No abstract available.
Autonomic Agents* ; Autonomic Nervous System*

BACKGROUND: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. MATERIAL AND METHOD: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi- fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were introduced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. RESULT: Sympathetic rami were completely blocked in cadaver dissection study. Hyperhidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Compensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. CONCLUSION: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy. Operative success rate was similar to the traditional sympathicotomy; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.
Anesthesia, General ; Autonomic Nerve Block ; Cadaver* ; Ganglia ; Hemorrhage ; Humans ; Hyperhidrosis* ; Hypohidrosis ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Supine Position ; Surgical Instruments ; Sweating, Gustatory ; Sympathetic Nervous System ; Thoracic Wall ; Thoracoscopy ; Ventilation

No abstract available.
Autonomic Nervous System*

Orthostatic hypotension with other signs of progressive neuronal degeneration particularly affecting the autonomic nervous system has been recognized independently and is called Shy-Drager syndrome. Degenerative changes in the autonomic ganglia, loss of neurons in the intermediolateral columns and degenerative changes in the neurons of the cortex and basal ganglia have been reported on examination of this condition. The authors report a case of Shy-Drager Syndrome with symptoms of orthosatatic hypotension, dysarthria, Parkinson's features, muscle wasting, sexual impotence, atonic bladder and loss of sweating.
Autonomic Nervous System ; Basal Ganglia ; Dysarthria ; Erectile Dysfunction ; Ganglia, Autonomic ; Hypotension ; Hypotension, Orthostatic ; Male ; Neurons ; Shy-Drager Syndrome* ; Sweat ; Sweating ; Urinary Bladder

Orthostatic hypotension with other signs of progressive neuronal degeneration particularly affecting the autonomic nervous system has been recognized independently and is called Shy-Drager syndrome. Degenerative changes in the autonomic ganglia, loss of neurons in the intermediolateral columns and degenerative changes in the neurons of the cortex and basal ganglia have been reported on examination of this condition. The authors report a case of Shy-Drager Syndrome with symptoms of orthosatatic hypotension, dysarthria, Parkinson's features, muscle wasting, sexual impotence, atonic bladder and loss of sweating.
Autonomic Nervous System ; Basal Ganglia ; Dysarthria ; Erectile Dysfunction ; Ganglia, Autonomic ; Hypotension ; Hypotension, Orthostatic ; Male ; Neurons ; Shy-Drager Syndrome* ; Sweat ; Sweating ; Urinary Bladder

Chronic pelvic pain is a common problem with variable etiology. The sympathetic nervous system plays an important role in the transmission of visceral pain regardless of its etiology. Sympathetic nerve block is effective and safe for treatment of pelvic visceral pain. One of them, the inferior hypogastric plexus, is not easily assessable to blockade by local anesthetics and neurolytic agents. Inferior hypogastric plexus block is not commonly used in chronic pelvic pain patients due to pre-sacral location. Therefore, inferior hypogastric plexus is not readily blocked using paravertebral or transdiscal approaches. There is only one report of inferior hypogastric plexus block via transsacral approach. This approach has several disadvantages. In this case a favorable outcome was obtained by using coccygeal transverse approach of inferior hypogastric plexus. Thus, we report a patient who was successfully given inferior hypogastric plexus block via coccygeal transverse approach to treat chronic pelvic pain conditions involving the lower pelvic viscera.
Anesthetics, Local ; Autonomic Nerve Block ; Humans ; Hypogastric Plexus ; Nerve Block ; Pelvic Pain ; Sympathetic Nervous System ; Viscera ; Visceral Pain

Monitoring the heart rate variability is a simple non-invasive method for evaluating the influences of drug therapy, motor, psychological therapy and stress on the functions of autonomic nervous system. The heart rate variability is applied widely in clinical as well as pathological mechanism of cardiovascular diseases and non-cardio vascular diseases in the world. Curently, many health care facilities installed the holder for monitoring the blood pressure and heart rate in Vietnam. Therefore, this method is available ready for studying, diagnosing and monitoring the treatment.
autonomic nervous system ; Heart rate

