Bilateral superior cervical ganglionectomy attenuates cardiac remodeling and improves cardiac function in pressure-overloaded heart failure mice / 中华心血管病杂志

Objective: To investigate the effect of bilateral superior cervical ganglionectomy on cardiac remodeling and function in pressure-overloaded heart failure (HF) mice. Methods: Pressure-overloaded HF mouse model was produced by severe thoracic aorta banding (sTAB). Bilateral superior cervical ganglionectomy (SCGx) was performed 2 weeks after sTAB. Twenty four 6-week-old male C57BL/6 mice were randomized divided into 4 groups (n=6 each): control group: sham sTAB+sham SCGx; denervated group: sham sTAB+SCGx; HF group: sTAB+sham SCGx; denervated HF group: sTAB+SCGx. Cardiac function was measured by echocardiography at week 0, 1, 2, and 4 after sTAB, respectively. All mice were sacrificed at the end of week 4 and heart tissues were harvested. HE and Masson staining were performed. Immunohistochemical staining (IHC) for tyrosine hydroxylase (TH), adrenergic receptor β1 (AR-β1) and CD68 was performed. Western blot was used to determine the protein expression level of TH, B type natriuretic peptide (BNP), and AR-β1. Results: Left ventricular ejection fraction (LVEF) declined continuously in HF group. LVEF was similar between denervated HF group and control group at various time points (P>0.05). LVEF was significantly higher in denervated HF group than in HF group at the end of week 4 (P<0.05). HE staining showed that cross sectional cardiomyocyte area was significantly larger in HF group than in control group and denervated HF group (P<0.05), which was similar between denervated HF group and control group (P>0.05). Masson staining showed that fibrosis level was significantly lower in denervated HF group than in HF group (P<0.05). IHC showed that TH+nerves and CD68+ macrophages were significantly increased in HF mice as compared to control mice (P<0.05), whereas this change was abolished in denervated HF group. AR-β1 was significantly down-regulated in HF group compared with control group (P<0.05), which was not affected by denervation (P>0.05). Western blot demonstrated that the expression level of TH and BNP was significantly higher in HF group compared with the control group (P<0.05), whereas this difference was diminished in denervated HF group (P>0.05). Conclusion: Bilateral superior cervical ganglionectomy can reduce sympathetic innervation and macrophage infiltration in pressure overloaded failure heart, thus attenuate cardiac remodeling and improve cardiac function.

Left atrial ganglionated plexi detection is related to heart rate and early recurrence of atrial fibrillation after surgical ablation

Abstract INTRODUCTION: Left atrial ganglionated plexi ablation is an adjuvant technique used to increase the success rate of surgical ablation of atrial fibrillation. Ganglionated plexi ablation requires previous detection. We aimed to assess determinants of successful ganglionated plexi detection and to correlate range of ganglionated plexi ablation with risk of early atrial fibrillation recurrence. METHODS: The study involved 34 consecutive patients referred for surgical coronary revascularization with concomitant atrial fibrillation ablation. Ganglionated plexi detection was done by inducing vagal reflexes in the area of the pulmonary veins and left atrial fat pads. RESULTS: Detection of GP was successful in 85% of the patients. There was no difference in preoperative characteristics nor in atrial fibrillation type between patients in whom ganglionated plexi detection was successful and others. The number of detected ganglionated plexi correlated significantly only with preoperative resting heart rate. Significant negative correlation was found in patients with preoperative heart rate>75 beat/min in terms of total number of detected ganglionated plexi (P=0.04). Average number of detected ganglionated plexi was significantly higher in patients with in-hospital atrial fibrillation recurrence requiring electrical cardioversion (3.8±3) in comparison to rest of the study population (2±1.3; P=0.02). In patients in whom 4 or more ganglionated plexi were detected, significantly increased risk of in-hospital atrial fibrillation recurrence was observed (OR 15; 95% CI 1.5-164; P=0.003). CONCLUSION: Left atrial ganglionated plexi detection was unsuccessful in a considerable percentage of patients. Preoperative heart rate significantly influenced positive ganglionated plexi detection and number of ablated ganglia. Higher number of detected ganglionated plexi was related with early recurrence of atrial fibrillation.

