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PubMed1990

Effect of sympathectomy on capillaries of the cochlear lateral wall.

The right superior cervical ganglia of 11 cats were removed. After intravenous injection of horseradish peroxidase, both sides of the cochleas were infused with 2% glutaraldehyde and the lateral wall of the cochlea was then microdissected. As control group, both sides of the cochleas of 4 cats were extracted while the superior cervical ganglia remained intact. The samples were incubated after a modified Graham-Karnovsky method and observed by light microscopy. The diameters of the capillaries of the stria vascularis and spiral ligaments were measured. In 8 cats (73%), the diameters of the capillaries of the stria vascularis on the side on which sympathectomy was performed were significantly greater than those on the opposite side. There was no statistical difference between the diameters of the capillaries of the spiral ligament on either the sympathectomized side or the intact side, except in 2 cats. In the control group (in which the superior cervical ganglia were left intact), no statistical difference was found as regards the diameters of the stria vascularis capillaries on either the left or right side. In summary, sympathectomy affected only the capillaries of the stria vascularis and not those of the spiral ligament.

Animals↗
PubMed1991

Feedback in the rabbit's central circadian system, revealed by the changes in its free-running food intake pattern induced by blinding, cervical sympathectomy, pinealectomy, and melatonin administration.

Long-term records of the number of food approaches per 30 min were obtained from 16 rabbits in constant light and after blinding. Optic nerve sectioning usually resulted in a shortening of the free-running period (tau; mean reduction = -0.26 hr) of the oscillator governing the rabbit's food intake pattern. Subsequent resection of both superior cervical ganglia always reduced this tau (mean = -0.41 hr), and it could be further shortened (mean = -0.24 hr) by chronic administration of melatonin. These observations led to experiments in which the food intake of 15 blinded rabbits was recorded before and after pinealectomy. This always resulted in a lengthening of tau (mean = +0.27 hr), which was never seen after subtotal or sham pinealectomy in 10 other blinded animals (mean = -0.05 hr). Sympathectomy also reduced tau (mean = -0.50 hr) in the pinealectomized rabbits, whereas it induced a smaller reduction (mean = -0.29 hr) after sham pinealectomy. These results, together with previous observations on the effect of sympathectomy on the retinal "dark" discharge and on the influence of the latter upon the food intake pattern, indicate that the cervical sympathetic nerves may form part of three feedback loops for the rabbit's central circadian system. These have separate postganglionic pathways; there are also differences in the circadian phasing of their activities and in their effects on tau.

Animals↗
PubMed1980

Effect of chemical sympathectomy on myocardial cell division in the newborn rat.

Myocardial chemical sympathectomy was achieved by daily SC injection of 100 micrograms/g body weight of 6-OH-dopamine to each of 239 Holtzman newborn rat pups for the first seven days of life. Effective sympathectomy was verified by identifying a decrease in ventricular myocardial norepinephrine concentrations to 31% +/- 12 S.E. of control at 20 days of age. Activity of DNA polymerase was used to indicate the extent of myocardial cell division. Beginning at eight days of age, DNA polymerase activity was increased in the sympathectomized pups relative to control. The DNA polymerase activity was highest relative to control at 16 days (235% +/- 31 S.E.) and remained elevated beyond 20 days (188% +/- 30 of control). The DNA polymerase data was analyzed by covariance and was significantly greater in the 6-OH-dopamine rat pups (P < 0.001).

Animals↗
PubMed2002

Possibilities at present for the application of lumbar sympathectomy in chronic occlusive arterial disease of the lower limbs.

BACKGROUND: Research on the limitations of the validity of lumbar sympathectomy in surgical treatment of lower limb occlusive arterial disease is still of great interest today. METHODS: Our study deals with 385 patients who underwent the surgical removal of a segment which includes the 2nd and the 3rd ganglion of the lumbar sympathetic chain in the period between the month of January 1989 and the month of December 1998. RESULTS: Results were good in 63.6% of patients and stationary in 10.53% of cases; in 26% of cases lumbar sympathectomy was not valid. CONCLUSIONS: Satisfactory results were recorded, as will be shown in this text, on patients experiencing a period of rest pain, patients with ischaemic dystrophic lesions and those with very advanced intermittent claudication equally favourable results were seen in diabetic patients.

