The Paraganglionic Chemoreceptor System

One would rarely have the opportunity to augment his medical library with a more exhaustive examination of the subject matter than is contained herein. Would only that all areas of one's professional responsibilities be available in such a complete, didactic, written form. Having a decided interest in the subject of head and neck paragangliomas for the past decade, I have had the opportunity to explore the subject through published medical literature and personal investi gation, and feel qualified to commend Doctors Zak and Lawson on their dedica tion, accuracy, and thoroughness in this presentation. One seeking any particular aspect of knowledge from historical to an up-to-date concept on the subject of paragangliomas will find his answer here. Vincent J. Hyams CAPT MC USN Chairman, Otolaryngic Pathology Department Armed Forces Institute of Pathology Washington, D.C. Preface One of us (F.G.Z.) initially became interested in the paraganglionic system when as a resident in pathology at The Mount Sinai Hospital, he performed an autopsy on an elderly woman with an intracranial tumor of the posterior fossa, which extended through the jugular foramen into the neck in a dumbbell fashion.

The International Society for Arterial Chemoreception (ISAC) was founded in August 1988 during the 9th International Symposium on Arterial Chemoreception which was held at Park City, Utah, USA. ISAC was established with the aim of providing a framework to support the increasing number of investigators from a wide variety of disciplines (anatomists, pathologists, respiratory physiologists and clinicians, high altitude physiologists, biochemists, biophysicists, physiologists and pharmacologists) who share a common interest in arterial chemoreception. ISAC took over the co-ordination of the international chemoreceptor meetings, with the membership deciding the venue for forthcoming meetings. During the Park City symposium Dublin was selected to host the 1993 meeting, under the Presidency of Professor Ronan O'Regan. The 12th International Meeting on Arterial Chemoreception, which was held in Dublin in August 1993, was acclaimed as a great success by all those present. The delegates not only shared in a wide-ranging feast of chemoreceptor based science, they had plenty of opportunity during the meeting for renewing acquaintances and establishing new friendships. The location for the meeting at University College Dublin's modem Belfield campus helped to promote such interaction, and the social programme was outstanding.

Arterial chemoreceptors are unique structures which continuously monitor changes in arterial blood oxygen, carbon dioxide, glucose, and acid. Alterations in these gases are almost instantaneously sensed by arterial chemoreceptors and relayed into a physiological response which restores blood homeostasis. Arterial Chemoreception contains updated material regarding the physiology of the primary arterial chemoreceptor; the carotid body. Moreover, this book also explores tantalizing evidence regarding the contribution of the aortic bodies, chromaffin cells, lung neuroepithelial bodies, and brainstem areas involved in monitoring changes in blood gases. Furthermore this collection includes data showing the critical importance of these chemoreceptors in the pathophysiology of human disease and possible therapeutic treatments. This book is a required text for any researcher in the field of arterial chemoreception for years to come. It is also a critical text for physicians searching for bench-to-bedside treatments for heart failure, sleep apnea, and pulmonary hypertension.

This book entitled Arterial Chemoreception is an edited compilation of the oral communications and posters presented at the IXth International Sym posium on Arterial Chemoreceptors held in Park City, Utah, from August 29th to September 3rd, 1988. The Symposium also saw the formal inau guration and first meeting of the International Society for Arterial Che moreception (ISAC). In all there were 87 presentations by 108 scientists from 18 countries. Authors making multiple presentations at Park City combined their results into single, longer papers for this volume. As a result this vol~me offers the reader 63 contributions of state-of-the-art research in this important and exciting field. Inasmuch as oxygen is the substrate sine qua non for the survival of all higher organisms, it is quite understandable that considerable interest sur rounds investigations into mechanisms responsible for detecting dwindling oxygen supplies in the organism. This interest has intensified as the newer techniques of cell, sub-cell, and molecular biology have become available. As detectors of insufficient oxygen in the arterial blood the arterial che moreceptors (carotid and aortic bodies) initiate many cardiopulmonary reflexes geared toward maintaining constant the delivery of oxygen to the tissues. These chemoreceptors, which also trigger secretions from the ad renal glands, are located near the carotid sinus and in the arch of the aorta.