, in the wall of the proximal urethra, and in paracervical tissue. VIP-immunoreactive nerve cell bodies occurred in all these ganglionic formations. These ganglia probably represent the origin of the VIP nerves of the genital tract since their removal in the female cat greatly reduced the VIP nerve supply. Transection of the hypogastric nerves had no overt effect. Transection of the cervix eliminated the VIP nerves above the level of the lesion, except those in the ovaries, supporting the view that the VIP nerves of the uterus and the oviduct are derived from a paracervical source.

Amine mechanisms in enterochromaffin and enterochromaffin-like cells of gastric mucosa in various mammals.

SummaryThe stomach wall from a variety of mammals (mouse, rat, hamster, guinea-pig, rabbit, cat, dog, pig, monkey and man) was analyzed histochemically and chemically for the presence of histamine, arylethylamines and the corresponding amino acid decarboxylases.1.Apart from adrenergic nerve terminals, the major cellular stores for gastric amines were mast cells, enterochromaffin cells, and a system of morphologically similar cells designated as enterochromaffin-like cells.2.Using the histochemical o-phthaldialdehyde technique, histamine could be visualized in gastric mast cells from all species. In addition, a yellow formaldehyde-induced fluorescence indicating the presence of 5-hydroxytryptamine or some other indole, was found in the gastric mast cells from mice, rats, rabbits, cats, dogs, pigs and monkeys. In hamsters the mast cells exhibited a green colour rather indicating the presence of a catecholamine.3.All argyrophilic epithelial cells in the stomach mucosa emitting a formaldehyde-induced fluorescence were classified as enterochromaffin. Yellow-fluorescent, presumably 5-hydroxytryptamine-containing, enterochromaffin cells were recognized in all species. In addition, the stomach mucosa of rabbits and cats contained scattered green-fluorescent enterochromaffin cells; in microspectrofluorometric analysis the fluorophore was identified with the formaldehyde condensation product of dopamine. The presence of dopamine in gastric mucosa of these two species was further confirmed by chemical estimation in combination with thin-layer chromatography.4.Already the presence of different arylethylamines in the enterochromaffin cells indicates the existence of several distinct cell types. A further classification was made on the basis of a different sensitivity to the amine-depleting action of reserpine.5.The enterochromaffin-like cells are argyrophil but not argentaffin. A distinguishing feature of these cells is their ability to produce and store arylethylamines, such as dopamine, upon administration of the amine precursor (e.g.l-DOPA), although normally the cells are devoid of fluorogenic amines demonstrable with the formaldehyde method. In addition, the enterochromaffin-like cells of mouse and rat store histamine histochemically detectable with the o-phthaldialdehyde technique. In the mouse and rat these cells appear to be the major site of gastric histidine decarboxylase. In no other species could histamine or histidine decarboxylase be demonstrated in the enterochromaffin-like cells.6.The regional distribution of the enterochromaffin and enterochromaffin-like cells varied markedly, but the localization of these two cell systems was characteristic for each species. It was very noticeable that the distribution of the cells within the gastric mucosa often was not limited to one or the other of the histologically definable glandular areas.7.From observations on the regional and topographic distribution of DOPA decarboxylase (i.e. non-specific l-amino acid decarboxylase) it is suggested that the enzyme occurs in both enterochromaffin and enterochromaffin-like cells, in particularly high concentration in the former cell type.8.The enterochromaffin and enterochromaffin-like cells — i.e. the entire system of gastric argyrophil cells — may have an endocrine function. It is evident that a thorough knowledge of the properties and distribution of the many types of cells comprising this system will assist in defining their respective endocrine mechanisms.

Qualitative study of pregnancy and childbirth experiences in Somalian women resident in Sweden

Objective To explore the attitudes, strategies and habits of Somalian immigrant women related to pregnancy and childbirth, in order to gain an understanding as to how cultural factors might affect perinatal outcome.

