Innervation of the sheep adrenal cortex: an immunohistochemical study with rat corticotrophin-releasing factor antiserum

Using indirect immunohistochemistry and an antiserum raised against rat corticotrophin-releasing factor (CRF) we have outlined an asymmetric network of cells and varicose fibers in sheep adrenal cortex. This network was not associated with the larger splanchnic nerves, but was occasionally found in small bundles or with blood vessels; in most instances fibers were found weaving independently through cortical parenchyma. A plexus of fibers was found in the zona reticularis, with a few fibers ramifying into adjacent medulla. Uni or bipolar cells were found throughout the cortex, with the greatest frequency at the corticomedullary junction; a multipolar-type cell was also found in this area. Staining of varicose structures and most cells was abolished by incubation with excess rat CRF 1-41, but not by ovine CRF or a range of other peptides. Though the immunoreactive species has not as yet been identified, it may thus share homology with sequences present in rat but not ovine CRF.     

Is additional epidural sympathetic block in microvascular surgery contraindicated? A preliminary report

The use of additional epidural sympathetic block during and after microvascular surgery in the lower extremities to prevent vasospasm is generally agreed on. However, a significant fall in the perfusion rate of the transplants was seen after application of bupivacaine (Marcain) via the epidural catheter. This effect has, to our knowledge, not been described before and is probably caused by the sympathectomy effect of this type of analgesia.     

Cardiopulmonary interactions in the cardiac patient in the intensive care unit

Critically ill cardiac patients often undergo mechanical ventilation. The interplay between pulmonary and cardiac mechanics is complicated and in many cases may result in impaired transfer of O2 from the atmosphere to the tissues. This article addresses the principles of pulmonary and peripheral gas exchange, as well as the mechanical effects of respiration on the circulation.     

Balanced analgesia after hysterectomy: the effect on outcomes.

Balanced analgesia (an opioid and a nonsteroidal anti-inflammatory agent) after hysterectomy often leads to better postoperative pain outcomes. Researchers compared post-hysterectomy patients who received balanced analgesia with those who received only morphine patient-controlled analgesia, and their relationship with pain scores, ambulation, and hospital length of stay.