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PubMed2004

[A new method of performance of thoracic sympathectomy, based on the analysis of peculiarities of anatomical architecture of cervicothoracic sympathetic stem].

Peculiarities of anatomic structure (disposition, form, size) of stellate ganglion, II and III thoracic sympathetic ganglions together with their branches were suggested. There were established their morphological differences. Peculiarities of anatomical structure of the "lateral branch" II sympathetic ganglions were studied, its role in occurrence of the disease recurrence after performance of the thoracic sympathectomy performance was proved. Basing on the results achieved the method of thoracoscopic sympathectomy performance for Raynaud's phenomenon was elaborated.

Humans↗
PubMed1976

Repetitive extrasystole as an index of vulnerability to ventricular fibrillation.

The assessment of ventricular vulnerability by inducing ventricular fibrillation (VF) presents limitations when neural activity is being investigated, especially in the unanesthetized animal. As repetitive extrasystoles (RE) have been observed to precede the occurrence of VF, it was relevant to determine whether the RE threshold provides a reliable index of cardiac susceptivility to fibrillation. The RE and VF threshold relationships were studied in 32 chloralose-anesthetized dogs during left stellate ganglion stimulation, vagus nerve stimulation, and beta-adrenergic blockage with practolol. The vulnerable period was scanned at 1-ms intervals and at 2-mA increments with a single, 2-ms, constant-current cathodal stimulus; RE and multiple RE were induced reproducibly when 66% and 82%, respectively, of the fibrillatory current was administered. The nadirs for RE and multiple RE were coincident in the cardiac cycle with the vulnerable-period threshold for VF. Stellate and vagal stimulation and beta-adrenergic blockade resulted in comparable changes in RE and VF thresholds and produced equivalent shifts in the cardiac cycle of the RE and VF vulnerable-period nadirs. These observations suggest that RE and VF phenomena share a common electrophysiologic basis and that the RE threshold can be used as an end point for measuring ventricular vulnerability to VF.

Animals↗
PubMed1984

Causalgic pain relieved by prolonged procaine amide sympathetic blockade. Case report.

Reversible sympathetic blocks diagnostically relieve causalgic pain. At times, repeated blocks may be therapeutic. Causalgic pain of the left hand was successfully treated in a nonsurgical candidate by a continuous infusion of local anesthetic (procaine) into the region of the stellate ganglion. This technique was performed without significant complication and gave relief from the causalgia for extended periods of time. It may provide an effective alternative to surgical sympathectomy in high-risk patients.

Autonomic Nerve Block↗
PubMed1980

Retrograde intraaxonal transport of horseradish peroxidase by neurons in octopus.

While retrograde axonal transport is the basis of a widely used neuroanatomical method, it has been rigorously demonstrated in vivo only in a few vertebrate species and not yet in an invertebrate. Evidence is presented that motor neurons of the octopus stellate ganglion are capable of retrograde intraaxonal transport of horeseradish peroxidase. This demonstration shows that retrograde transport occurs in widely divergent groups of animals, and may be a general property of neurons.

Animals↗
PubMed1983

Synaptic transmission in the decentralized middle cervical ganglion of the dog.

The middle cervical ganglion (MCG) was decentralized in 30 dogs by cutting the thoracic vagus and rami on one side. Two or more cardiopulmonary nerves were then dissected free and placed on bipolar stimulating and recording electrodes in mineral-oil baths. Stimulation of one cardiopulmonary nerve generated a compound action potential (CAP) in one or two others. The CAP was altered by changing the frequency of stimulation and by stimulating preganglionic fibers in the rami. These alterations displayed latency changes and temporal summation or inhibition. The ansae were sectioned to neurally isolate the MCG from the stellate ganglion. A CAP generated after blockade by hexamethonium, atropine, propranolol and phentolamine was abolished transiently by chymotrypsin, and for longer periods by manganese, injected locally into the MCG. These results suggest that a CAP that is generated by stimulating one cardiopulmonary nerve in a decentralized MCG and recorded from another may result from synaptic activity in the MCG and that complex neuronal interactions occur within the MCG.

Animals↗
PubMed1985

Synaptic long-term enhancement (LTE) induced by a heterosynaptic neural input.

The slow excitatory postsynaptic potential (s-EPSP) response of cat stellate ganglion can be enhanced for hours (long term enhancement, LTE) following a conditioning preganglionic train of low frequency pulses, even when test s-EPSPs are elicited by an unconditioned input line. This provides another model for associational alterations of synaptic efficacy.

Animals↗
PubMed1981

Thoracoscopy for intrathoracic tumors.