Histochemical and chemical studies on pre- and postnatal development of the different systems of “short” and “long” adrenergic neurons in peripheral organs of the rat

SummaryThe adrenergic innervation in the submaxillary gland, heart, kidney, small intestine, and accessory male genital organs and the development of the adrenal chromaffin cells and the sympathetic ganglia were studied in the rat from 15 days post coitum to 16 days post partum using the fluorescence histochemical method of Falck and Hillarp. The postnatal development of the noradrenaline concentrations in the heart and vas deferens was followed by fluorometric determinations.At about 15 days post coitum, the anlagen of the sympathetic chains were well visible in the form of two dorsal segmented columns of small branching sympathicoblasts exhibiting an intense catecholamine fluorescence. In the midline, ventrally to these two anlagen, another column of sympathicoblasts developed; this seemed to give rise to the prevertebral ganglia and to the short adrenergic neurons supplying the internal genital organs. At the level of the adrenal anlagen, small intensely fluorescent chromaffin cells were collected in two bilateral groups which became enclosed by adreno-cortical cells. This enclosure was, however, not complete even at two weeks post partum.Bundles of growing sympathetic nerves were visible in the periphery of the various organs studied at 19–21 days post coitum. A terminal innervation of the organs suggestive of a functional transmitter mechanism did not start to establish until at or immediately after birth. The final pattern of innervation was usually reached at about one week post partum, and the following development proceeded largely in the form of a quantitative increase in the number of nerves participating in the innervation apparatus. The adult level of noradrenaline in the heart and vas deferens was reached three to five weeks after birth. The small intestine was an exception in that the final pattern of innervation in the wall was attained immediately after birth.There was no overt difference in the rate of development of the terminal sympathetic innervation in organs supplied by short adrenergic neurons (accessory male genital organs) compared to the innervation of the submaxillary gland, heart and kidney, which receive classical long adrenergic neurons.

Conization as only treatment of carcinoma in situ of the uterine cervix

Knife conization was performed in 2,099 cases with abnormal vaginal smears. The frequency of complications was low. Carcinoma in situ was diagnosed in 1,500 cases and follow-up showed that conization was curative in 87%. The curative rate was depending on whether the resection margins were free of pathologic epithelium or not. If smears were repeatedly negative the first year after conization a new diagnosis of cancer was made in 0.4%. It was not possible to decide whether these lesions were residual changes or true recurrences. Treatment of carcinoma in situ by conization has so far reduced the frequency of invasive cervical cancer by 60%.

Comparative study of the autonomic innervation of the mammalian ovary, with particular regard to the follicular system

SummaryThe autonomic innervation of the ovary was studied in 12 mammalian species utilizing the cholinesterase method in combination with pseudocholinesterase inhibition for the cholinergic component, and glyoxylic acid histochemistry together with fluorometric determination of noradrenaline for the adrenergic component. Ovaries from cow, sheep, cat, and guinea pig were very richly supplied with adrenergic nerves in the cortical stroma, particularly enclosing follicles in various stages of development. In the follicular wall the nerve terminals were located in the theca externa, where they ran parallel to the follicular surface. Numerous adrenergic terminals also surrounded ovarian blood vessels. The adrenergic innervation was of intermediary density in the human ovary and in the pig, dog, cat, and opossum. Ovaries from rabbit, mouse and hamster had a sparse adrenergic nerve supply. The amount of intraovarian adrenergic nerves agreed well with the tissue concentration of noradrenaline in the various species. The cholinergic innervation was generally less well developed, but had the same distribution as the adrenergic system around blood vessels and in the ovarian stroma, including follicular walls.

Vasoactive intestinal polypeptide nerves in the human female genital tract

VIP, a recently recognized neuropeptide, has been demonstrated by immunohistochemistry in nerves of the human female genital organs. Such nerves were most numerous in the isthmic part of the fallopian tube and in the cervix. They were found in smooth muscles, around blood vessels, and beneath the epithelium. Immunoreactive VIP nerve cell bodies were found in paracervical tissue, suggesting a local origin of genital VIP nerves. Besides the well-known adrenergic and cholinergic nerves, peptidergic nerves may constitute a new component in the autonomic nervous system.

