glycogen and Pyloric-Stenosis

Smooth muscle cell biopsies obtained at pyloromyotomy from 37 children with infantile hypertrophic pyloric stenosis (IHPS) were studied by light and electron microscopy and compared with 6 autopsy control cases without any clinical evidence of this disorder. In cases with IHPS an apparently irregular increase in the number of smooth muscle cells by mitosis was accompanied by an increase of the endoplasmic reticulum, proliferation of mitochondria and regressive changes, such as shrinkage, swelling, necrosis and apoptosis of smooth muscle cells. Other alterations, seen in some but not all cases consisted of large numbers of unusual dense granules some of which were clearly associated with actin filaments and, therefore, regarded as derivatives of the normally occurring dense bodies. Furthermore, intermyofibrillar and subsarcolemmal glycogen accumulations, various nuclear abnormalities and pleomorphic membranous cytoplasmic or nuclear bodies occurred. While smooth muscle cell abnormalities predominated in some cases of IHPS, in others there were more severe axonal changes in the myenteric plexus. It is suggested, therefore, that a primarily myogenic type of IHPS can be distinguished from a predominantly neurogenic type.

Topics: Biopsy; Cytoplasm; Glycogen; Humans; Hypertrophy; Inclusion Bodies; Infant; Infant, Newborn; Microscopy, Electron; Muscle, Smooth; Pyloric Stenosis

The significance of mucous change in the human duodenum in a series of patients with peptic ulcer disease has been appraised. No specific correlation was demonstrated with the acid output of the stomach if the extent of the change is considered, but it was shown to be more common in the higher acid states. Electron microscopic studies confirmed the specific structure of the mucous cells of the duodenum and suggest that they arise either by transformation of Brunner's gland cells or as a distinctive population in the crypts. It is suggested that the mucous change is a protective mechanism involved in some way as yet unknown with the healing of ulcers.

Topics: Biopsy; Cell Membrane; Cell Nucleus; Cytoplasm; Cytoplasmic Granules; Desmosomes; Duodenum; Endoplasmic Reticulum; Epithelial Cells; Epithelium; Extracellular Space; Gastric Juice; Glycogen; Golgi Apparatus; Humans; Intestinal Mucosa; Microscopy, Electron; Mitochondria; Peptic Ulcer; Pyloric Stenosis; Ribosomes; Stomach Neoplasms; Stomach Ulcer