Background & Objective: Neurogenic tumors typically originate from the peripheral nerves, paraganglionic nerves, or the autonomic nervous system. Tumors arising from peripheral nerves are classified as schwannoma, neurofibroma, and malignant peripheral nerve sheath tumors while tumors arising from the sympathetic chain ganglion cells are classified as ganglioneuroma, ganglioneuroblastoma, and neuroblastoma. Tumors arising from the parasympathetic chain ganglion cells are classified as paraganglioma. Neurogenic tumors of the thorax are uncommon and originate from large airways, lungs, the mediastinum, or the chest wall. In this study, we report the clinical and histopathological features of 42 patients diagnosed with neurogenic tumors of the thorax. Methods: A retrospective review of the medical records of 42 patients diagnosed with intrathoracic neurogenic tumors and treated in Uludag University between 2002 and 2012 was conducted. All pathology specimens were examined by a pathologist experienced in the examination of soft tissue tumors. The patients were evaluated according to age, gender, location and histological characteristics of the tumor. Results: The study group included 42 patients diagnosed thoracic neurogenic tumors, including 31 female (74%) and 11 male (26%). The sex ratio was 2.8 (female/male) and the mean age of the study population was 38.52 years. The age of patients ranged from 3 to 73 years. The neurogenic tumor was located in the posterior mediastinum in 31(74%) patients, anterior mediastinum in 2 (5%) patients, and in the chest wall in 9 (21%) patients. The origin of the neurogenic tumor was the peripheral nerve sheath in 31 (74%) patients, and the ganglion cells in 10 (24%) patients, and the paraganglion system in 1 (2%) patient. The study group also included 20 (48%) patients diagnosed with schwannoma, 6 (14%) patients diagnosed with malignant peripheral nerve sheath tumor , 5 (12%) patients diagnosed with neurofibroma , 5 (12%) patients diagnosed with ganglioneuroma, 4 (10%) patients diagnosed with neuroblastoma , 1 (2%) patient diagnosed with ganglioneuroblastoma and 1 (2%) patient diagnosed with paraganglioma. Our study group comprised 36 adults and 6 children. Of the adult patients, 20 (55%) had schwannomas, 6 (17%) malignant peripheral nerve sheath tumor, 5 (14%) neurofibroma, 4 (11%) ganglioneuromas, and 1 (3%) paraganglioma. Four of the six children (66%) included in our study group were diagnosed with neuroblastoma, 1 (17%) child was diagnosed with ganglioneuroma, and 1 (17%) child was diagnosed with ganglioneuroblastoma. The malignancy rate was 83% in children and 17% in adults. Conclusion: Age is an important clinical parameter in terms of histological type and malignancy rate. In our study group, malignancy rate in children was much higher than adults. The most common thoracic neurogenic tumor in adults and children was schwannoma and neuroblastoma, respectively.
Autonomic Nervous System ; Neuroblastoma ; Neurilemmoma

Activity of the enteric nervous system (ENS) is controlled by the autonomic nerves under the normal physiological condition, even though ENS has been regarded to be independent from the central nervous system. However, the relation between myenteric neurons and vagus nerves has not been fully clarified. For the defining of topographical and functional relationship between these two nervous systems, we analyzed how many myenteric neurons are activated after electrical vagal stimulation in the rat. Bilateral cervical vagi were electrically stimulated (10 V, 5 msec, 40 Hz) for a duration of 30 minutes, and then each part of the small intestine was obtained. Fos, as a functional marker for neuronal activation, immunohistochemistry was used for the detection of vagally activated myenteric neurons. Total number of myenteric neurons was obtained using cuprolinic blue stained samples, and was calculated as 12,819+/-1,514, 14,261+/-1,452, 15,411+/-2,380 per unit area (1 cm2) in duodenum, jejunum and ileum, respectively. Fos-positive myenteric neurons were scarcely observed in the normal control group. After the electrical vagal stimulation, Fos-immunoreactive (IR) neurons were detected as 31+/-17%, 17+/-9%, 16+/-10% of total number of myenteric neurons in duodenum, jejunum and ileum, respectively. These data demonstrate that only some (16~31%) of myenteric neurons are regulated by vagal efferent input, and the duodenum receives much more vagal input functionally than other distal regions. Furthermore, these findings can be applied to trials defining the functional circuit of the myenteric nervous system linked to the vagus nerves, since Fos-positive nuclei can be easily double-labeled with various neurotransmitters existing in the myenteric neurons.
Animals ; Autonomic Pathways ; Central Nervous System ; Duodenum ; Enteric Nervous System ; Ileum ; Immunohistochemistry ; Intestine, Small* ; Jejunum ; Myenteric Plexus* ; Nervous System ; Neurons* ; Neurotransmitter Agents ; Rats* ; Vagus Nerve

No abstract available.
Autonomic Nervous System ; Hypohidrosis* ; Reflex, Abnormal*