Effect of selective beta-adrenoceptor blockade and surgical resection of the celiac-superior mesenteric ganglion complex on delayed liquid gastric emptying induced by dipyrone, 4-aminoantipyrine, and antipyrine in rats

There is evidence for participation of peripheral β-adrenoceptors in delayed liquid gastric emptying (GE) induced in rats by dipyrone (Dp), 4-aminoantipyrine (AA), and antipyrine (At). The present study aimed to determine whether β-adrenoceptors are involved in delayed GE induced by phenylpyrazole derivatives and the role of the prevertebral sympathetic nervous system in this condition. Male Wistar rats weighing 220-280 g were used in the study. In the first experiment rats were intravenously pretreated with vehicle (V), atenolol 30 mg/kg (ATE, β1-adrenergic antagonist), or butoxamine 25 mg/kg (BUT, β2-adrenergic antagonist). In the second experiment, rats were pretreated with V or SR59230A 2 mg/kg (SRA, β3-adrenergic antagonist). In the third experiment, rats were subjected to surgical resection of the celiac-superior mesenteric ganglion complex or to sham surgery. The groups were intravenously treated with saline (S), 240 µmol/kg Dp, AA, or At, 15 min after pretreatment with the antagonists or V and nine days after surgery. GE was determined 10 min later by measuring the percentage of gastric retention (%GR) of saline labeled with phenol red 10 min after gavage. The %GR (means±SE, n=6) values indicated that BUT abolished the effect of Dp (BUT+Dp vs V+Dp: 35.0%±5.1% vs 56.4%±2.7%) and At (BUT+At vs V+At: 33.5%±4.7% vs 52.9%±2.6%) on GE, and significantly reduced (P<0.05) the effect of AA (BUT+AA vs V+AA: 48.0%±5.0% vs 65.2%±3.8%). ATE, SRA, and sympathectomy did not modify the effects of treatments. These results suggest that β2-adrenoceptor activation occurred in delayed liquid gastric emptying induced by the phenylpyrazole derivatives dipyrone, 4-aminoantipyrine, and antipyrine. Additionally, the released neurotransmitter did not originate in the celiac-superior mesenteric ganglion complex.

Effects of dorsal root ganglion destruction by adriamycin in patients with postherpetic neuralgia / Efeitos da destruição da raiz dorsal ganglionar pela adriamicina em pacientes com neuralgia pós-herpética

PURPOSE: To investigate the effects of dorsal root ganglion destruction in patients with postherpetic neuralgia (PHN). METHODS: Seventy-two patients with PHN selected were randomly divided into two groups (n=36). Group A was the control group (treated by injection) and group B was the group of dorsal root ganglion destruction by adriamycin. Visual analog scale scores (VAS), SAS, SF-MPQ scores. Clinical effects and therapy safety were evaluated before therapy, one week, three and six months after therapy. Forty-four patients were available for intention-to-treat analysis. RESULTS: The average pain scores on the Likert scale were significantly reduced at each point in group B. Patients in group B reported clinical effectiveness at six months as excellent response, good response, improved but unsatisfactory or unchanged 16, 12 and 8.VAS scores at each time point after the operation were lower than that before operation and in group A, there was significant difference. Patients showed significant improvement in sleep scores in group B. There was significant difference at T2 in group A than T1. There was no significant difference in group A at T3, T4 after the operation than that before operation. Between group comparison: there was significant difference between group A and group B at each time point after the operation. CONCLUSIONS: Dorsal root ganglion destruction by adriamycin under guidance of C-arm perspective, the puncture operation was accurate without any adverse reaction or serious complications, which could effectively relieve pain of patients with postherpetic neuralgia, but the long-term effects needed further study.

