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At least 595 records · Page 33Linked to original sources
PubMed1981

Thermographic assessment of impaired sympathetic function in peripheral nerve injuries.

Twenty-three patients with focal, strictly unilateral lesions of the peripheral nervous system were examined by infrared-thermography. The Minor sweat test was used to determine if sympathetic outflow was disturbed. In fifteen patients without a concomitant sympathetic lesion (controls) thermosymmetry was not disturbed. Eight patients had evidence of abnormal sweat secretion. In these patients thermoregulation was severely disturbed. During the first 5 to 8 months, affected skin areas were hyperthermic, whereas later only hypothermia was observed. Cold stimuli increased temperature differences in patients with disturbed sympathetic function, but not in controls. Thermography is a reliable, non-invasive technique to detect a lesion of sympathetic outflow and permits an estimation of the time-course of the lesion.

Adolescent↗
PubMed1986

The human dive reflex: an experimental, topographical and physiological analysis.

This study examined the eliciting conditions, response topography and autonomic nervous system (ANS) control of the dive reflex as evoked in humans. Twenty-four subjects received eight trials in each of the three treatment conditions: breath holding without face immersion (BH); face immersion without breath holding (FI); and the "full dive" FIBH condition. It was the combination of both FI and BH in 23 +/- 0.5 degrees C water that was necessary to elicit the dive reflex. A precise topographical analysis differentiated the FIBH condition from the FI and BH control conditions in terms of the emergence of a secondary component initiated approximately 12 seconds after trial onset. During this secondary component, augmentation of bradycardic (mean = 16.3 bpm) and digital vasoconstrictive (mean = -24.9%) responses were maintained throughout the duration of the 40-second dive. A joint consideration of the heart rate and the T-wave amplitude measures as indices of the action of both branches of the ANS suggested that the dive reflex involves concurrent sympathetic and parasympathetic activation. A potential conditioning application of the dive reflex for countering paroxysmal supraventricular tachycardia was discussed.

Adolescent↗
PubMed1997

Quantitative evaluation of sympathetic nervous system dysfunction in patients with reflex sympathetic dystrophy.

The sympathetic nervous system function in 20 patients with reflex sympathetic dystrophy (RSD) of one upper extremity was examined by a non-invasive laser Doppler method to assess fingertip blood flow and vasoconstrictor response to deep inspiration. We observed an increased blood flow but an unchanged vasoconstrictor response in the affected hand in stage 1 of the disorder, but in stage 2 there was a decreased blood flow and a stronger vasoconstriction following an inspiratory gasp. Skin blood flow and vasoconstrictor response returned to normal following successful treatment of the condition. These results suggest that in RSD patients the sympathetic nervous system function is altered and is different in the various stages. The objective method used in our study may be of value in the diagnosis and management of RSD.

Adult↗
PubMed1986

Role of reflex sympathetic withdrawal in the hemodynamic response to an increased inotropic state in patients with severe heart failure.

Newer positive inotropic agents used in the treatment of severe heart failure not only increase cardiac contractility, but also cause peripheral vasodilation. It is not known to what extent this vasodilation is due to a direct peripheral action of the drug, as opposed to reflex withdrawal of sympathetic tone secondary to an augmented inotropic state. In 16 patients with severe heart failure, a 48 hour intravenous infusion of milrinone, a positive inotropic vasodilator drug, resulted in an increase in stroke volume index from 26 +/- 2 to 34 +/- 3 ml/m2 (p less than 0.001), a reduction in forearm vascular resistance measured by venous plethysmography from 43 +/- 5 to 27 +/- 3 U (p less than 0.003) and an increase in forearm venous capacitance from 2.1 +/- 0.2 to 2.9 +/- 0.2 ml/100 ml (p less than 0.001). To determine whether a withdrawal of sympathetic tone contributed to this vasodilation, milrinone was infused directly into the left main coronary artery in eight of the patients, thereby eliminating any direct vascular effects of the drug. Intracoronary milrinone (50 micrograms/min) caused an increase in peak positive first derivative of pressure (658 +/- 49 to 784 +/- 68 mm Hg/s; p less than 0.01) and stroke volume index (20 +/- 2 to 25 +/- 3 ml/m2; p less than 0.0001), which was associated with a reduction in plasma norepinephrine from 540 +/- 101 to 423 +/- 90 pg/ml (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Administration Schedule↗
PubMed1984

Prostaglandins in severe congestive heart failure. Relation to activation of the renin--angiotensin system and hyponatremia.

To determine whether prostaglandins are involved in circulatory homeostasis in congestive heart failure, we measured plasma levels of the metabolites of vasodilator prostaglandins I2 and E2 in 15 patients with severe chronic heart failure. Mean circulating levels of both metabolites were 3 to 10 times higher than those in normal subjects. Plasma levels of both metabolites correlated directly with plasma renin activity and plasma angiotensin II concentrations (r = 0.64 and 0.84, respectively). Individual serum sodium concentrations were inversely correlated with levels of prostaglandin E2 metabolites (r = -0.92, P less than 0.001) and plasma renin activity (r = -0.69, P less than 0.02). Of 23 patients with severe heart failure challenged with indomethacin (an inhibitor of prostaglandin synthesis), the 9 with hyponatremia had significant decreases in the cardiac index (1.99 +/- 0.12 to 1.72 +/- 0.13 liters per minute per square meter of body-surface area, P less than 0.001) and significant increases in the pulmonary capillary wedge pressure (17.4 +/- 2.0 to 24.0 +/- 1.9 mm Hg, P less than 0.001) and systemic vascular resistance (1882 +/- 239 to 2488 +/- 315 dyn x sec x cm-5, P less than 0.001), whereas the 14 patients with a normal serum sodium concentration had no significant hemodynamic changes. We conclude that both vasoconstrictor (renin-angiotensin) and vasodilator (prostaglandin) mechanisms are operative in patients with heart failure complicated by hyponatremia and that these mechanisms interact to modulate circulatory homeostasis.

Adult↗
PubMedDate not supplied

Immunohistochemical-scintigraphic correlation of sympathetic cardiac innervation in postischemic left ventricular aneurysms.

BACKGROUND: This study was conceived to explore the correspondence between scintigraphic imaging of the sympathetic innervation of human postischemic left ventricular aneurysms and direct immunohistochemical localization of the nerve fibers in the same area. MATERIALS AND METHODS: In 7 patients undergoing left ventricular aneurysmectomy for postischemic ventricular aneurysm, the findings of thallium 201 and metaiodobenzylguanidine myocardial scintigraphy were compared with direct immunohistochemical localization of the nerve fibers in the same area. This comparison showed good correspondence between scintigraphic and immunohistochemical data, although scintigraphy failed to detect areas of minimal sympathetic innervation. Moreover, microscopic analysis showed sympathetic nerve fibers with peculiar morphology and distribution in the aneurysmal zone. CONCLUSION: There is a good correspondence between immunohistochemical and scintigraphic imaging in the detection of sympathetic cardiac nerves in human left ventricular aneurysms; a morphologically abnormal sympathetic reinnervation can be found in the aneurysmal area (although denervation can persist in some zones).

3-Iodobenzylguanidine↗