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PubMed1997

Intracerebroventricular choline reverses hypotension induced by acute chemical sympathectomy.

1. The effect of centrally administered choline on blood pressure was investigated in rats made hypotensive by chemical sympathectomy. Chemical sympathectomy was produced by intravenous (i.v.) injection of 50 mg kg-1 of 6-hydroxydopamine (6-OHDA). Intracerebroventricular (i.c.v.) administration of choline (50-150 micrograms) 2 h after 6-OHDA treatment increased blood pressure and reversed the hypotension in a dose-dependent manner without affecting the heart rate. The pressor response was associated with an increase in plasma vasopressin levels. 2. Pretreatment of rats with the nicotinic receptor antagonist, mecamylamine (50 micrograms, i.c.v.), but not the muscarinic receptor antagonist atropine (10 micrograms, i.c.v.), blocked both the pressor and vasopressin responses to choline (150 micrograms). Pretreatment of rats with hemicholinium-3 (HC-3), a high affinity choline uptake inhibitor, greatly attenuated the pressor response to i.c.v. choline (150 micrograms). 3. The vasopressin V1 receptor antagonist, beta-mercapto-beta,beta-cyclopentamethylenepropionyl-O-Me-Try,Arg) - vasopressin (10 micrograms kg-1; i.v.) given 5 min after i.c.v. choline, decreased the blood pressure but failed to return it to the pre-choline levels. Prazosine (0.5 mg kg-1; i.p.), an antagonist of alpha-adrenoceptors, also decreased blood pressure. Administration of both antagonists together eliminated the pressor response to choline, and the blood pressure was reduced further to below the pre-choline levels. 4. It is concluded that i.c.v. choline can increase blood pressure in rats made hypotensive by acute chemical sympathectomy through the activation of central nicotinic receptors by presynaptic mechanisms. An elevation in plasma levels of both vasopressin and catecholamines (possibly released from the adrenal medulla) is involved in the pressor response to choline.

Adrenergic alpha-Antagonists↗
PubMed2002

Computed tomography fluoroscopy-guided chemical lumbar sympathectomy: simple, safe and effective.

Demographic, clinical and laboratory data were retrospectively collected from records of 146 cases of CT fluoroscopy-guided chemical lumbar sympathectomy for the palliation of inoperable peripheral vascular disease (PVD) between January 1997 and August 1999. Of these, 16% had claudication, 39% had rest pain and 44% had ischaemic ulcers or gangrene. Seventy-three percent of elective cases were outpatients. At 3 months, 27 cases were lost to follow up, leaving 119 cases. Within 3 months, improvement, defined as doubling of the walking distance, cessation of rest pain or healing of ulcers, occurred in 30.3% of cases. No change was observed in 45.4% of cases and 24.3% of cases deteriorated. Patients with ulcers or gangrene had significantly poorer results than those without any ischaemic lesions, as only 19% versus 39% of patients improved (P < 0.05). The presence of hypertension, diabetes mellitus, hyperlipidaemia and smoking had no value in predicting clinical outcome (P > 0.05). There were no major complications noted. CT fluoroscopy-guided chemical lumbar sympathectomy is safe and effective, with a complication rate of less than 1%, and efficacy of at least 30% measured within 3 months. It is a simple and minimally invasive procedure, easily performed on an outpatient basis. CT fluoroscopy-guided chemical lumbar sympathectomy should be considered for all patients in the early stages of inoperable PVD.

Adult↗
PubMed1975

[Nutritional effects following lumbar sympathectomy in arterial occlusive disease (author's transl)].

The effect of lumbar sympathectomy on regional blood-flow and on oxygen uptake of tissue has been investigated in animal experiments and in man. Lumbar sympathectomy did always result in increase of limb blood-flow, but did not significantly improve oxygen consumption of the observed extremity. This finding was manifested by marked narrowing of the arterial-venous oxyhemoglobin saturation difference suggesting that lumbar sympathectomy caused opening of arterial-venous shunts.

Animals↗
PubMed2000

Chemical lumbar sympathectomy revisited: survey of the current practice of vascular surgeons in Scotland.

