Ross syndrome is characterized by a triad of segmental anhidrosis, tonic pupil, and generalized areflexia. Selective postganglionic autonomic denervation could be the differential diagnostic point for other diseases of the autonomic nervous system. Here we report a patient with regional anhidrosis in his left hand and sole, and anisocoria. An evaluation of sweating and the pupillary response together with generalized areflexia confirmed the diagnosis of Ross syndrome. The finger wrinkle test is a simple and useful tool for revealing segmental sympathetic denervation.
Anisocoria* ; Autonomic Denervation ; Autonomic Nervous System ; Diagnosis ; Fingers* ; Hand ; Humans ; Hypohidrosis* ; Sweat ; Sweating ; Sympathectomy ; Tonic Pupil

BACKGROUND: little is known about the mechanisms responsible for ventricular tachycardia during myocardial ischemia and reperfusion. The purpose of this study was to evaluate the effects of the autonomic nervous system on ventricular tachycardia in dogs. METHODS: Four groups of eight dogs were studied. The control group had intact autonomic neural innervation:the stellectomy group had bilateral transection of stellate ganglia:the vagotomy group had bilateral transection of cervical vagi; and the autonomic denervation group underwent bilateral transection of stellate ganglia and cervical vagi. Open-chest dogs anesthetized with ketamine were studied in 3 sequential steps: denervation, ischemia, and reperfusion stage. At the end of each step, we estimated effective refractory period (ERP) at four sites : the apex of non-ischemic area, the base of non-ischemic area, the apex of ischemic area, and the base of ischemic area. We observed early afterdepolarization (EAD) through recording monophasic action potential on the ischemic epicardium during ischemia and reperfusion stages. RESULTS: In ischemia stage, deltaERPs(ERPmax.-ERPmin.) were significantly prolonged, compared to deltaERPs at denervation stage, and deltaERPs of the vagotomy group tended to be prolonged to 60 minutes after myocardial ischemia, as compared to those of the stellectomy group and the autonomic denervation group. The incidence of ventricular tachycardia during ischemia presented a significant increase in the vagotomy group, compared to the control group. However, there was no difference in incidence of ventricular tachycardia between the stellectomy group and the control group. deltaERP at the group with the occurrence of ventricular tachycardia were significantly prolonged , compared to the other group without the occurrence of ventricular tachycardia. In terms of the incidence of EAD, there was no difference between the groups and it was not associated with ventricular tachycardia. deltaERP was significantly decreased to 30 minutes after reperfusion, at which point there was no significant difference between the groups. There was no correlation between EAD and ventricular tachycardia. However, deltaERP with ventricular tachycardia indicated much more significant increase than deltaERP without ventricular tachycardia. CONCLUSIONS: Sympathetic nerve may be related to prolongation of deltaERP and incidence of ventricular tachycardia in the ischemic period. However, EAD is not related to ventricular tachycardia during ischemia and reperfusion. These findings suggest that the major mechanism of ventricular tachycardia may be a reentry in ischemia and reperfusion period.
Action Potentials ; Animals ; Autonomic Denervation* ; Autonomic Nervous System ; Denervation ; Dogs ; Heart* ; Incidence ; Ischemia* ; Ketamine ; Myocardial Ischemia ; Pericardium ; Reperfusion* ; Stellate Ganglion ; Tachycardia* ; Tachycardia, Ventricular ; Vagotomy

Immunohistochemical study have been made to examine the autonomic innervation of the human vas dererens following vasectomy one to 7 years previously. Samples from sites on the proximal (testicular) and distal (urethral) sides of the original vasectomy have been compared with control specimens as to the arrangement and distribution of autonomic nerves containing vasoactive intestinal polypeptide (VIP), catecholamine, substance-P and enkephalin. In contrast with tissues from the urethral portion and from controls, the testicular specimens revealed a marked reduction in the catecholeminergic innervation of the muscular layer. In addition VIPergic nerves distributed at the subepithelial layer were nearly absent from the testicular side of the vas deferens. The degrees of denervation were independent of the obstructive interval between vasectomy and vasectomy reversal. Substance-P and enkephalin containing nerves were rarely found from both sides of the vas deferens. Therefore, these findings suggest that the consequences of denervation of vas deferens may play an important role in those patients in whom infertility persists despite evidence of satisfactory mechanical continuity achieved by vasectomy reversal.
Autonomic Pathways ; Denervation ; Enkephalins ; Humans* ; Infertility ; Vas Deferens* ; Vasectomy* ; Vasoactive Intestinal Peptide ; Vasovasostomy