Adult↗
PubMed1975

[Age changes in rat vasomotor reflexes and sympathetic neuron ultrastructure following chemical sympathectomy].

Prolonged administration of guanethidine (20 mg/kg) to newborn rats caused a marked reduction in the number of cells in stellate ganglia. The administration of guanethidine for 14 days decreased the amount of cells to 30% of the normal (partial sympathectomy), and for 28 days--to 0.5% (complete sympathectomy). At the age of two months the blood pressure pressor reflexes to asphyxia and femoral nerve stimulation were absent in both groups of the sympathectomized animals. These responses, however, were restored in the partially sympathectomized animals at the age of four months. No restoration took place in the completely sympathectomized animals. The electron microscopic studies of neurons in the partially sympathectomized animals showed the presence of a great number of neurofibrils. According to literature data this fact was typical of cells in which an active growth of axon fibers took place.

Aging↗
PubMed1998

Thoracoscopic sympathectomy: a case report.

Thoracoscopic sympathectomy was first described in 1951 but was not popularized until this decade. With the advent of videoendoscopic techniques and advances in minimally invasive surgery, thoracoscopic sympathectomy has been shown to be a safe and effective therapy in the treatment of various autonomically mediated disorders. Furthermore, numerous investigators have reported high rates of technical success and patient satisfacrion. These minimally invasive techniques used to resect the sympathetic ganglia significantly reduces the morbidity and mortality often associated with conventional open procedures. In addition, endoscopic techniques provide a magnified view of the surgical field and allow for precise identification of the sympathetic chain and points of resection.

Journal Article↗
PubMed1975

The effect of constant light and chemical sympathectomy on the development of serotonin, n-acetyltransferase and monoamine oxidase activities in the rat epiphyses.

The daytime activity of N-acetyltransferase per mg epiphysis decreased to 1/10 the newborn level by the age of 13 days, and subsequently remained unchanged. The night activity was equal to the day activity at the age of 3 days, was higher at the age of 6 days and was 20 X that of the day level at the age of 40 days. Keeping animals in constant light after birth depressed the development of these diurnal differences in N-acetyltransferase activity and slowed down the decrease in enzyme activity after birth. Sympathectomy with 6-hydroxydopamine after birth abolished the development of the diurnal rhythm in N-acetyltransferase in 12-day-old rats in two experiments out of five and only decreased the night activity without abolishing the rhythm in three experiments. Monoamine oxidase activity (MAO) per mg epiphysis, which is the same in newly born and in adult animals, decreased to half the original value for 6 days after birth and then increased again. Constant light after birth did not influence MAO activity, but sympathectomy with 6-hydroxydopamine decreased activity in the epiphysis in 12-day-old animals.

Acetyltransferases↗
PubMed1991

[Experimental study of progressive facial hemiatrophy: effects of cervical sympathectomy in animals].

Progressive facial hemiatrophy (Romberg's syndrome) is of unknown cause and uncertain pathogenesis. The main pathogenetic hypotheses are: sympathetic system alterations, localized scleroderma, trigeminal changes, possibly of genetic origin. To test the hypothesis of sympathetic system alterations, we designed an experimental model with ablation of the superior cervical sympathetic ganglion in rabbits, cats and dogs. All the animals were operated upon when 30 days old and were examined monthly for 1 year. During this period localized alopecia, corneal ulceration, keratitis, strabismus, enophthalmos, ocular atrophy, hemifacial atrophy and slight bone atrophy on the side of the sympathectomy were observed. Thus, cervical sympathectomy reproduces in animals the principal clinical alterations of Romberg's syndrome. Our data suggest that the sympathetic system is involved in the pathogenesis of this syndrome.

Animals↗
PubMed1989

Transthoracic sympathectomy for palmar hyperhidrosis in children under 16 years of age.

Palmar hyperhidrosis can be a disabling condition in children. We report the results of transthoracic sympathectomy in 18 children aged 16 years or under. Follow-up, 1 to 11 years after surgery, revealed a high incidence of late sequelae, but these were not significant when compared to the primary condition. Transthoracic sympathectomy is recommended for children with severe palmar hyperhidrosis.

