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PubMed1975

Biochemical and functional evaluation of the sympathectomy produced by the administration of guanethidine to newborn rats.

The administration of guanethidine to newborn rats has been shown by morphological criteria to destroy sympathetic neurons. Newborn rats were injected with guanethidine (50-100 mg/kg/day for 20 days). Upon maturation (at 10 weeks old), the degree of destruction of the sympathetic nervous system (sympathectomy) was assessed. Marked decreases (80-98%) in the norepinephrine concentration in several tissues (heart, spleen, intestine, mesentery, kidney, uterus, vas deferens) were observed in the guanethidine-treated rats when compared to saline-treated controls. No changes were observed in the epinephrine concentration in the adrenals or in the norepinephrine levels in whole brain. Analysis of brain areas showed no change in the norepinephrine levels in brain stem and cerebrum and a small (18%) decrease in the cerebellum. Stimulation of the sympathetic vasomotor outflow in the pithed rat preparation produced almost no response in guanethidine-treated animals. Periarterial nerve stimulation of the isolated perfused kidney preparation also produced essentially no response in guanethidine-treated animals. Isolated intestinal preparations from guanethidine-treated animals responded to nerve stimulation with contractions rather than relaxation as seen in preparations from control animals. Isolated vas deferens preparations responded normally to nerve stimulation despite a 95% decrease in tissue norepinephrine concentration. These data indicate that administration of guanethidine to newborn rats produces a more complete peripheral sympathectomy, especially of the vasculature, than immunosympathectomy or neonatal administration of 6-hydroxydopamine and does so with no significant effect on central noradrenergic neurons.

Adrenal Glands↗
PubMed1990

[Heat exchange and skin thermometry before and after lumbar sympathectomy].

The authors studied the flow of heat and skin temperature of the legs and feet in 73 patients with atherosclerosis obliterans before and after lumbar sympathectomy. A regularity was revealed according to which numerical determination of heat emission in combination with thermometry in characteristic points of the leg and foot was a good test in determining the stage of the disease and a prognostic index of the efficacy of lumbar sympathectomy and rehabilitation of the patient in the immediate and late-term postoperative period.

Adult↗
PubMed1989

Development of the linkage of beta-adrenergic receptors to cardiac hypertrophy and heart rate control: neonatal sympathectomy with 6-hydroxydopamine.

Presynaptic neural projections are thought to participate in the maturation of postsynaptic sensitivity to neurotransmitters. In the current study, we have examined the effects of sympathectomy with 6-hydroxydopamine on the ontogeny of the linkage of beta-adrenergic receptors to cardiac growth and heart rate control in the rat. Destruction of sympathetic projections at birth compromised the ability of beta-receptor stimulation to evoke cardiac hypertrophy, a defect which persisted into young adulthood. The chronotropic response to beta-receptor activation, assessed by acute challenge with a submaximally-effective dose of isoproterenol, also exhibited a slowed development, but did eventually achieve normal sensitivity. In contrast, neonatal sympathectomy had only minor effects on resting heart rate, basal heart rate (the intrinsic rate in the absence of autonomic input) or maximal heart rate; these animals also showed beta-receptor desensitization of chronotropic action in response to chronic isoproterenol treatment. Chronic isoproterenol treatment itself lowered the basal heart rate, regardless of whether animals were normal or sympathectomized. Thus, during critical developmental periods, sympathetic input to beta-receptors selectively programmes the linkage between postsynaptic receptors, tissue growth and heart rate.

Animals↗
PubMed1989

Lumbar sympathectomy: a place in clinical medicine.

Currently lumbar sympathectomies are infrequently performed because the effectiveness of the procedure is unclear. The previous indication of limb-threatening ischemia has been usurped by distal arterial reconstruction. Some vascular surgeons feel there is no remaining clinical role. This paper suggests four categories of patients, represented by five case reports, where lumbar sympathectomy may prove beneficial: 1) Hypertensive patients with painful leg ulcers; 2) Toe and foot amputations in which arterial reconstruction is not feasible; 3) Posttraumatic causalgia (sympathetic dystrophy); 4) As an adjunct to distal graft bypass.

Adult↗
PubMed1989

[Evaluation of the effectiveness of sympathectomy using the skin oximetry method].

The use of the method of epicutaneous oxygenometry showed that it reflects objectively the condition of circulation in the extremity. Oxygen tension in the skin of patients with atherosclerosis obliterans of the lower extremities reduced with the gradual advancement of the disease. The operation of lumbar sympathectomy increases the level of skin oxygenation. The efficacy of the operation is highest in stage II but diminishes in stage III of the disease. Sympathectomy fails to improve regional circulation essentially in later stages of the disease.

Adult↗
PubMed1989

[Dynamics of the functional activity of the lymph nodes under conditions of sympathectomy].