OBJETIVO: Investigar os efeitos da destruição da raiz dorsal ganglionar em pacientes com neuralgia pós-herpética. MÉTODOS: Setenta e dois pacientes selecionados com neuralgia pós-herpética foram randomicamente distribuídos em dois grupos (n=36). Grupo A foi o grupo controle (tratado por injeção) e o grupo B foi o grupo com destruição da raiz dorsal do gânglio pela adriamicina. Os escores da Escala Analógica Visual (VAS), SAS, SF-MPQ escores, efeitos clínicos e segurança terapêutica foram avaliados as antes da terapia, uma semana, três e seis meses após a terapia. Quarenta e quatro pacientes foram avaliados pela análise de intenção-em-tratar. RESULTADOS: A média dos escores de dor na escala de Likert foi significativamente reduzida em cada ponto no grupo B. Pacientes no grupo B relataram efetividade clínica aos seis meses com excelente resposta (16), boa resposta (12), melhora mais insatisfatória ou sem modificações (8). Escores VAS a cada tempo após o procedimento foram melhores em comparação ao pré-operatório. No grupo A não foi observada diferença significativa. Pacientes mostraram melhora nos escores de dormir no grupo B. Houve diferença significante no T2 no grupo A que T1. Não houve diferença significante no grupo A nos tempos T3 e T4 após a cirurgia em relação a antes. Comparação entre os grupos: houve diferença significante entre os grupos A e B a cada tempo após a cirurgia. CONCLUSÕES: A destruição da raiz dorsal ganglionar pela adriamicina sob perspectiva guiada pelo C-arm, a cirurgia pontual foi acurada sem qualquer reação adversa ou complicação séria, que pode efetivamente aliviar a dor em pacientes com neuralgia pós-herpética, mas os efeitos de longo prazo necessitam mais estudos.

The effects of superior cervical ganglionectomy on the ability of spatial memory using radial arm maze in the rats

BACKGROUND: Stress, elevated sympathetic nervous system, glucocorticoid concentration affect learning and memory. The aim of this study was to evaluate the effects of superior cervical ganglionectomy on the spatial memory using radial arm maze test. METHODS: Male Sprague-Dawley rats were used. Rats were divided into two groups: a superior cervical ganglionectomy group and a control group. Each rat was put into the radial arm maze two times per day for 4 days. We checked the number of the total visit, the total error, the reference memory error, the working memory error. And then a superior cervical ganglionectomy group received bilateral superior cervical ganglionectomy, and a control group received a sham operation. The radial arm maze test was then repeated and we evaluated the effect of superior cervical ganglionectomy on spatial memory. RESULTS: There were no significant differences in ratio of total error, reference memory error, and working memory error. CONCLUSIONS: Bilateral superior cervical ganglionectomy in rats does not effect the spatial memory. However, further studies are needed to determine the effect of superior cervical ganglionectomy on spatial memory.

Simpatectomía torácica videotoracoscópica: nuestra experiencia / Endoscopic thoracic sympathectomy as definitive treatment of palmar and axillary hyperhidrosis: authors' experience

Evaluar los resultados, las complicaciones postoperatorias y el grado de satisfacción de los pacientes intervenidos quirúrgicamente en nuestro servicio con diagnóstico de hiperhidrosis palmar y axilar mediante la realización de simpatectomía torácica videotoracoscópica como tratamiento definitivo de su condición. Material y método: estudio retrospectivo de Enero de 2005 a Enero 2009. Se realizó simpatectomía de los ganglios T2-T4 a los csos que presentaban hiperhidrosis palmar y simpatectomía de los ganglios T2-T5 a los que presentaban hiperhidrosis palmar y axilar. Resultados: Población total 20 pacientes, simpatectomía T2-T4 a 8 (40 %) y simpatectomíaT2-T5 a 12 (60 %). Dieciséis pacientes refirieron mejoría total, los otros 4 mejoraron parcialmente sus síntomas. El 100 % confirmó estr satisfecho con los resultados obtenidos. En el control postoperatorio, todos los pacientes presentron hiperhidrosis compensatoria, siendo severa en 2 casos y no severa en 18. En el 60 % de los pacientes se manifestó en el abdomen y piernas, y en el 40 % restante en la región dorsal. Se observó un caso de neumotórax, cuatro casos de neuralgia interecostal, sequedad de manos se presentó en 3 pacientes y se halló sudoración residual en 4 pacientes. Conclusión: la simpatectomía torácica videotoracoscópica puede ser realizada de forma segura y con excelentes resultados como tratamiento de elección en la hiperhidrosis palmar y axilar. La hiperhidrosis compensatoria es la mayor complicación pero es bien tolerada y no afecta el grado de satisfacción postoperatoria de los pacientes.