Adolescent↗
PubMed1979

Gastric acid secretion after chemical sympathectomy.

Adrenergic nerve terminals in several organs are selectively destroyed by 6-hydroxydopamine (6-OHDA) resulting in a chemical sympathectomy that is reversible. In this study the acute and chronic effects of 6-OHDA on gastric mucosa and acid secretion were evaluated. Four dogs were given 6-OHDA (40 mg/kg, intravenously). Gastric biopsies were taken before treatment and biweekly thereafter and were analyzed by fluorescence microscopy (Hillarp-Falck). Degeneration of adrenergic nerve terminals in the mucosa was complete at 1 week. Early regeneration was noted at 3 weeks and appeared to be complete at 9 weeks. In another group of seven dogs with a gastric fistula, dose-response curves to pnetagastrin (PPG, 0 to 5 microgram/kg/hr) were determined. Then 6-OHDA (40 mg/kg) was given to these dogs and secretory studies were repeated weekly thereafter for 8 weeks. After 6-OHDA administration, acid secretion increased in response to submaximal doses of PPG, whereas maximal secretion was unchanged. The peak increase occurred the second week; thereafter secretion gradually returned to control values. We conclude that chemical sympathectomy (6-OHDA) increases gastric acid secretion in response to submaximal PPG stimulation. This increase correlates well with the 6-OHDA--induced degeneration of adrenergic terminals in the mucosa. These data suggest that the adrenergic innervation of the stomach has an inhibitory effect on the control of acid secretion in the dog.

Animals↗
PubMed1983

Baroreflex control of heart rate during cardiac sympathectomy by epidural anesthesia in lightly anesthetized humans.

To evaluate the effects of acute sympathetic denervation on the baroreflex control of heart rate, baroreflex sensitivities were compared in lightly anesthetized humans who had either cervical (N = 20) or lumbar epidural anesthesia (N = 18), or neither (N = 18). Levels of anesthesia during cervical block using 10 ml of 2% mepivacaine without epinephrine were C3-T7 and T7-S1 during lumbar epidural block. Baroreflex sensitivity was assessed with a pressor test using phenylephrine infusion to increase systolic blood pressure by 60 mm Hg within 2 min. There were no statistically significant differences in the baroreflex sensitivities in the absence of epidural block and during lumbar epidural block, the slopes of the regression line (in msec of RR interval change per mm Hg increase in systolic blood pressure, i.e., msec/mm Hg) relating systolic pressure and the succeeding pulse interval being 3.8 +/- 1.4 (mean +/- SD) and 3.7 +/- 1.7, respectively. The mean slope during cervical block, 1.1 +/- 1.2 msec/mm Hg, was significantly different from the slopes observed in the absence of epidural block and during lumbar epidural block (P less than 0.01). The results suggest that cardiac sympathectomy induced by epidural anesthesia can suppress partially baroreceptor function by interrupting sympathetic efferent fibers innervating the heart during high levels of epidural anesthesia, but that lumbar sympathectomy during epidural anesthesia is unlikely to affect baroreceptor activity.

Adult↗
PubMed1995

Alteration of antioxidant status following sympathectomy: differential effects of modified plasma levels of adrenaline and noradrenaline.