By means of mechanotron 6MYIC and perfusion with physiological solution using the "running vesicle", dynamics of functional activity of the popliteal lymph nodes have been studied in 17 non-inbred dogs under conditions of unilateral sympathectomy for 1 week up to 5 months of the experiment. Dependence of the lymph node functional activity on the adrenomediator concentration level in their tissues has been determined by means of the microfluorometry method in the preparations treated after Falck-Hillarp method in E. M. Krokhina modification. Lymph nodes of intact dogs serve as a control. Unilateral sympathectomy of the lymph node is stated to produce an enhancement of the period for its filling and emptying with lymph, resulting from an increased level of the mediator in the fibrillar stroma at the expense of compensatory enhancement of functional activity of the nervous fibers of the contralateral origin. During the remote postoperative period the amplitude of the lymph node capsule fluctuations is stipulated by certain pathomorphological changes, produced by deficiency in concentration of catecholamines in the organ's parenchyma. As to the periodicity of the capsule fluctuations in the intact lymph nodes, it is limited with the cycle of 3-6 min.

Animals↗
PubMed1988

Role of sympathetic neurons in biochemical and functional development of the kidney: neonatal sympathectomy with 6-hydroxydopamine.

Renal sympathetic function develops over the first 3 weeks of postnatal life in the rat. In the current study, the effects of neonatal sympathectomy with 6-hydroxydopamine were examined on renal biochemical and functional development. The completeness and persistence of sympathetic nerve loss were confirmed by direct measurement of norepinephrine levels and turnover. Evidence was obtained for adverse effects on cellular maturation, as shown by perturbations in the ornithine decarboxylase/polyamine system, which is controlled partially by beta adrenergic input and which regulates macromolecule synthesis in developing cells. A later phase of 6-hydroxydopamine-induced alterations in renal development was seen during the period in which synaptogenesis is prominent and sympathetic tone is high (end of the 2nd postnatal week to end of the 3rd week): the denervated kidneys displayed supersensitivity of beta adrenergically mediated cyclic AMP responses without changes in receptor binding. The alterations in biochemical indices of cellular maturation were accompanied by abnormalities of renal function. 6-Hydroxydopamine caused an increase in the fractional excretion of sodium and deficits in physiological responsiveness of the kidney to a vasopressin analog. Later on, alterations in glomerular filtration rate and basal urinary osmolality also were prominent. These results indicate that neonatal sympathectomy has an adverse effect on the biochemical and functional development of the kidney.

Animals↗
PubMedDate not supplied

Purinergic supersensitivity following sympathectomy adds further support to co-transmission in the rat vas deferens.

Adrenergic and purinergic compounds contract the longitudinal muscles of the rat vas deferens. Whereas ATP and related purinergic analogs produced contractions of greater magnitude in the prostatic half as compared to that of the epididymal end, the magnitude of the alpha 1-adrenoceptor-induced responses was larger in the epididymal than in the prostatic half of the rat ductus. Chemical sympathectomy following a 48 hr 6-hydroxydopamine-treatment (6-OHDA) caused a leftward displacement of the concentration-response curves for adrenergic and purinergic drugs, this effect being more evident in the prostatic segment. Sympathectomy caused a significant increase in the maximal response induced by ATP and adrenergic compounds which was more evident in the prostatic half of the rat ductus. The denervation-induced supersensitivity was stimulus-specific since angiotensin II and acetylcholine showed no significant change in potency. In the case of bradykinin, there was a manifest increase in the maximal response of the prostatic segment of the ductus of the chemically denervated tissues. In addition, denervation also caused an increase in the potency of prazosin and phentolamine as alpha 1-adrenoceptor blocking agents; denervation did not change the potency of yohimbine as an alpha 2-adrenoceptor blocker.

Adenosine Triphosphate↗
PubMedDate not supplied

Lumbar sympathectomy in occlusive diseases.

To assess the real value of Lumbar Sympathectomy it is of prime importance to be aware of both the mechanisms of the neurogenic vasomotricity in a normal limb, and the effect of a sympathetic interruption on a normal and arteriopathetic limb. These mechanisms are studied and discussed by means of different vascular functional tests and results of operative procedure. It leads to identify the patients who are likely to respond well to sympathectomy either for distal skin troubles, or for claudication.

Anesthesia↗
PubMed1986

Lumbar sympathectomy.

Lumbar sympathectomy is used in patients with threatened or early gangrene of the toes where reconstructive arterial surgery is not possible--usually because arteriography has demonstrated absence of a "run off" suitable for endarteriectomy or a bypass graft. It may also be a supplement to reconstructive surgery of the aorta or the common iliac arteries. It is indicated in intractable Raynaud's disease affecting the feet and is particularly helpful in severe hyperhidrosis of the feet. In many cases the procedure can be performed nonoperatively by chemical sympathectomy using an injection of aqueous phenol into the lumbar chain.

Autonomic Nerve Block↗
PubMedDate not supplied

Percutaneous chemical lumbar sympathectomy with alcohol with computed tomography control.

