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2 results

  • Section 3 - Endocrine disorders in the critically ill

  • Edited by George M. Hall, St George's Hospital, London, Jennifer M. Hunter, University of Liverpool, Mark S. Cooper, University of Birmingham
  • Book:
    Core Topics in Endocrinology in Anaesthesia and Critical Care
    Published online:
    06 July 2010
    Print publication:
    01 April 2010, pp 125-184

  • Summary

    Pancreatic islet cell tumours and carcinoids are rare, and patients with these tumours form a small part of the case-load of the anaesthetist who regularly undertakes anaesthesia for major abdominal surgery. Insulinoma is the commonest functioning pancreatic neuroendocrine tumour (NET). Gastrinoma is the second commonest functioning pancreatic neuroendocrine tumour, and contrasts with insulinoma in several respects. The absence of symptoms is characteristic of non-functioning tumours. VIPoma is a rare tumour. Secretion of Vasoactive Intestinal Polypeptide produces watery diarrhea. Major upper abdominal surgery involves a bilateral subcostal incision, may last for several hours, requires dissection of lymphatic tissue and causes fluid shifts. It occasionally results in severe blood loss. A. Holdcroft has described a pre-operative checklist for the additional problems of the patient with a NET. Pre-operative investigations include pulmonary function tests, ECG, full blood count, clotting screen, electrolytes and liver function tests.

  • Vascularisation in adipose depots surrounding immune-stimulated lymph nodes

  • HILARY A. MACQUEEN, VERINA WAIGHTS, CAROLINE M. POND
  • Journal:
    The Journal of Anatomy / Volume 194 / Issue 1 / January 1999
    Published online by Cambridge University Press:
    01 January 1999, pp. 33-38
    Print publication:
    January 1999

  • We report a change in the vascularisation of the adipose depots surrounding the popliteal lymph node that has, and the contralateral node that has not, been exposed to a simulated immune challenge. The percentage of the depot that consists of vessels, as measured by image analysis, decreases over a period of 2 d after immune stimulus, then increases in a biphasic manner over the next 2–3 wk. By 1 mo after the stimulus, the vascularisation has returned to baseline values. The adipose tissue surrounding both the stimulated and the unstimulated lymph nodes shows a similar pattern, but the unstimulated depot lags by 3–6 d in reaching its maximum vascularisation. These data support the hypothesis that perinodal adipose tissue is involved in peripheral immune responses.