The influence of altered levels of endogenous catecholamines following adrenalectomy or 6-hydroxydopamine (6-OH) treatment (alone or in combination) on enzymatic (glutathione reductase, catalase, glutathione peroxidase and Cu, Zn superoxide dismutase) and non-enzymatic (glutathione) antioxidant components of heart, liver, kidney, lung and erythrocytes in male Wistar rats was investigated. Functional antioxidant status was assessed in terms of susceptibility to t-butylhydroperoxide-induced sulfhydryl group oxidation (an indirect measure of glutathione depletion) and lipid peroxidation, as measured by thiobarbituric acid-reactive substance (TBARS) formation. Reduced levels of adrenaline and noradrenaline resulted from adrenalectomy and 6-OH treatment, respectively, while a combination of these treatments led to a reduction in the levels of both catecholamines. Adrenalectomy was associated with alterations in glutathione reductase activity in the heart and liver (increased). 6-OH treatment alone produced an elevation in glutathione reductase activity only in the heart. In adrenalectomized animals, 6-OH treatment produced no further increases in glutathione reductase activities of heart or liver. In lung, however, the combination of adrenalectomy and 6-OH treatment caused an elevation in both glutathione peroxidase and glutathione reductase activities. Glutathione levels of liver alone were elevated following adrenalectomy, while those of erythrocytes and liver (but not other tissues investigated) were increased by the combination of adrenalectomy and 6-OH treatment. The kidney was relatively resistant to the effects of sympathectomy and showed no changes in any of the antioxidant components measured. Adrenalectomy alone or in combination with 6-OH produced an increased in susceptibility to peroxide-induced sulfhydryl group oxidation only in the heart. 6-OH treatment caused a reduction in peroxide-induced TBARS formation only in the kidney. Both adrenalectomy and the combination of adrenalectomy and 6-OH treatment were associated with reduced TBARS formation in the liver, lung and kidney, but not heart. Results from this study demonstrate that the effects of sympathectomy on antioxidant status vary among tissues. Differences between adrenalectomy and 6-OH treatment on antioxidant components are suggestive of differential actions of adrenaline and noradrenaline on tissue antioxidant status which may have important implications under conditions associated with elevations in levels of these catecholamines including chronic stress and myocardial infarction.

Adrenalectomy↗
PubMed1977

Suppression of the primary immune response by chemical sympathectomy.

The effects of general sympathectomy with 6-hydroxydopamine (6-OHDA) on antibody production to sheep red cells (SRBC) were studied in mice. Intraperitoneal administration of 6-OHDA in a dose of 1 to 300mg/kg resulted in a significant decrease in hemagglutinin titer and number of direct plaque-forming cells which were observed only in the early period of the primary immune response. Following treatment with 6-OHDA 10mg/kg i.p., the noradrenaline content in murine spleen was significantly reduced from 63 to 42% of control value between 2 and 10 days after injection indicating that chemical sympathectomy suppresses the primary immune response.

Animals↗
PubMed1996

Assessment of outcome after thoracoscopic sympathectomy for hyperhidrosis in a specialized unit.

Transthoracic endoscopic electrocautery of the sympathetic chain is increasingly being used as a technique for producing the effects of upper thoracic sympathectomy. In November 1990 we introduced this operation as a regional service in Northern Ireland and have assessed the results in patients with idiopathic hyperhidrosis of the palms and axillae. There were 92 sympathectomics carried out for hyperhidrosis on 47 patients between 26 November 1990 and 6 September 1993. Full follow-up was possible in 45 patients (96%) at a median of 13 months (range 3-36) after the operation. Symptoms were improved in 43 patients (96%) at review. In three patients surgery failed to control symptoms on one side, and in two there was bilateral recurrence at 4 and 8 months after initial good results. Compensatory hyperhidrosis occurred in 35 patients (56%) and was severe in 4 (9%). Nine of 34 patients (34%) with plantar symptoms reported improvement in these post-operatively. This paper, with its high level of full follow-up, confirms thoracoscopic sympathectomy to be effective treatment for both palmar and axillary hyperhidrosis. Patient selection, however, is important and the risk of compensatory hyperhidrosis must be fully explained.

Adult↗
PubMed1998

Thoracoscopic sympathectomy for hyperhidrosis: is there a learning curve?

The aim of this study was to evaluate the learning curve of upper dorsal thoracoscopic sympathectomy. From June 1993 to December 1996, we performed 232 sympathectomies on 116 patients with primary palmar hyperhidrosis. The T2-T3 ganglia were resected by electrocuting and were removed for histologic examination. The series was divided into two groups of 58 patients each, and operations in each group occurred during a period of 21 months. Follow-up was obtained on 111 patients for a mean of 25.06+/-12.62 months. All limbs were dry after the operation, and hyperhidrosis did not recur. The anesthesia time was reduced, but the operating time, the difficulty in identifying and in resecting the ganglia, compensatory hyperhidrosis, postoperative neuralgia, and subjective satisfaction with the procedure were similar in both groups. The learning curve in the present study was mainly reflected by a reduction in the incidence of Horner's syndrome.

