EFFECTS OF ACUTE SUPERIOR CERVICAL GANGLIONECTOMY ON CEREBRAL BLOOD FLOW AND METABOLISM IN STROKE-PRONE SPONTANEOUSLY HYPERTENSIVE RATS SUBJECTED TO CEREBRAL ISCHAEMIA

1. The effects of acute bilateral superior cervical ganglionectomy on cerebral blood flow and metabolism were investigated in stroke-prone spontaneously hypertensive rats (SHRsp), before and during cerebral ischaemia. 2. The resting cerebral blood flow was comparable between the control and denervated animals. 3. There was no significant difference in cerebral blood flow or concentration of tissue energy metabolites (adenosine triphosphate [ATP], lactate and pyruvate) between the sham-operated control and denervated animals during ischaemia. 4. The results suggest that sympathetic innervation of cerebral vessels originating from superior cervical ganglia may not play a major role in the progression of cerebral ischaemia in SHRsp.     

ANOMALOUS AZYGOS VEIN: A POTENTIAL DANGER DURING ENDOSCOPIC THORACIC SYMPATHECTOMY

A report of a patient with an azygos lobe and an associated anomalous azygos vein covering the upper thoracic sympathetic chain. This anomaly poses a significant risk during the procedure of endoscopic thoracic sympathectomy. A chest X-ray is useful in detecting this anomaly and alerting the surgeon to potential problems.     

胸腔镜下胸交感神经干切断术治疗手汗症(附300例报告)

目的总结胸腔镜胸交感神经干切断术300例的临床经验。方法分析2003年1月至2006年1月经胸腔镜胸交感神经干T_2～T_4切断术治疗手汗症的临床资料。以患侧手掌皮肤温度较术前升高1℃～3℃或更高,转干燥者为有效。手掌皮肤温度较术前增加小于1℃仍为潮湿者为无效。结果300例手术均获成功,术后患者手掌多汗症状消失,双手转为干燥温暖状,术后掌温升高(2.8±0.8)℃;282例术后随访1～36个月无一例复发,术后转移代偿性多汗60例占21.2%。结论胸交感神经干切断术是治疗手汗症安全、微创和有效的方法。     

A new method of thoracoscopic sympathectomy in hyperhidrosis palmaris

Summary Although hyperhidrosis palmaris is a benign condition, it may cause considerable psychological, social, and occupational disturbances. There are many conservative measures used to treat hyperhidrosis, but surgical sympathectomy is the only permanent cure. Of the various surgical approaches to the upper thoracic sympathetic ganglia, one must select the approach that combines good functional results and a satisfactory cosmetic outcome with only minor complications. Twenty-one patients (10 men and 11 women) with hyperhidrosis palmaris underwent synchronous bilateral T2 sympathectomy between 1 October 1989 and 30 April 1990. These patients underwent a new method of thoracoscopic sympathectomy without preoperative pneumothorax. All were relieved of excessive sweating in their upper extremities immediately after the operation. In addition, the technique led to significant savings in operation and hospitalization time. We recommend thoracoscopic sympathectomy as the best approach for sympathectomy in cases of hyperhidrosis palmaris.     

Thoracoscopic wedge resection

Summary Thoracoscopic surgery is decidedly expanded by the ability to perform pulmonary wedge resections of the lung by using the Endo-GIA-stapler. In addition to thoracoscopic biopsies, since July 1991 we have carried out wedge resections in 12 patients suffering from spontaneous pneumothorax (nine) or peripheral bronchial carcinoma (three). Postoperatively one air fistula persisted over 9 days. The chest tube was removed within 48 h in all other patients. There was no other major complication. The postoperative hospitalization period lasted 4.6 days (1–9 days). Operating time was 44 min (30–70 min). The benefit for the patient consists in the little-impaired breathing mechanics, the short hospital stay, and the favorable cosmetic result.     

Meal patterns and glucoprivic feeding in the guanethidine-sympathectomized, adrenodemedullated rat

The feeding behavior of rats sympathectomized by neonatal administration of guanethidine (GUA) and/or adult adrenal demedullation (MDL) was investigated. GUA treatment tended to decrease body weight gain and food intake, chiefly by decreasing meal size and increasing satiety ratios. It also attenuated the increase in food intake caused by 2-deoxy-D-glucose (2DG; 150, 300, 450 mg/kg, IP) but not by insulin (3, 6, 9 U/kg, IP). MDL altered meal patterns in the same manner as GUA treatment but the effects were of smaller magnitude. It did not influence the response to either glucoprivic challenge. Combined GUA treatment and MDL generally produced additive effects. These results suggest that the major sympathetic influence on feeding is through adrenergic innervation and not circulating catecholamines. The hypothesis that the alteration in feeding patterns produced by ventromedial hypothalamic lesions is due to decreased sympathetic activity was not supported.     

Study on the mechanism of the appearance of noise effects

Summary This study was undertaken to investigate the dose-response relationship between the biological effect and noise exposure, and to consider the mechanism of the appearance of noise effects. Rats were exposed to noise at intensities of 60 dB (A), 80 dB (A) and 100 dB (A) for 240 min and examined for the change of activities of dopamine--hydroxylase (DBH) in serum and adrenal glands. Plasma cyclic adenosine 3,5-monophosphate (c-AMP) levels were also measured. Some rats were given 6-hydroxydopamine (6-OHDA) as a chemical sympathectomyzing agent 20 h before noise exposure in order to consider the mechanism of the appearance of noise effects. By noise exposure, serum DBH activity was significantly (P<0.01) increased at each intensity compared with the control group, but there were no remarkable changes in adrenal DBH activity. Plasma c-AMP level was also significantly elevated in response to the noise stress. When the rats, which had been pretreated with 6-OHDA, were exposed to noise with an intensity of 100 dB (A), the response of serum DBH activity was no longer observed. Therefore it is suggested that the effect due to noise exposure appears through the post-ganglionic sympathetic nerve fiber.