Percutaneous chemical lumbar sympathectomy with alcohol (PCLSA) using computed tomography (CT) control was performed in 8 patients suffering from advanced peripheral arterial occlusive disease. PCLSA under CT guidance was found to be a simple and safe procedure. The use of CT control added precision in the guidance of needle placement. Positive results were obtained in all patients, without significant morbidity. PCLSA may be an alternative to surgical sympathectomy.

Adult↗
PubMed1986

[Oxygen tension in tissues of the extremities during lumbar sympathectomy].

Measurements of oxygen tension in the lower extremity skin in patients with obliterating atherosclerosis has revealed the basal decrease of tissue oxygenation. Lumbar sympathectomy caused a temporary aggravation of regional hypoxia resulting from reflex responses to mechanical irritation of autonomic ganglions during operation. A preliminary injection of pentamine, blockade of lumbar ganglia with novocaine, sparing technique of ganglionectomy considerably reduced or even prevented hypoxic reaction of tissues. The efficiency of the operation is dependent on the degree of basal arterial ischemia, stage of the disease and technique of performing sympathectomy.

Adult↗
PubMedDate not supplied

Antinociceptive and behavioral effects of leu-enkephalin (LENK) or D-Ala2-met-enkephalinamide (DAMEA) in rats after central chemical sympathectomy or serotoninectomy.

In rats with central chemical sympathectomy induced by two injections into the lateral brain ventricle (icv) of 250 micrograms of 6-hydroxydopamine or with central chemical serotoninectomy induced by 75 micrograms of 5,6-dihydroxytryptamine icv the antinociceptive and behavioral effects of LENK (200 micrograms icv) or DAMEA (10 or 20 micrograms icv) were examined. The chemical lesion of central noradrenaline or dopamine neurons or specific lesion of serotonin neurons abolished antinociceptive effects of LENK and DAMEA. Both peptides inhibited exploratory activity of rats. Central chemical serotoninectomy but not sympathectomy reversed some behavioral effects induced by LENK and DAMEA. These results suggest modulatory influence of the central noradrenaline and serotonin neurons in the antinociceptive mechanism of action of enkephalins and the participation of the central serotonin neurons on the behavior of rats induced by enkephalins.

5,6-Dihydroxytryptamine↗
PubMed1986

[Effect of guanethidine sympathectomy on cardiac functions in rat pups].

Catecholamine level in the blood, heart and adrenal tissues, and heart sensitivity to catecholamines were determined in 3-week-old rats after chemical sympathectomy. It was shown that tachycardia in sympathectomy rats was caused by increased heart sensitivity to catecholamines due to the reduction in their concentration.

Adrenal Glands↗
PubMed1985

[Sympathectomy and microcirculation: physiopathologic reflections].

Sympathectomy provokes vascular motor denervation, and drastically modifies the vasomotor equilibrium of the limbs which is also dependent on metabolic, humoral and myogenic factors. Therapeutic efficacy of sympathectomy is related to the state of activity and reactivity of these other factors. The fall in peripheral resistance resulting from the opening up of cutaneous arteriovenous anastomoses increases flow through a stenosis or bypass, with the tendency for development of the collateral circulation. Positive effects may be obtained also when trophic disorders exist, but there is the risk of a nutritional circulation steal in the presence of blood hyperviscosity, with the need for associated rheologic treatment. Indications are few in Raynaud's disease, except for digital arterial disease.

Arteriovenous Anastomosis↗
PubMed1979

Extended deep femoral angioplasty and lumbar sympathectomy as a limb salvage procedure.

Limb salvage in 27 limbs (26 patients) using the combined operations of extended deep femoral angioplasty and lumbar sympathectomy is described. A successful result was obtained in 14 cases (52%) at 6 months falling to 12 (45%) at 16 months. Prediction of outcome and postoperative progress was monitored by the measurement of the leg: arm pressure ratio using the Doppler ultrasound apparatus. No patient with a preoperative ratio of less than 0.3 had a successful result. It is proposed that lumbar sympathectomy is a logical adjunct to surgery in these patients in order to enhance the development of the collateral circulation.

Aged↗
PubMedDate not supplied

Experimental study of sensitization to catecholamines after lumbar sympathectomy.

In a first time, the authors have shown a real supersensitivity to the action of catecholamines after lumbar sympathectomy in dog. Then, they have established a protocol which can be applied to the exploration of those phenomena in arteritic patients. Same doses of epinephrine and norepinephrine (which correspond to a slight hypercatecholamine blood level under stress) are injected intravenously, comparatively before and after lumbar sympathectomy. The modifications of E.C.G., arterial blood pressure and rheographic record, caused by those injections seem to prove the existence of a sensitization which is still lasting 4 months after the operation, but which does not seem to be noxious. Therefore, this sensitization generates compensating reflex reactions to arterial hypertension, leading to a favorable increase of the blood flow in the denervated territories.

Animals↗