The technique of thoracoscopy has been performed on 49 occasions in 45 patients for the diagnosis or staging of intrathoracic tumors. The patients ranged from 8 months to 68 years old. Eight procedures were performed for pleural disease, 16 for mediastinal masses, 22 for parenchymal lesions, and 3 for intrathoracic staging. Seventeen patients had had previous invasive procedures performed without a pathological diagnosis being established. In 28 thoracoscopy procedures, a positive diagnosis for malignancy was obtained; in 6 instances, areas of unsuspected tumor involvement were identified. A correct diagnosis was obtained by thoracoscopy in 45 procedures for a 92% overall accuracy rate. There was no clinically significant morbidity in this series and no procedure-related mortality. Thoracoscopy, performed under stellate ganglion block and regional anesthesia, has proved to be a very attractive method of diagnosing intrathoracic neoplasia with very low morbidity.

Adolescent↗
PubMed1985

[Intensification of vagal inhibition of the work of the heart by a sympathetic nerve].

Stimulation of the stellate ganglion sympathetic nerve added to stimulation of the vagus under conditions of obsidan suppression of beta-adrenoreceptors, intensifies the vagal inhibitory effect on the heart work. Possible participation of adrenergic and serotoninergic structures in the mechanism of the inhibitory phenomenon, was investigated.

Animals↗
PubMed1985

Negative chronotropic and parasympatholytic effects of alinidine on canine sinus node and AV junction.

The direct effects of alinidine (N-allyl-clonidine) on the sinus node and atrioventricular (AV) junction were studied in 18 anesthetized dogs. Stimulus frequency-response curves to right stellate ganglion and right cervical vagus stimulations as well as responses to norepinephrine or acetylcholine were determined before and after selective perfusion of alinidine into the sinus node artery. Alinidine (1 microgram/ml) had no effect on spontaneous sinus rate [148 +/- 5 (SE) beats/min]. However, alinidine concentrations of 5, 10, and 25 micrograms/ml produced significant (P less than 0.05) sinus slowing to 138, 127, and 121 beats/min, respectively. Recovery to control rate was dose dependent and took from 4 to 33 min. Sinus rate increases with right stellate stimulations were not affected by alinidine. However, sinus rate decreases with right vagal stimulations were significantly (P less than 0.01) attenuated by alinidine. The negative chronotropic effects of acetylcholine were not influenced by alinidine. Alinidine (1-100 micrograms/ml into AV node artery) had no effect on the A-H interval of the His bundle electrogram. However, alinidine (10 and 25 micrograms/ml) diminished the AV block produced by stimulation of the left vagus in electrically paced hearts but not the negative dromotropic actions of directly administered acetylcholine. Thus alinidine has direct negative chronotropic effects, no effect on sinus node responses to sympathetic stimulation, ability to diminish sinus node and AV junctional responses to vagal stimulations without interference at the cholinergic muscarinic receptor, and 4) no effect on AV nodal conduction.

Acetylcholine↗
PubMed1998

Sympathetically mediated pain after reduction mammoplasty: an unusual complication.

We present a case report of a patient who developed an unusual bilateral breast pain syndrome after a reduction mammoplasty. Her symptoms and physical examination findings resolved after four stellate ganglion blocks, of which two on each side were performed over a period of 2 weeks. The case serves to alert clinicians to the possibility of a patient developing a sympathetically mediated pain syndrome after reduction mammoplasty.

Breast↗
PubMed1975

Electrical alternation of the T-wave: clinical and experimental evidence of its relationship with the sympathetic nervous system and with the long Q-T syndrome.

In a patient affected by the "long Q-T" syndrome we observed episodes of alternation of the T-wave associated with emotional or physical stresses. In anesthetized and vagotomized cats, we could reproduce both the lengthening of the Q-T interval and episodes of alternation of the T-wave by electrical stimulation of the left stellate ganglion. Our experiments provide further support on the relationships between the "long Q-T" syndrome and the sympathetic nervous system and indicate that alternation of the T-wave may depend on abrupt increases in the sympathetic discharge.

Animals↗
PubMed2001

Norepinephrine transporter (NET) is expressed in cardiac sympathetic ganglia of adult rat.

The sympathetic nervous system plays a cardinal role in regulating cardiac function through releasing the neurotransmitter norepinephrine (NE). In comparison with central nervous system, the molecular mechanism of NE uptake in myocardium is not clear. In present study, we proved that in rat the CNS type of NE transporter (NET) was also expressed in middle cervical-stellate ganglion complex (MC-SG complex) which is considered to control the activity of heart, but not expressed in myocardium. The results also showed that NET expression level in right ganglion was significantly higher than in the left, rendering the greater capacity of NE uptake in right ventricle, a fact which may contribute to the maintenance of right ventricular function under pathologic state.

Animals↗
PubMed1998

Morphological characteristics of primary sensory and post-synaptic sympathetic neurones supplying the temporomandibular joint in the cat.