To evaluate the results, postoperative complications and the satisfaction of the patients underwent surgery in our department with a diagnosis of palmar and axillary hyperhidrosis by performing endoscopic thoracic sympathectomy as definitive treatment of their condition. Methods: retrospective study from January 2005 to January 2009. For palmar hyperhidrosis, sympathectomy from T2-T4 ganglia eas performed and, for palmar and axillary hiperhidrosis sympathectomy of T2-T5 ganglia. Results: total population 20 patients, sympathectomy T2-T4 was performed at 8 (40 %) and sympathectomy T2-T5 in 12 (60 %). Sixteen patients reported overall imporvement, the other 4 partially imporved his symptoms. Confirmed to be 100 % satisfied with the results. In controlling postoperative, all patients experienced compensatory hyperhidrosis, and severe in 2 cases and not severe in 18, 60 % of patients developed this condition in the abdomen and legs, and the remaining 40 % in the dorsal region. We observed a case of pneumothorax, four cases of intercostal neuralgia, dry hands are presented in 3 patientes and resiudal sweating was found in 4 patients. Conclusion: endoscopic thoracic sympathectomy may be performed safely and with excellent reults as a treatment of choice for palmar and axillary hyperhidrosis. Compensatory hyperhidrosis is the major complication but is ewll tolerated and does not affect the satisfaction level of postoperative patients.

The effects of superior cervical ganglionectomy on the anxiety in the rats / 대한마취과학회지

BACKGROUND: Therapeutic indications for stellate ganglion block range from head and upper arm disease to general disease including psychosomatic disorders. The aim of this study was to evaluate the effects of superior cervical ganglionectomy on anxiety using the elevated plus maze test. METHODS: Male Sprague-Dawley rats (150-250 g) were used. Each rat was put into the elevated plus maze 5 minutes per day for 10 days. We checked the number of entries into each arm (open arm and closed arm) and the duration of time staying in each arm. Rats were then divided into two groups: a group that received bilateral superior cervical ganglionectomy, and a control group that received a sham operation. The elevated plus maze test was then repeated and we evaluated the effect of superior cervical ganglionectomy on anxiety. RESULTS: Although there was an increased tendency of ganglionectomized rats to enter each arm, there were no significant differences in number of entries or in duration of stay between experimental and control groups. CONCLUSIONS: Bilateral superior cervical ganglionectomy in rats does not reduce anxiety. However, further studies are needed, ones combined with neuroendocrine and clinical studies, to determine the effect of superior cervical ganglionectomy on behavioral responses.

Nuevas perspectivas en el síndrome de QT largo / New perspectives in long QT syndrome

Long QT Syndrome (LQTS) is a cardiac channelopathy characterized by prolonged ventricular repolarization and increased risk to sudden death secondary to ventricular dysrrhythmias. Was the first cardiac channelopathy described and is probably the best understood. After a decade of the sentinel identification of ion channel mutation in LQTS, genotype-phenotype correlations have been developed along with important improvement in risk stratification and genetic guided-treatment. Genetic screening has shown that LQTS is more frequent than expected and interestingly, ethnic specific polymorphism conferring increased susceptibility to drug induced QT prolongation and torsades de pointes have been identified. A better understanding of ventricular arrhythmias as an adverse effect of ion channel binding drugs, allow the development of more safety formulas and better control of this public health problem. Progress in understanding the molecular basis of LQTS has been remarkable; eight different genes have been identified, however still 25% of patients remain genotype-negative. This article is an overview of the main LQTS knowledge developed during the last years.