Adolescent↗
PubMed1998

Increased immunoexpression of atrial natriuretic peptide in the heart conduction system of the rat after cardiac sympathectomy.

The present investigation was designed to elucidate which role the sympathetic nerves play in the immunoexpression of atrial natriuretic peptide in the cardiac conduction system of the rat. In order to destroy the cardiac sympathetic nerve terminals, both surgical and chemical sympathectomy were performed. By use of immunohistochemical and radioimmunoassay techniques, the immunoreactivity and level of atrial natriuretic peptide in the conduction system and in the cardiac myocardium were determined. In contrast to the low degree of immunoreaction for atrial natriuretic peptide seen in control rats, the sympathectomized rats exhibited pronounced immunoreactivity for atrial natriuretic peptide in the atrioventricular bundle and bundle branches, which normally have high numbers of sympathetic nerve fibres. On the other hand, in the peripheral parts of the conduction system, where there are ordinarily few sympathetic nerve fibres, the degree of immunoreaction was unchanged. The quantitative measurements also showed that the entire ventricles, including the conduction system, contained increased levels of atrial natriuretic peptide in the treated hearts. The present study shows that destruction of the sympathetic nervous system leads to an increased level of atrial natriuretic peptide in the Purkinje fibres of bundle branches, which thus seem to have a dormant capacity for synthesis of this peptide. The results provide new evidence about the change in atrial natriuretic peptide levels that occurs when sympathetic innervation is altered.

Animals↗
PubMed1982

Catecholamines in the carotid body of several mammalian species: effects of surgical and chemical sympathectomy.

The catecholamine content of the carotid body of several mammalian species has been assayed using high performance liquid chromatography coupled to electrochemical detection and radioenzymatic assays. Although there were strain differences in the content of catecholamines in the carotid body of the rat, noradrenaline was equal to or exceeded the dopamine level in this species. No apparent differences were found in carotid bodies of animals killed by cervical dislocation or those dissected from anaesthetized animals. Noradrenaline concentrations were found to be substantially higher than those of dopamine in the cat and guinea-pig carotid body, though dopamine was the predominant amine in the rabbit and ferret. Unilateral superior cervical ganglionectomy or chemical sympathectomy with 6-hydroxydopamine substantially depleted noradrenaline without influencing dopamine in the rat carotid body. A marked selective reduction in noradrenaline was also observed in the rabbit and guinea-pig following ganglionectomy, though similar procedures in the cat failed to alter the levels of either catecholamine in the carotid body. The present data highlights the marked species variation in catecholamine content and the contribution to the latter by sympathetic innervation to this organ. This information will be useful in determining the species specificity regarding the relative roles of dopamine and noradrenaline in the modulation of chemoreceptor afferent discharge.

Animals↗
PubMed1985

Selective efferent chemical sympathectomy of rat kidneys.

Surgical denervation of kidneys results in interruption of both afferent and efferent renal nerves. We attempted selective efferent renal denervation in rats by slow infusions of 6-hydroxydopamine (6-OHDA) into the right renal artery. Integrity of efferent renal nerves was assessed by chemical and physiological methods and by measuring responses of mean arterial blood pressure (MAP) and heart rate (HR) to intrarenal (ir) infusion of bradykinin in conscious rats. Results were compared with those in surgically denervated and ir saline-infused rats. Surgical denervation of left kidney reduced renal norepinephrine (NE) to 58 and 14% of control levels at 1 and 7 days, respectively, after surgery. Increase in left renal resistance during posterior hypothalamus (PH) stimulation was only 70 +/- 28% (n = 5) compared with 289 +/- 69% (n = 6) in control animals. Response in opposite kidney was unchanged. Although 0.1 mg 6-OHDA ir caused considerable reduction of NE levels in both kidneys, responses to PH stimulation were unchanged. 6-OHDA (1 mg) reduced NE levels in infused and control kidney and atria. Functional evidence for denervation was only obtained in the kidney infused with 6-OHDA. Responses of MAP and HR to ir bradykinin were unchanged 7 days after 1 mg 6-OHDA. The data suggest that ir 6-OHDA results in functional efferent sympathectomy without affecting afferent renal nerves.

Animals↗