OBJECTIVE: To investigate the current practice of chemical lumbar sympathectomy by vascular surgeons in Scotland. DESIGN AND SUBJECTS: Postal questionnaire survey of all practising vascular surgeons in Scotland (n = 40) identified from the list of members of the Vascular Society of Great Britain and Ireland. RESULTS: Most surgeons (30 of the 34 respondents, 88%) practise chemical lumbar sympathectomy. Their main indications are in line with current recommendations in relevant publications. Controversial areas include its use as an adjunct to operation and in treating diabetic feet. The procedure is done by vascular surgeons (16 of 34 respondents, 47%) and anaesthetists or radiologists (14 of the 34 respondents, 41%). There is a wide variation in the technical aspects of the procedure. All respondents make a clinical assessment of outcome. CONCLUSION: The role of chemical lumbar sympathectomy is likely to remain controversial because of the lack of a valid prognostic marker, technical variability, and the fact that it is often used in elderly patients.

Aged↗
PubMed2000

Operative monitoring of hand and axillary temperature during endoscopic superior thoracic sympathectomy for the treatment of palmar hyperhidrosis.

OBJECTIVE: To find out how much the temperature in the palm rises after upper thoracic sympathectomy for palmar hyperhidrosis, and correlate the temperature with the outcome. DESIGN: Retrospective study. SETTING: University hospital, Spain. SUBJECTS: 73 patients (34 women and 39 men, age range 16-42 years, mean 26) who were operated for palmar hyperhidrosis between 1 January 1995 and 31 December 1997. INTERVENTIONS: Bilateral thoracic endoscopic sympathectomy during which the temperature was monitored on the skin of both axillae and thenar eminences, and in the oesophagus. MAIN OUTCOME MEASURES: Morbidity, alleviation of hyperhidrosis, recurrence rate, and differences in temperature postoperatively. RESULTS: There was minor bleeding during operation in 25 cases (34%), but in only 4 was it sufficient to require insertion of a drain; 2 patients developed transient Homer's syndrome; but the most common complication was compensatory hyperhidrosis (n = 52, 71%). In only 5 was this other than mild and required treatment with aluminium chloride in ethanol 25%. Palmar hyperhidrosis was alleviated in all cases, axillary sweating was considerably improved, and there was improvement in the feet in 56 (77%). There were 5 recurrences, all on the right side, during a mean follow up of 9 months (range 2-36), but in no case was the sweating severe. In almost all cases the temperature of the palm was less than that of the axilla before operation by a mean (SD) of 0.9 (0.3) degrees C. The rise in temperature varied from 1.7 (0.4) degrees C to 2.6 (0.4) degrees C. In the 5 patients who developed recurrences the increase was less (0.5 (0.4) degrees C). CONCLUSION: Thoracic endoscopic sympathectomy is safe, simple, and effective in treating palmar hyperhidrosis that has not responded to conservative treatment. Intradermal monitoring is an accurate and cost-effective way of monitoring temperature during operation. Although it is essential to achieve a rise in temperature of 1 degrees C, our most important finding was that the final temperature in both hands and axillae should be above 35 degrees C and as near as possible to 36 degrees C.

Adolescent↗
PubMed2000

Transthoracic endoscopic sympathectomy for craniofacial hyperhidrosis: analysis of 46 cases.

BACKGROUND AND PURPOSE: Craniofacial hyperhidrosis may result in social phobia and has a strong negative impact on the quality of life. The traditional therapeutic options are psychotherapy and pharmacologic treatment, but these often fail. We wished to investigate whether transthoracic endoscopic sympathectomy (TES) of the lower part of the stellate ganglion is efficient and safe in the treatment of craniofacial hyperhidrosis. PATIENTS AND METHODS: Between July 1995 and September 1999, a total of 21 men and 25 women with a mean age of 41.2 years (range 22-58 years) underwent TES for craniofacial hyperhidrosis. All patients were placed in a semisitting position under single-lumen intubated anesthesia. We ablated the lower part of the stellate ganglion at the second rib using a storz 8-mm 0 degrees thoracoscope via one 0.8-cm incision just below each axilla. Questionnaires were sent to all patients postoperatively. RESULTS: Among these 46 patients, 92 sympathectomies were performed. Usually, TES was accomplished within 15 minutes (range 7-20 minutes). The surgical complications were minimal: one segmental atelectasis of the lung (2%). There was no surgical mortality. With a mean postoperative follow-up of 32.1 months (range 3-51 months), the results of TES were highly satisfactory in most patients although 37 (80%) developed compensatory sweating of the trunk and lower limbs, the distribution being the axillae in 15 (33%), back in 36 (78%), lower chest and abdomen in 22 (48%), lower limbs in 34 (74%) and sole in 1. The recurrence rates of craniofacial hyperhidrosis were 0 in the first and the second years and 2% each in the third and fourth years. CONCLUSION: Transthoracic endoscopic sympathectomy is a safe and effective method for treating craniofacial hyperhidrosis.