El síndrome de QT largo (SQTL) es una canalopatía que genera grave alteración en la repolarización ventricular predispone a arritmias malignas y muerte súbita. Fue la primera canalopatía arritmogénica descrita y quizá la mejor entendida hasta ahora. Transcurrida ya más de una década de la identificación de la primera mutación asociada al SQTL, se ha hecho evidente que este trastorno es mucho más frecuente de lo que inicialmente se pensaba; los avances en el conocimiento de la fisiopatología molecular de esta enfermedad han permitido hacer una correlación genotipo-fenotipo, optimizando el tratamiento y permitiendo estratificar el riesgo en forma precisa. Se ha logrado entender con mayor detalle los efectos adversos de distintas drogas que interactúan con los canales iónicos, permitiendo así generar fármacos más seguros y, en su defecto, monitorizar de cerca aquellos que a pesar de tener este efecto adverso, es necesaria su administración. Los avances son importantes pero no todo está dicho, 25% de los casos no tienen mutaciones en los genes descritos hasta la fecha, por lo que el SQTL continúa siendo motivo de investigación. El presente artículo constituye un resumen de los principales conceptos desarrollados en los últimos diez años que han sido cruciales en el manejo de esta enfermedad.

Effects of cervical sympathectomy on vasospasm induced by meningeal haemorrhage in rabbits / Efeitos da simpatectomia cervical sobre o vasoespasmo induzido por hemorragia meníngea em coelhos

This study investigates the role of cervical sympathectomy in the prevention of acute vasospasm induced by meningeal haemorrhage in rabbits. Sixteen adult English Norfolk rabbits were divided into 2 experimental groups: bilateral cervical sympathectomy of the superior sympathetic ganglion (SSSG, n=8), and bilateral SSSG and sympathectomy of the inferior sympathetic ganglion (SISG, n=8). Other 24 animals were used as controls. Basilar artery diameter was evaluated by angiography. SSSG protected the animals against developing cerebral vasospasm; SSSG associated with SISG did not increase this effect.

Este estudo investiga o papel da simpatectomia cervical na prevenção do vasoespasmo agudo induzido por hemorragia meníngea em coelhos. Para tanto, foram utilizados 16 coelhos adultos da raça Norfolk inglesa, divididos em 2 grupos experimentais: simpatectomia cervical bilateral do gânglio simpático cervical superior (SSSG, n=8) e SSSG associada a simpatectomia cervical bilateral do gânglio simpático cervical inferior (SISG, n=8). Outros 24 animais foram usados como controles. Os diâmetros das artérias basilares foram avaliados por medições após angiografias. SSSG protegeu os animais contra o vasoespasmo; SSSG associada a SISG não aumentou este efeito.

The Effect of Superior Cervical Ganglionectomy on Recovery of Olfaction in Induced Anosmic Mice / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study was undertaken to evaluate the effect of superior cervical ganglionectomy (SCG) on anosmia, which is peripherally induced in the mice. MATERIALS AND METHOD: Three groups of mice (BCF1) were studied: normal control (nasal instillation of saline, n=6); zinc sulfate group (nasal instillation of 64 mM zinc sulfate, n=25); SCG group (superior cervical ganglionectomy after nasal instillation of 64 mM zinc sulfate, n=25). Tissues of olfactory mucosa were obtained at 1, 2, 3, 4 and 7 weeks after instillation of zinc sulfate, and processed for immunohistochemistry using antisera to olfactory marker protein (OMP) to evaluate the olfactory regeneration. RESULTS: No OMP-positive cells were observed in the first two weeks after the instillation of zinc sulfate in both zinc sulfate group and the SCG group. However, the OMP-positive cells appeared first at 3 weeks after the instillation in both groups, and gradually increased in number at 4 and 7 weeks. In the SCG group, the increase of OMP-positive cells was significantly greater than those of the zinc sulfate group. The number of OMP-positive cells in the SCG group at 7 weeks was almost similar to that of the normal control group. CONCLUSION: SCG enhances regeneration of olfactory receptor cells at 3 weeks after injury. It was inferred from the above results that SCG has a significant effect on the regeneration of olfactory receptor cells and we suggest that SCG could be an effective treatment modality for olfactory dysfunction.