Purpose: The ideal neurourophysiologic investigatory technique would objectively and quantitatively evaluate functional status of all parts of the neurologic network involved in obtaining and maintaining penile erection. We assessed electrical activity of the corpus cavernous smooth muscle in normal and neurogenic erectile dysfunction men using SPACE. Material and Methods: A total of 39 normal subjects and 40 neurogenic erectile dysfunction patients underwent single potential analysis of cavernous electricity(SPACE) with a 2-channel EMG amplifier and surface electrodes. The electrical potentials were processed with the cut off frequencies at 0.3 - 32 Hz, a paper speed of 0.5cm/sec, and a range of amplitude of 0.5mV. Results: In 35 of 39 normal subjects(89.7%) and 5 of 10 incomplete suprasacral spinal cord injury patients, similar single potentials of uniform shape were recorded. In patients with peripheral autonomic denervation, irregular shape potentials with higher frequency and lower amplitude were found. In 3 of 5 patients with long standing diabetes(over 15 years), SPACE shows electrical silence. Conclusion: These results suggest that SPACE test is a useful noninvasive and reproducible method for evaluating cavernous innervation in erectile dysfunction. Furthermore, the single potential means intact cavernous innervation.
Autonomic Denervation ; Electrodes ; Erectile Dysfunction ; Humans ; Male ; Muscle, Smooth* ; Penile Erection ; Spinal Cord Injuries

BACKGROUND AND OBJECTIVES: Major epicardial fat pads contain cardiac ganglionated plexi (GP) of the autonomic nervous system. Autonomic denervation may improve the success rate of atrial fibrillation (AF) ablation. This study was designed to elucidate the acute effects of blocking the right atrium-pulmonary vein (RA-PV) and left atrium-inferior vena cava (LA-IVC) fat pads on the electrophysiologic characteristics of the atrium and AF inducibility with a botulinum toxin injection. Materials and Methods: Eight mongrel dogs were studied. The RA-PV and LA-IVC fat pads were exposed through a median thoracotomy. Botulinum toxin (BT, 50 U to each fat pad, n=6) or normal saline (NS, n=2) was injected in the entire area of two fat pads. The study protocol was applied before injection and repeated at 1, 2, 3, 4, and 5 hours thereafter. The sinus rate, ventricular rate during rapid atrial pacing with a cycle length of 50 ms, and AF inducibility were measured with and without vagal stimulation (VS). Bilateral cervical VS was applied (20 Hz, 0.2 ms, 5.6+/-2.0 V). AF inducibility was evaluated with burst pacing with 200 impulses at a 50-ms cycle length. RESULTS: VS effects on the sinus node and AF inducibility were eliminated a few hours after injection of BT; these changes were not observed after injection of NS. CONCLUSION: Short-term autonomic denervation of the atria was achieved by blocking the major epicardial GP with BT.
Adipose Tissue ; Animals ; Atrial Fibrillation ; Autonomic Denervation ; Autonomic Nervous System ; Autonomic Pathways ; Botulinum Toxins ; Dogs ; Ganglion Cysts ; Sinoatrial Node ; Thoracotomy ; Veins