Adult↗
PubMed1990

Sympathectomy alters acetylcholinesterase expression in adult rat heart.

STUDY OBJECTIVE: The aim of the study was to determine the significance of adrenergic nerve associated acetylcholinesterase for the pool of total acetylcholinesterase molecules. DESIGN: Acetylcholinesterase was analysed after destruction of adrenergic nerves by 6-hydroxydopamine or bilateral stellate sympathectomy. Effectiveness of treatment was verified by determining noradrenaline concentrations in right ventricle. Acetylcholinesterase activity was assayed in homogenates of atria and portions of left ventricular free wall. SUBJECTS: Adult male Sprague-Dawley rats were used, weight 225-260 g, n = 5 per experimental group. MAIN RESULTS: Sympathectomy caused a small decrease in acetylcholinesterase activity, due to a decrease in the activity of the tetrameric globular form of the enzyme. Choline acetylcholinesterase activity was not altered by sympathectomy, which is an indication that cholinergic nerves were not affected. CONCLUSIONS: The contribution of adrenergic neurones to the cardiac pool of acetylcholinesterase is measurable and consists primarily of the tetrameric globular form of the enzyme.

Acetylcholinesterase↗
PubMed1998

Intrathecal neostigmine, but not sympathectomy, relieves mechanical allodynia in a rat model of neuropathic pain.

INTRODUCTION: Pain resulting from a usually nonpainful stimulus (allodynia) is a common characteristic of neuropathic pain. Among animal models of allodynia, tight ligature of lumbar spinal nerves has been of special interest because it has been reported to be relieved by sympathectomy. The purpose of this study was to determine whether spinal analgesic agents, which have opposite effects on sympathetic nervous system activity (clonidine decreases it and neostigmine increases it), have differing efficacy in this model. METHODS: Male Sprague-Dawley rats were anesthetized, and the left L5 and L6 spinal nerves were ligated. At least 2 weeks later, a lumbar intrathecal or jugular intravenous catheter was inserted. Withdrawal threshold to mechanical stimulation of the hind paw was determined by application of von Frey filaments before surgery; after surgery; after intrathecal injection of clonidine, neostigmine, or their combination; after intravenous injection of phentolamine or guanethidine; and after surgical sympathectomy. RESULTS: Spinal nerve ligation reduced withdrawal threshold ipsilateral to the lesion. This allodynia was relieved by clonidine (50% block of allodynia at 20+/-1.2 microg and neostigmine (50% block of allodynia at 2+/-0.1 microg, and they interacted synergistically to block allodynia. Neither chemical nor surgical sympathectomy altered allodynia. DISCUSSION: These results disagree with previous observations that mechanical allodynia in this animal model depends on sympathetic nervous system activity. Therefore, intrathecally administered analgesic agents, one that reduces sympathetic outflow from the spinal cord (clonidine) and one that increases it (neostigmine), were similarly effective in this model.

Animals↗
PubMed1994

Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limbs. A critical analysis and long-term results of 480 operations.

OBJECTIVE: This evaluated the long-term outcome after endoscopic thoracic sympathectomy (ETS) from below D1 to D4, using a single-site access technique for primary hyperhidrosis of the upper limbs. SUMMARY BACKGROUND DATA: Primary hyperhidrosis of the upper limbs is a distressing and often socially disabling condition. Endoscopic thoracic sympathectomy is considered the treatment of choice, causing minimal morbidity and high initial success rates. However, data regarding long-term results are scarce. METHODS: Two hundred seventy of 323 patients (83.7%), in whom 480 sympathectomies were performed, answered a questionnaire after a mean of 14.6 years postoperatively regarding the early postoperative result, side effects, and complications caused by the operation and long-term results with particular emphasis on patient satisfaction. RESULTS: There was no postoperative mortality and no major complications requiring surgical reintervention. A majority of the patients (98.1%) were relieved, and 95.5% were satisfied initially. Permanent side effects included compensatory sweating in 67.4%, gustatory sweating in 50.7% and Horner's trias in 2.5%. However, patient satisfaction declined over time, although only 1.5% recurred. This left only 66.7% satisfied, and a 26.7% partially satisfied. Compensatory and gustatory sweating were the most frequently stated reasons for dissatisfaction. Individuals operated for axillary hyperhidrosis without palmar involvement were significantly less satisfied (33.3% and 46.2%, respectively).