The Effects of Superior Cervical Ganglionectomy on C-fos Expression in Rat Brain / 대한마취과학회지

BACKGROUND: C-fos is a marker of neuronal activity and its expression may be related to various types of stimulation of primary sensory neurons. We evaluated the effect of superior cervical ganglionectomy on c-fos expression in rat brain, which was expected to have the same effect as stellate ganglion block in human. METHODS: Male Sprague-Dawley rats (140-150 g) were divided into 4 groups; a no treatment (control group, n = 10), a 2 hour enflurane inhalation (anesthesia group, n = 10), a cervical skin incision only group (sham group, n = 10) and a superior cervical ganglionectomy group (sympathectomy group, n = 10). Two hours after each procedure, rats were killed and perfused with formaldehyde solution. c-fos protein expressions in the thalamus, hypothalamus, cortex, amygdala and cingulate gyrus were examined by immunohistochemistry using a specific antibody. RESULTS: In the thalamus, c-fos expression increased in the sympathectomy group vs. the control and the anesthesia groups, and in the sham group vs. the control group. In amygdala, the sham group showed significantly higher c-fos expression than the control group. In the hypothalamus and cortex no significant differences among the 4 groups were apparent. In the cingulate gyrus higher c-fos expression was observed than the control and anesthesia group but no differences with sham group. CONCLUSIONS: Superior cervical ganglionectomy itself may not affect c-fos expression in rat brain. For best results special effort should be made to avoid surgical or emotional stress.

Spinal Cord Stimulation for Intractable Postherpetic Neuralgia

Postherpetic neuralgia(PHN) is a neuropathic pain syndrome that is often intractable. A 75-year-old man suffered intractable pain due to herpes zoster between T4 and T6 dermatome. Allodynia, the severe superficial pain that he could not wear his clothes, was improved by ablative surgery such as dorsal root entry zone lesions and dorsal root ganglionectomy. However, deep cramping pain was sustained. Because of this excruciating pain, spinal cord stimulation(SCS) was decided. After the operation, the pain has been improved to tolerable state. As with our case, a constant deep cramping pain associated with other refractory painful condition of PHN, SCS could be considered as a useful option.

Dosal Root Ganglionectomy for a Post-Herpetic Neuralgia: Case Report

We report a case of thoracic post-herpetic neuralgia which was improved by dorsal root ganglionectomy. The patient had failed to obtain adequate pain relief from conservative therapy such as carbamazepine, amitriptyline, thioridazine, gabapentin, and transcutaneous lidocaine infiltration. Thoracic dorsal root ganglionectomy from T5 to T7 on left side was performed and satisfactory pain relief without significant postoperative neurologic deficit was achieved. Although dorsal root entry zone operation for refractory pain was the most commonly performed procedure in past, dorsal root ganglionectomy is an alternative anatomically and technically safe procedure for the pain in the thoracic lesion. The clinical feature, operative technique and clinical result are presented with review of the literatures.

Superior cervical ganglionectomy leads to dampening of amplitude of temperature rhythm in rats.

The circadian rhythm of body temperature (CRT) is a robust marker of the endogenous pacemaker function and is one of the most frequently studied rhythms. Melatonin, the main secretion of the pineal gland seems to have more of a thermomodulatory role in controlling the body temperature than having a direct role in thermoregulation. The sympathetic innervation to the pineal via the superior cervical ganglion determines the melatonin secretion, and superior cervical ganglionectomy (SCGx) decreases the secretion of melatonin. The present study was conducted on the Wistar rats (n = 12) to determine the role of melatonin in modulation of CRT. Adult male rats were either ganglionectomised (n = 6) or sham ganglionectomised (n = 6). Rectal temperature was recorded for CRT analysis. Cosinar analysis of the temperature record was done to get the acrophase, amplitude and mesor. Our results show that SCGx decreases the amplitude to the rhythm but has no effect on the mesor of the rhythm. Our study confirms that melatonin has little role to play in the thermoregulation and its role is mainly in thermomodulation.