BACKGROUND AND OBJECTIVES: Antiarrhythmic effect of renal denervation (RDN) after acute myocardial infarction (AMI) remains unclear. The goal of this study was to evaluate the effect of RDN on ventricular arrhythmia (VA) after AMI in a porcine model.METHODS: Twenty pigs were randomly divided into 2 groups based on RDN (RDN, n=10; Sham, n=10). After implanting a loop recorder, AMI was induced by occlusion of the middle left anterior descending coronary artery. Catheter-based RDN was performed for each renal artery immediately after creating AMI. Sham procedure used the same method, but a radiofrequency current was not delivered. Electrocardiography was monitored for 1 hour to observe VA. One week later, the animals were euthanized and the loop recorder data were analyzed.RESULTS: Ventricular fibrillation event rate and the interval from AMI creation to first VA in acute phase were not different between the 2 groups. However, the incidence of premature ventricular complex (PVC) was lower in the RDN than in the Sham. Additionally, RDN inhibited prolongation of the corrected QT (QTc) interval after AMI. The frequency of non-sustained or sustained ventricular tachycardia, arrhythmic death was lower in the RDN group in the early period.CONCLUSIONS: RDN reduced the incidence of PVC, inhibited prolongation of the QTc interval, and reduced VA in the early period following an AMI. These results suggest that RDN might be a therapeutic option in patients with electrical instability after AMI.
Animals ; Arrhythmias, Cardiac ; Autonomic Denervation ; Coronary Vessels ; Denervation ; Electrocardiography ; Humans ; Incidence ; Methods ; Myocardial Infarction ; Renal Artery ; Swine ; Tachycardia, Ventricular ; Ventricular Fibrillation ; Ventricular Premature Complexes

OBJECTIVETo investigate the effects on erectile function of transplanted major pelvic ganglion into the corpus cavernosum of adult male rats undergoing transection of bilateral cavernous nerves.

METHODSTwenty-six male Sprague-Dawley rats (3 - 4 month-old and 300 - 400 g/each) were divided into 2 groups: experimental group (transection of bilateral cavernous nerves and transplantation of left ganglion into left crus of penis, n = 16) and control group (transection of bilateral cavernous nerves only, n = 10). Erectile function was measured by injecting APO, and intracavernous pressure was measured 1 and 3 months afterwards by electric-stimulating the right major pelvic ganglion or the left crus. Half animals in each group were sacrificed 1 and 3 months afterwards for detecting nNOS-containing nerve fibers of corpus cavernosum. Electron microscopy of the implanted area was performed to assess neuronal survival.

RESULTSBoth of the two groups have no erectile response to APO injection. Electrostimulation on the right major pelvic ganglion and left crus failed to produce erection in experimental group. The mean pressure changes in the two groups, measured by stimulating the left crus, were (9.41 +/- 3.20) and (4.16 +/- 2.58) cmH(2)O 1 month afterwards, and (13.67 +/- 4.18) and (5.09 +/- 2.74) cmH(2)O 3 months afterwards, respectively (P < 0.05). An increased number of nNOS-containing nerve fibers in left crus was detected in experimental group 1 and 3 months later, compared with control one (218.7 +/- 24.5, 18.0 +/- 3.7; 183.2 +/- 19.7, 19.0 +/- 3.8; P < 0.05). Ultrastructure examination by transmission electron microscope confirmed the survival of the implanted ganglion.

CONCLUSIONMajor pelvic ganglion can survive in the corpus cavernosum, and it has significant effects on the number of nNOS-containing nerve fibers and the alteration of intracavernous pressure.

Animals ; Autonomic Denervation ; Celiac Plexus ; surgery ; Ganglia, Autonomic ; transplantation ; Graft Survival ; Male ; Nitric Oxide Synthase ; metabolism ; Penile Erection ; physiology ; Penis ; innervation ; surgery ; Rats ; Rats, Sprague-Dawley ; Transplantation, Autologous