Adolescent↗
PubMed1985

Effects of chronic peripheral sympathectomy on plasma levels of, and the pressor response to, vasopressin.

The purpose of the present study was to assess the effect of chronic peripheral sympathectomy in rats on plasma vasopressin (basal and dehydrated) and on pressor sensitivity to vasopressin. Sympathectomy was produced in male Sprague-Dawley rats by daily injection of guanethidine (45 mg/kg) for 9 days. Control rats received saline over the same period. Plasma vasopressin was determined by radio-immunoassay, and pressor sensitivity was determined by monitoring mean arterial pressure response to graded injections of vasopressin (0.1-20 mU) in conscious rats. Sympathectomized rats showed ptosis and supersensitivity to norepinephrine, and had significantly greater basal and dehydrated plasma vasopressin levels than controls (10.3 +/- 1.5 versus 6.2 +/- 0.7, and 12.4 +/- 0.9 versus 8.6 +/- 1.0 pg/ml, s.e.m, respectively, P less than 0.05 for both). Sympathectomized rats also had an increased pressor sensitivity to vasopressin (dose response curve shifted to left, lower threshold, greater slope, P less than 0.001). Injection of a vasopressin pressor-antagonist, d (CH2)5 Me Tyr AVP, had no effect on blood pressure in control rats but caused a significant decrease of blood pressure in sympathectomized rats (15 +/- 1.0 mmHg, P less than 0.001). These results suggest that chronic peripheral sympathectomy in rats is associated with increased basal and dehydrated plasma vasopressin, and increased pressor sensitivity to vasopressin. The effect of the vasopressin antagonist suggests that vasopressin may play a role in blood pressure maintenance in sympathectomized rats.

Animals↗
PubMed1991

Effects of sympathectomy on skin and muscle microcirculation during dorsal column stimulation: animal studies.

Electric stimulation of the dorsal spinal cord (DCS) in the treatment of pain in peripheral vascular disease is known to enhance peripheral circulation, but the mechanisms are still obscure. An earlier study has provided indirect evidence that the vasodilator effect is dependent upon alteration of sympathetic vasomotor activity. In the present study, surgical interruption of sympathetic pathways was performed to define the role of the sympathetic system for the stimulation-induced vasodilation. Three groups of normal rats were used: one group subjected to lumbar sympathectomy, one group sham-operated about 1 week before performing spinal cord stimulation, and a third group, without pretreatment, serving as a second control. Stimulation was applied to one dorsal column at the thoracolumbar junction, and peripheral microcirculation was recorded in hind limb skin and muscle by laser Doppler technique. The stimulation parameters were chosen to correspond with those used clinically in man. A cold test with monitoring of cold-induced changes in peripheral blood flow was used to assess the completeness of the sympathectomy. The preoperative cold test induced a reciprocal response, vasoconstriction in the skin and vasodilation in muscle. DCS with clinical parameters did not produce this reciprocity in the control and sham-operated rats, but induced a vasodilation in both skin and muscle. After complete sympathectomy, defined as postoperative disappearance of the vasomotor responses to cold, the vasodilation in skin and muscle in response to DCS was abolished; however, the vasodilatory response to high-intensity stimulation (approximately 10 times the motor threshold) was not affected. Incomplete sympathetic denervation in some animals resulted in partial preservation of a vasodilatory response to DCS.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2000

Microinvasive transaxillary thoracoscopic sympathectomy: technical note.