Effects of Deafferented Sensory Inputs on c-fos mRNA Expression in Medial Vestibular Nucleus of Rats Following Unilateral Labyrinthectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Fos is a protein product of proto-oncogene c-fos, which is induced by various kinds of stimulations such as noxious, physiologic and electrical stimulations. In the vestibular system, there have been several evidences that c-fos was expressed in the brainstem vestibular nuclei during vestibular compensation following unilateral labyrinthectomy (ULX). In this study, the author evaluated the effect of deafferented sensory inputs on the c-fos mRNA expression in the medial vestibular nucleus of unilaterally labyrinthectomized rats. MATERIALS AND METHODS: Animals in the experimental group underwent tarsorraphy and cervical dorsal ganglionectomy to deprive them of visual and proprioceptive sensory inputs immediately after ULX, whereas the experimental group II did not receive any procedure after ULX. Expression of c-fos mRNA was demonstrated by in situ hybridization technique. All animals were sacrificed at 1, 3, 6, 9, 24, 48 hours after ULX and frozen sectioned tissues of brainstem were used in situ hybridization. RESULTS: Three hours after ULX, the expression of c- fos mRNA was increased in the dorsal portion of medial vestibular nucleus (dMVN) in both groups and after 6 hours of ULX, it was markedly reduced. In group I (deafferented), however, asymmetric expression was observed in 24 hours after the operation. In group II, the increased expression of c-fos mRNA in the ipsilateral dMVN continued until 9 hours after the operation and thereafter, the asymmetry of c-fos mRNA expressions between the ipsilateral and contralateral dMVN was decreased. CONCLUSION: These findings suggest that vision and proprioception influenced the expression of c-fos mRNA in the brainstem medial vestibular nucleus after ULX and corrected the asymmetric expression between the healthy and lesioned nuclei earlier than the deafferented group.

Sistema nervioso autónomo y páncreas. (Análise da influencia de diversos tipos de denervación outonómica en los fenómenos de regeneración glandular y en las de las interaciones del eje endocrino-exocrino / Autonomic nervous system and pancreas. (Analysis of the influence of different types of autonomic denervation in glandular regeneration phenomena and the interactions of the exocrine-endocrine-Axis)

The present tests, in male Wistar rsts, center around the trophic and functional changes of the pancreatic gland (R G), both exocrine and endocrine, induced by different types of autonomic nervous interruptions. First Group of Tests: Following one year celiac ganglionectomy (CG), nonpancreatectomized (Non-Pt) rats showed, basally, in blood, adrop of glucose (G), without changes of insulin (I). At autpsy, the CG animals showed an increase of the pancreatic we weight, of the total protein, of the RNA but not DNA. In the Pt. 95 per cent rats, superimposing CG triggered, on the one hand, a drop to control values of the raised G blood levels, and on the other, a rise of I Besides, in feces, a rising of chymotrypsin concentration. At autopsy, in the PG, an increase of total protein and of RNA. Second Group of Tests: CG, after 6 months, induced, in blood, both basally and a 2 h glucose tolerance test, significant opposite enzyme activities changes in respect to C. Indeed, as amylase (A) was increased, that of lipase (L) was depressed. When alcohol feeding (AF) was superimposed to CG rats, a reversal of the L values was observed. The latter reached levels significantly higher those of the C. In in-vitro tests, the isolated islets of CG disclosed to release more I to the bath medium than those of the C animals. Third Group of Tests: Analyzing, in conscious animal, the L excretory changes in the basal bile pancreatic secretion (BB-PS) induced by chronic (2 months interruption of the autonomic nervous innervation of the PG, it was found that CG, truncal vagotomy (V), the association of CG + V, peri-Vaterian duodenotomy (PV-D), but not bilateral splachnicectomy (Spl), inhibit, significantly the L output. It was also shown that superimosing AF to the V or CG + V animals reverted to C values the I depressed levels...