Bladder dysfunction after radical rectal cancer surgery has been well known but there has not been sufficient objective data in Korea. We performed consecutive urodynamic study preoperatvely, postoperative tenth day and postoperativesixth month on 71 patients undergone radical rectal surgery. Compared with preoperative state. each urodynamic parameters changed significantly : maximal flow rate and average flow rate decreased ; voiding sense and residual urine volume increased ; bladder capacity, compliance and detrusor pressure decreased ; and maximal urethral pressure, functional urethral pressure and functional urethral length changed. All in all, we came out with the results that autonomic denervation was developed in 59 (83%) out of 71 in postoperative tenth day and 11 (28%) out of 39 in postoperative sixth month. Except for the residual urine volume and detrusor pressure, no significant recovery was observed in postoperative sixth month. Univariate analysis showed that sex, age, tumor size, distance from anal verge, stage, intraluminal tumor position and mode of operation had no significant influence on urodynamic parameters. However, the higher the stage, the more damages were found in multivariate analysis using logistic regression with correction of sex and age. Bladder dysfunction after rectal cancer operation is caused by partial autonomic denervation where urologic care is necessary, however as a whole, bladder dysfunction is considered to be a temporary change.
Autonomic Denervation ; Compliance ; Humans ; Korea ; Logistic Models ; Multivariate Analysis ; Neck* ; Rectal Neoplasms ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urinary Incontinence* ; Urodynamics

Bladder dysfunction after radical rectal cancer surgery has been well known but there has not been sufficient objective data in Korea. We performed consecutive urodynamic study preoperatvely, postoperative tenth day and postoperativesixth month on 71 patients undergone radical rectal surgery. Compared with preoperative state. each urodynamic parameters changed significantly : maximal flow rate and average flow rate decreased ; voiding sense and residual urine volume increased ; bladder capacity, compliance and detrusor pressure decreased ; and maximal urethral pressure, functional urethral pressure and functional urethral length changed. All in all, we came out with the results that autonomic denervation was developed in 59 (83%) out of 71 in postoperative tenth day and 11 (28%) out of 39 in postoperative sixth month. Except for the residual urine volume and detrusor pressure, no significant recovery was observed in postoperative sixth month. Univariate analysis showed that sex, age, tumor size, distance from anal verge, stage, intraluminal tumor position and mode of operation had no significant influence on urodynamic parameters. However, the higher the stage, the more damages were found in multivariate analysis using logistic regression with correction of sex and age. Bladder dysfunction after rectal cancer operation is caused by partial autonomic denervation where urologic care is necessary, however as a whole, bladder dysfunction is considered to be a temporary change.
Autonomic Denervation ; Compliance ; Humans ; Korea ; Logistic Models ; Multivariate Analysis ; Rectal Neoplasms* ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urodynamics*

Bladder dysfunction is a common occurrence following radical hysterectomy. It is a direct consequence of the intraoperative disruption of the autonomic nerve supply to the bladder. We herein evaluated 158 patients who underwent radical hysterectomy for carcinoma of cervix in the Dept. of Obstet.-Gynecol., Seoul National University Hospital into two separate part. In Part 1,140 patients who received the surgery from Jan. 1980 to Dec 1981 were subjected to this study. The records and the follow-up results were analysed retrospectively. Immediate postoperatively, 44.7% of patients presented bladder dysfunction such as large residual urine over 100 cc and delayed perception of bladder filling sensation. In 6 month follow-up group, 15.8% of patients complained urologic symptoms such as strain. stress incontinence, urgency and sensory loss. In 1 year follow-up group, the same symptoms were persisted in 11.5% of patients. In Part 2, urodynamic test was performed in 10 patients preoperatively and 18 patients postoperatively. No differences were found between two groups except marked increase of bladder volume at the first voiding sensation. Urecholine denervation test of Lapides was done in 18 patients postoperatively and three patients revealed positive test, which means partial parasympathetic detrusor denervation. To decrease the incidence of bladder dysfunction, the use of suprapubic cystostomy, subcutaneous injection of urecholine, intermittent self catheterization are recommended rather than indwelling urethral catheter. Urodynamic test is necessary to define the nature and to manage the patients with bladder dysfunction after radical hysterectomy.
Autonomic Pathways ; Bethanechol Compounds ; Catheterization ; Catheters ; Cervix Uteri ; Cystostomy ; Denervation ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Incidence ; Injections, Subcutaneous ; Retrospective Studies ; Sensation ; Seoul ; Urinary Bladder* ; Urinary Catheters ; Urodynamics