OBJECTIVE: To describe a two-port transaxillary thoracoscopic approach for thoracic sympathectomy that maximizes working space, improves manipulative ability, and enhances visualization of the surgical field. METHODS: Positioning of the patients was optimized to displace the scapula posteriorly, widen the avenue of approach to the sympathetic ganglia, and create a more direct route to the target. The semi-Fowler position permitted the lung apex to fall away from mediastinal structures, obviating a separate retraction port. A 30-degree endoscope allowed an unobstructed view of surgical progress, and anatomic relationships were manipulated in a temporal sequence to facilitate dissection. RESULTS: Microinvasive transaxillary sympathectomy was performed successfully in 13 patients, all of whom had a good outcome without complications. CONCLUSION: The modifications implemented increase the speed and safety of thoracoscopic sympathectomy while minimizing complications.

Axilla↗
PubMed2002

Biportal thoracoscopic sympathectomy: surgical techniques and clinical results for the treatment of hyperhidrosis.

OBJECTIVE: To describe a bilateral thoracoscopic sympathectomy procedure, using a biportal approach, for the treatment of severe hyperhidrosis. METHODS: Between May 1996 and September 2000, 103 consecutive patients underwent thoracoscopic sympathectomy procedures to treat bilateral hyperhidrosis (206 procedures). Operative results, complications, and patient satisfaction were determined by reviews of hospital and office charts and by follow-up assessments in the outpatient clinic. Long-term results were determined with clinical examinations, follow-up office visits, and follow-up questionnaires. RESULTS: Ninety-three patients presented with primary palmar hyperhidrosis, eight with primary axillary hyperhidrosis, and two with primary craniofacial hyperhidrosis. Rates of complete resolution in the primary area affected were 100% in palmar and craniofacial cases and 75% in axillary cases. The average length of hospitalization was 1.06 days, and 96 patients (93.2%) were discharged on or before the end of the first postoperative day. Of 59 patients (57.3%) who developed compensatory hyperhidrosis, only 11 patients (10.7%) reported that it was bothersome and none considered it disabling. All postoperative complications were transient; five patients experienced unilateral Horner's syndrome, three patients experienced intercostal neuralgia, and two patients required a chest tube after surgery because of a pneumothorax. CONCLUSION: Thoracoscopic sympathectomy using a biportal approach effectively treats hyperhidrosis and is associated with short hospital stays, high patient satisfaction rates, and low rates of compensatory hyperhidrosis or other complications.

Adolescent↗
PubMed2003

Palmar hyperhidrosis: intraoperative monitoring with laser Doppler blood flow as a guide for success after endoscopic thoracic sympathectomy.

OBJECTIVE: Video-assisted endoscopic thoracic sympathectomy is an effective surgical procedure for treating patients with palmar hyperhidrosis. An increase by more than 1 degrees C in palmar temperature has been observed to be predictive of good outcome. In this study, we investigated the use of palmar laser Doppler flowmetry as an intraoperative assessment of the efficacy of the operation. METHODS: One hundred sixty-six patients underwent a total of 330 endoscopic thoracic sympathectomy procedures from March 1996 to June 2001. We studied 17 patients (15 men, 2 women) who underwent a total of 33 procedures. The patients' mean age was 27.07 +/- 7.92 years, and the mean hospital stay was 2.23 +/- 0.66 days. RESULTS: Mean baseline laser Doppler blood flow was 2.63 +/- 2.56 ml/min/100 g. After the procedure, mean blood flow increased significantly to 7.24 +/- 5.88 ml/min/100 g (r = 0.768, P < 0.000, 95% confidence limit, -6.1060, -3.0946), a 232.18 +/- 219.12% increase. Mean palmar temperature increased to 1.44 +/- 1.44 degrees C. All patients experienced relief after the operation. Compensatory hyperhidrosis occurred in 10 (58.8%) of 17 patients. CONCLUSION: Monitoring of palmar laser Doppler blood flow changes is a useful adjunct during endoscopic thoracic sympathectomy surgery, and, when coupled with the established methods of endoscopic visualization and palmar temperature, it can predict the success of the procedure accurately.

Adolescent↗
PubMed1992

The treatment of chronic extremity pain in failed lumbar surgery. The role of lumbar sympathectomy.