Evaluation of C2 root ganglioectomy in the management of cervicogenic headache

The aim of this study was to assess the percutaneous radio frequency thermocoagulation in the treatment of occipital pain due to Cl-C2 facet arthrosis. This was a preliminary experience in the management of 175 patients who had presented with occipital pain due to Cl-C2 arthrosis. Medications together with physiotherapy were able to relieve the occipital pain in 63 patients. Nerve block was effective in 97 patients with immediate pain relief, however, there were variable degrees of pain recurrence in both severity and pain free period. Percutaneous radio frequency thermocoagulation was done in 70 patients with a recurrence in nine patients. Percutaneous thermocoagulation was a very effective, easy and safe way to control the cervicogenic headache

Left Thoracic Sympathetic Ganglionectomy with Thoracoscope for the Treatment of the Long QT Syndrome: A case report / 대한흉부외과학회지

The long QT syndromes have been classified into acquired or inheritary forms, both of which are associated with a characteristic type of life-threatening polymorphic ventricular tachycardia called torsade de points. Beta-adrenergic blocker is the first cholic treatment, but in those whom cardiac events are not prevented by beta - blockade, left thoracic sympathetic ganglionectomy may be useful in selected cases. A 50-year-old woman had an recurrent syncopal attack in which she was unconscious for 1-2 min and 1-2 times a month for 10 years. The EKG revealed that QT & QTc intervals were 744 and 632 msec respectively. Treatment with Beta-adrenergic blocker and calcium channel blocker was ineffective in preventing recurrence of syncopal spell. Therefore, she underwent left thoracic sympathetic ganglionectomy with thoracoscope. During the 9 months after operation, she was free of syncopal episodes and is doing well.

Initiation of Torsades de pointes by head-up tilt test in congenital long QT syndrome patient

Long QT syndrome is a cardiac disorder of repolarization which is characterized by elctrocardiographic abnormalities including prolonged QT interval, T-wave abnormalities and polymorphic ventricular tachycardia known as Torsades de Pointes. Its clinical manifestation are recurrent syncope, seizure, and sudden death. Recently,we experienced Torsades de Pointes(TdP) by head-up tilt test in 24 year-old female patient presenting recurrent syncope and long QT interval. Beta-blocker and left cervicothoracic sympathetic ganglionectomy were not effictive, then we tried mexiletine. After mexiletine medication, the QT interval was significantly shortened and there was no more syncope.

Left Stellate Ganglion Block Prior to Induction of Anesthesia for Surgical Sympathectomy in a Patient with Long QT Syndrome / 대한마취과학회지

Long QT Syndrome is characterized by syncope and fatal ventricular arrhythmia. Monotherapy with beta blockers is the first-line therapy. In patients with recurrent syncope despite therapy with beta blockers, combinations of the following modalities of treatment may be considered: pacemakers, left cervicothoracic sympathectomy, and implantable cardioverter defibrillators. Recently, we anesthetized a patient with Long QT Syndrome who underwent thoracoscopic left upper ganglionectomy for recurrent episodes of syncope and ventricular arrhythmia despite aggressive use of propranolol. Because of the increased risk of developing fatal ventricular arrhythmias during anesthesia and surgery, we performed a left stellate ganglion block prior to induction of anesthesia to prevent the ventricular arrhythmia that may be triggered by stimulation of the sympathetic nervous system and to assess the effect of surgical ganglionectomy on the QT interval. Following the block, the QT interval was shortened, and anesthesia and surgery was uneventful though anesthetic induction caused serious sympathetic responses. We recommend a left stellate ganglion block prior to induction of anesthesia in patients with Long QT Syndrome resistant to beta blocker to prevent fatal arrhythmia and to predict the efficacy of the surgical sympathectomy on the QT interval.