The cells of origin of peripheral nerves that supply the temporomandibular joint were investigated by examining the centripetal transport of wheat germ agglutinin-horseradish peroxidase (WGA-HRP). Following WGA-HRP injection into the temporomandibular joint capsule of the cat, a large number of labelled neurones were observed in the trigeminal and superior cervical ganglia ipsilateral to the injection site, while no labelled neurones were detected in the cervical dorsal-root ganglia. Only one labelled neurone was seen in the stellate ganglion. Labelled neurones were primarily located in the posterolateral and dorsal regions of the trigeminal ganglion, but their distribution in the superior cervical ganglion was not localized to specific regions. The labelled neurones in the trigeminal ganglion were significantly larger than those in the superior cervical ganglion but the sizes of smaller neurones overlapped, suggesting that trigeminal ganglion neurones send both myelinated and unmyelinated fibres to the temporomandibular joint. The innervation of the temporomandibular joint by somatosensory and sympathetic fibres suggests that sympathetic nerves could be responsible for allodynia or neuropathic pain caused by temporomandibular disorders.

Animals↗
PubMed2002

A model of myocarditis.

Myocarditis was induced by synergic interactions of serotonin- and cholinergic nerve fibers during potentiation of vagal inhibition of cardiac activity by stimulation of the stellate ganglion. Thus modeled myocarditis was associated with increased content of serotonin and decreased concentrations of acetylcholine and catecholamines in the myocardial tissue. Blockade of 5HT3(S3) receptors in autonomic ganglia and 5HT1,2(S1,2) receptors in the myocardium improved myocardial contractility and reduced the severity of myocarditis.

Acetylcholine↗
PubMed1975

The long Q-T syndrome.

Recent clinical and experimental data on the long Q-T syndrome (LQTS) are presented and discussed. The pathogenesis of LQTS is dependent on an imbalance between various components of the cardiac sympathetic innervation. A congenital decreased activity through the right cardiac sympathetic nerves seems to be the more likely pathogenetic mechanism for the majority of cases. Other forms of sympathetic imbalance, including left or even right hyperactivity, are, however, possible in isolated cases. Beta-blockers, at full blocking dose, represent the therapy of choice and are greatly effective in reducing the mortality (from 73 per cent to 6 per cent). If syncopal attacks are not eliminated by the medical therapy, the the ablation of the left stellate ganglion along with the first thoracic ganglia is the most rational and specific therapy. The possiblity for the correctly diagnosed and treated patients to escape an otherwise impending death calls urgently for diffusion of the knowledge about the long Q-T syndrome.

Adolescent↗
PubMed2003

Sympathectomy for complex regional pain syndrome.

BACKGROUND: With the easier and earlier recognition of complex regional pain syndrome (CRPS), a reappraisal of its therapy, particularly the role and timing of sympathectomy, is warranted. PATIENTS AND METHODS: Over a 9-year period, 42 patients with CRPS type II of the upper extremity were referred for sympathectomy. Patients were categorized according to the duration of the symptoms (group I, <3 months; group II, >3 months). All patients underwent initial medical treatment; stellate ganglion blocks were performed when symptoms persisted beyond 6 weeks. Patients were referred for thoracoscopic sympathectomy on persistence of the pain syndrome. A visual linear analogue scale was used to evaluate outcome of sympathectomy. RESULTS: Thoracoscopic dorsal sympathectomy was successfully undertaken in 32 patients. In the remaining 10 patients, thoracoscopy was not technically feasible and open sympathectomy was performed. There was an overall improvement in all 42 patients undergoing sympathectomy (P <.001, Wilcoxon signed rank test). The outcome in group I was significantly better than in group II (P <.003, Mann-Whitney U test). The diagnosis of sympathetically mediated pain with stellate blockade did not correlate with clinical outcome. Patients undergoing thoracoscopic sympathectomy had a better outcome than those undergoing open sympathectomy. There were no complications, and the hospital stay was shorter in the thoracoscopic group. CONCLUSION: Early recognition of CRPS and prompt recourse to surgical sympathectomy is a useful option in the management of CRPS.

Adolescent↗
PubMed1979

Autonomic control of right atrial contractile strength in the dog.

The combined effects of parasympathetic and sympathetic stimulation on right atrial contractile strength were assessed in open-chest, pentobarbital-anesthesized dogs. A factorial experimental design was employed to quantify the percent changes in atrial contractile strength in spontaneously beating and paced hearts as a function of the frequencies of vagal and stellate ganglion stimulation. In 7 of 10 dogs, there was a substantial interaction between the two autonomic divisions; the sympathetically mediated inotropic effect became less pronounced as the background level of vagal stimulation increased. The relationship between stimulation frequencies and atrial contractile strength was not significnatly altered by pacing the hearts.

Animals↗
PubMed1950

Cerebral thrombosis and embolism; a method of treatment.

Acute cerebral thrombosis and embolism give rise to arterial spasm, edema, and anoxia of the cerebral tissues supplied by the affected artery or arteries. Sympathetic block induced by injecting the stellate ganglion with procaine appears to relieve spasm and results in improved cerebral circulation and clinical improvement in a significant number of cases. Sympathetic block should be combined with the usual supportive measures and not infrequently with anticoagulants. Every effort should be made to institute treatment as soon as possible after the onset of symptoms.

Anticoagulants↗