Persistent lower extremity pain after unsuccessful lumbar surgery continues to be a disabling condition. The results of deafferentation procedures for radiculopathy have been disappointing. Hence, the prospect of isolating a potentially reversible component of extremity pain is quite attractive. Given the frequency with which vasomotor complaints occur in this setting, the occurrence of autonomic dysfunction seems quite plausible. Autonomic dysfunction was investigated in 17 patients who had undergone previous lumbar surgery and had chronic limb pain. Patients underwent a preblockade thermogram, sympathetic blockade, and postblockade thermograms. All patients reported substantial relief after blockade, and all underwent retroperitoneal sympathectomy. All patients were followed for at least 2 years. The clinical results were disappointing, with only one patient reporting substantial relief. Although the results of thermography initially seemed to correlate with clinical outcome, further follow-up failed to yield any correlation. Additionally, no specific combination of response to blockade or thermogram was predictive of the clinical success after sympathectomy. Now, lumbar sympathectomy is not recommended in the setting of chronic radiculopathy and persistent extremity pain.

Female↗
PubMed2002

Endoscopic thoracic sympathectomy for hyperhidrosis: experience with both cauterization and clamping methods.

The goal was to review results of sympathectomy, performed with use of either cauterization or clamping, in patients with hyperhidrosis (n = 1,312): 653 early patients undergoing electrocautery sympathectomy, 305 later patients undergoing cauterization, and 354 patients treated with a clamping procedure. Patients were interviewed by telephone about the status of symptoms, adverse outcomes, and satisfaction. Palmar hyperhidrosis was cured in all but one patient, with a 98% satisfaction rate in the clamping group and 94.3% and 95.1% in the two cauterization groups ( < or = 0.025, clamping > cauterization). Facial sweating or blushing was cured in the majority (88%) of the 301 patients reporting this symptom. Severe compensatory hidrosis occurred in less than 6% (3% of the clamping group; < or = 0.001, clamping < cauterization). Recurrence rate was 3.0%. A number of factors were related to outcome. Endoscopic thoracic sympathectomy with clamping appears to be at least as safe and effective as earlier cauterization techniques, with the potential advantage of reversibility in those patients unhappy with the outcome.

Adolescent↗
PubMed2003

Thoracoscopic sympathectomy for palmaris hyperhidrosis.

INTRODUCTION: Palmaris hyperhidrosis is a disorder mediated by the sympathetic nervous system. It causes excessive sweating. This study evaluated the safety, efficacy, and outcome after thoracoscopic sympathectomy in patients with palmaris hyperhidrosis. METHODS: We reviewed the medical records of 18 patients (10 male) who underwent bilateral thoracoscopic sympathectomy between July 1998 and June 2001. RESULTS: The patients' mean age was 34 years. No conversions to thoracotomy occurred. Three 2- to 5 mm trocars were used. The thoracic sympathetic chain was resected from ganglia T2-T4, except in one patient with axillary hyperhidrosis requiring resection to T5. The mean operating time was 112 minutes, the mean blood loss was 50 ml, and the mean postoperative hospital stay was 1.2 days. Two patients had a unilateral pneumothorax requiring tube thoracostomy; one patient developed a chest wall hematoma at a trocar site that resolved without treatment, and one patient developed a transient unilateral Horner's syndrome. There have been no hospital readmissions. After a mean follow-up period of 14 months, 11 patients (56%) reported compensatory sweating. Sixteen patients (89%) were satisfied with their outcomes. One patient was dissatisfied because of excessive compensatory sweating, and another continues to have mild unilateral sweating on one hand and compensatory sweating of the face. CONCLUSION: Thoracoscopic sympathectomy is a safe and effective alternative treatment for palmaris hyperhidrosis. Compensatory sweating occurs in more than 50% of patients but is tolerable in most. The majority of patients are satisfied with their short-term outcomes.

Adult↗
PubMed1979

Analysis of intestinal cell proliferation after guanethidine-induced sympathectomy. II. Percentage labelled mitoses studies.

Neonatal administration of guanethidine-sulfate results in an alteration of the cell proliferative pattern of the small intestinal epithelium of the young adult rat. Sympathectomy with guanethidine has previously been shown to depress mitotic, labelling, and total cellular migration indices while increasing the generation cycle time (Tc) of small intestinal crypt cells as measured by a stathmokinetic method. The present study showed that the G1, S and G2 phases of the crypt cell cycle are altered by sympathectomy, G1 accounting for most of the increase in Tc. In addition, the percentage of [3H]-thymidine labelled crypt cells is reduced and the duration of crypt cell transit is lengthened by guanethidine-induced sympathectomy.

Animals↗