Randomised controlled trial of atenolol and pindolol in human pregnancy: effects on fetal haemodynamics.

OBJECTIVE--To compare the effects of uteroplacental circulation of two beta adrenoceptor blockers, atenolol (cardioselective) and pindolol (non-selective with intrinsic sympathomimetic activity). DESIGN--Controlled double blind double dummy study. SETTING--Departments of obstetrics and gynaecology in two Swedish university hospitals. SUBJECTS--29 women with pregnancy induced hypertension in the third trimester, 13 randomised to atenolol and 16 to pindolol. MAIN OUTCOME MEASURES--Pulsatility index in fetal aorta, umbilical artery, and maternal arcuate artery. Volumetric blood flow in fetal aorta and umbilical vein. RESULTS--Mean arterial blood pressure decreased by 9.0 (95% confidence interval -13.0 to -5.0) mm Hg in the atenolol group and by 7.8 (-11.4 to -4.2) mm Hg in the pindolol group. During atenolol treatment the pulsatility index increased significantly from 1.82 (SD 0.20) to 2.07 (0.32) in the fetal thoracic descending aorta, from 1.44 (0.28) to 1.79 (0.27) in the abdominal aorta, and from 0.93 (0.17) to 1.05 (0.19) in the umbilical artery; the volumetric blood flow in the umbilical vein decreased from 106 (28.8) to 84 (22.6) ml/min/kg. No such changes were seen after treatment with pindolol. Birth weight was similar in the two groups but placental weight was significantly different (529 (122) g in atenolol group v 653 (136) g in pindolol group; p = 0.03). CONCLUSION--The hypotensive effect was similar with both drugs, but only the beta 1 blocker atenolol had significant effects on fetal haemodynamics, although within normal ranges. The implications of these findings can be only speculative, but negative fetal consequences of beta 1 adrenoceptor blockade cannot be excluded.

Adrenergic innervation of the human uterus

The uterine adrenergic transmitter is in many animal species dramatically reduced during pregnancy, probably leading to a functional denervation near term. In order to clarify whether similar changes also occur in the human uterus, the adrenergic innervation of the isthmic myometrium during nonpregnant and pregnant conditions was analyzed by fluorescence histochemistry for demonstration of adrenergic nerves, and by quantitative measurements of norepinephrine and its synthesizing enzymes, tyrosine hydroxylase and dopa decarboxylase. At term pregnancy all fluorescent adrenergic nerves in the myometrium had disappeared, and the norepinephrine concentration had been reduced to almost zero. Parallel to this the activities of tyrosine hydroxylase and dopa decarboxylase were markedly reduced. By contrast, the activity of the acetylcholine-synthesizing enzyme, choline acetyltransferase, was unchanged, indicating that the adrenergic system was selectively affected. The results confirm that the adrenergic nerves in the human uterus, like those in uterine horns of laboratory animals, undergo fundamental changes in the course of pregnancy. This probably reflects entirely different conditions for a sympathetic influence on the myometrium during the last two trimesters of pregnancy compared to the non-pregnant situation.

Enkephalin-immunoreactive nerve fibers in the feline genito-urinary tract.

SummaryBesides the classical neurotransmitters acetylcholine and norepinephrine the genito-urinary tract contains also neuropeptides. The distribution of substance P- and VIP-containing nerve fibers have earlier been described. Also enkephalin-immunoreactive nerve fibers occur in the male and female genito-urinary organs of the cat. The nerves are more numerous in male than in female genital tract. The prostatic gland and vas deferens receive the largest supply. In the female genital tract the enkephalin-immuno-reactive nerve fibers are regularly seen in the smooth muscle layer of the cervix. Of special interest is the rich occurrence of the enkephalin nerve fibers among the nerve cell bodies in the para-urethral and cervical ganglia supporting the view that enkephalin may play a neuromodulating role.