PubMed · 9398969
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J S Kelly, R C Prielipp. 1997. Stethoscopy.. https://doi.org/10.1007/bf03013354
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About one third of the patients presenting for surgery are smokers. Smoking has acute and chronic effects on the cardiovascular, respiratory and immune systems, microcirculatory function and drug metabolism. Smoking is related to a wide range of per- and postoperative complications. Short term smoking cessation will probably reduce the disadvantageous acute effects of nicotine and carbon monoxide on the cardiovascular system, while the changes in lung function take about eight weeks to improve. Whether the rate of postoperative complications can be reduced by preoperative smoking cessation is unknown. The preoperative period might be a beneficial time for a greater smoking cessation intervention by an interdisciplinary hospital staff team.
The main functions of the larynx are protection of the airways, respiration, and vocalization. Previous studies have suggested a link between the mechanisms controlling vocalization and afferent feedback from the larynx. We inquired whether stimulation of the laryngeal afferents that run in the internal branch of the superior laryngeal nerve (ISLN) activates neurons of the periaqueductal gray (PAG), a midbrain region implicated in vocalization. We counted the number of neurons expressing Fos, the protein product of the immediate early gene c-fos, in the PAG. The counts were done both in experimental cats after electrical stimulation of the ISLN and nonstimulated controls. We also investigated the possible presence of nitric oxide synthase, an enzyme that synthesizes nitric oxide, in PAG neurons that respond to laryngeal afferent stimulation by double labeling for reduced nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase and Fos. Fos expression was significantly greater (P < or = 0.00714) in the lateral and dorsolateral regions of the PAG in the experimental group than in the controls. The Fos-immunoreactive neurons did not contain NADPH-diaphorase, a marker for nitric oxide synthase. Our study suggests that laryngeal afferent stimulation activates neurons in discrete longitudinal columns of the PAG including the regions that have previously been shown to be involved in vocalization, and that these neurons do not contain nitric oxide synthase.