Humans ; Hypertension ; Sympathetic Nervous System ; metabolism ; pathology

Sustained activation of sympathetic nervous system in response to stimulation of a wide variety of stress factors is an independent risk factor for the development of essential hypertension. Adrenal hormone biosynthesis pathway as an important part of the sympathetic nervous system consists of hormones, neurotransmitters, receptors, and a variety of synthases and invertases. In this article, we have systematically reviewed research progresses made in elucidating the interactions between genes of the adrenal hormone biosynthesis pathway and stress factors in the pathogenesis of essential hypertension.
Animals ; Hormones ; metabolism ; Humans ; Hypertension ; genetics ; metabolism ; pathology ; Sympathetic Nervous System ; metabolism ; pathology

Involvement of the peripheral nerveous system by diabetes is referred to as diabetic neuropathy. The frequency of diabetic neuropathy ranges from 5% to 60% and the pain management is one of the greatest problem. The patient was a 57-year-old man who has been treated with diabetes(DM type IIa) for about 12 years. The symmetrical pain, swelling and sensory loss on feet were started 3 months before admission and the burning pain was intensified at night with resultant insomnia. The systoms were aggravated 1 month ago and they were not relieved by any medication and physical therapy. We attempted lumbar epidural block to the patient and the result was good. So we performed a permanent lumbar sympathetic ganglion block with neurolytics(99.9% alcohol) for the long term relief of pain. The patient was satisfied with the result of the block and discharged.
Burns ; Diabetic Neuropathies* ; Foot ; Ganglia, Sympathetic ; Humans ; Metabolism ; Middle Aged ; Pain Management* ; Sleep Initiation and Maintenance Disorders ; Sympathetic Nervous System

Apoptosis ; Child ; Heart Failure ; metabolism ; physiopathology ; Humans ; Signal Transduction ; Sympathetic Nervous System ; metabolism ; physiopathology ; Ventricular Remodeling

OBJECTIVETo review the advances in studies on renal denervation.

DATA SOURCESReferences concerning renal denervation and resistant hypertension cited in this review were collected from PubMed published in English and those of renal denervation devices from official websites of device manufacturers up to January 2014.

STUDY SELECTIONArticles with keywords "renal denervation" and "resistant hypertension" were selected.

RESULTSRenal and systemic sympathetic overactivity plays an important role in pathology of hypertension as well as other diseases characterized by sympathetic overactivity. Renal denervation is a new, catheter based procedure to reduce renal and systemic sympathetic overactivity by disruption of renal sympathetic efferent and afferent nerves through radiofrequency or ultrasound energy delivered to the endoluminal surface of both renal arteries. Although several studies have shown the efficacy and safety of renal denervation in the treatment of resistant hypertension and the potential benefit of the procedure in other diseases, Symplicity HTN 3 study, the most rigorous clinical trial of renal denervation to date, failed to meet its primary endpoint. The procedure also has other limitations such as the lack of long term, efficacy and safety data and the lack of the predictors for the blood pressure lowering response and nonresponse to the procedure. An overview of current renal denervation devices holding Conformité Européenne mark is also included in this review.

CONCLUSIONSRenal denervation is a promising therapeutic approach in the management of resistant hypertension and other diseases characterized by sympathetic overactivity. In its early stage of clinical application, the efficacy of the procedure is still controversial. Large scale, blind, randomized, controlled clinical trials are still necessary to address the limitations of the procedure.

Blood Pressure ; physiology ; Denervation ; methods ; Humans ; Hypertension ; Kidney ; innervation ; Neurosurgical Procedures ; Sympathetic Nervous System ; metabolism

Ever since it was first introduced as a method of scintigraphically measuring regional myocardial perfusion, myocardial perfusion study has been widely used in patients diagnosed or suspected with coronary artery diseases, and continuously improved upon. In addition to the technological enhancement of nuclear medicine equipments, the innovation of radiopharmaceuticals used in the cardiac exams were important contributors to such improvement. Besides the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. More information can be collected before diagnosing coronary vascular disease, evaluating the patient's condition, or assessing therapeutic effects. In this review article, the clinical efficacy and characteristics of radiopharmaceutical products tailored for cardiac SPECT that are commonly used in Korea currently, plus the ones not being used yet but have proven value are briefly described.
Coronary Artery Disease ; Humans ; Korea ; Metabolism ; Nuclear Medicine ; Perfusion ; Radiopharmaceuticals* ; Sympathetic Nervous System ; Tomography, Emission-Computed, Single-Photon* ; Vascular Diseases

The present study was designed to examine the possible relationship between the function of the labyrinth and the role of the sympathetic nervous system In experimental motion sickness produced by rotatory movement(8O r.p.m.). The catecholamines in the brain, the heart and the adrenal gland of rats were rapidly reduced to one half of normal values following exposure to rotatory movement. The pretreatment with streptomycin and dramamine completely prevented the depletion by the rotatory movement of the catecholamines in the brain, the heart and the adrenal gland, but scopolamine did not prevent the decrease. Bretylium or chlorpromazine signifcantly inhibited reduction of the catechol-amines in both of the brain and the heart. However they did not influence the decrease in the adrenal gland. The reduction of the tissue catecholamines in rotatory movement is presumed to be caused largely by activation of the sympathetic nervous system mediated through labyrinthine stimulation.
Animals ; Catecholamines/*metabolism ; Labyrinth/*physiopathology ; Male ; Motion Sickness/*etiology ; Rats ; *Rotation ; Sympathetic Nervous System/*physiopathology ; OID - NASA: 70030571

BACKGROUND: It used to induce hypercarbia that carbon dioxide insufflated into the peritoneum in laparoscopic surgery. It might stimulate sympathetic nervous system, and decrease splanchnic circulation, hepatic function, and metabolism of anesthetics. The purpose of the present study was to examine the influence of hypercarbia on concentrations of propofol at the time of eye opening and recovery of orientation after propofol target controlled infusion (TCI) during a laparoscopic cholecystectomy. METHODS: Fifty patients were divided randomly into a laparoscopic group (group 1, n = 25) and an exploratory group (group 2, n = 25). A propofol infusion was started at a propofol target concentration of 6microgram/ml, and anesthesia was maintained at 4microgram/ml by using a Diprifusor (TM) turing the operation, intraabdominal pressure was maintained automatically at 12 14 mmHg by a CO2 insufflator and controlled ventilation settings were adjusted about 50 mmHg of PaCO2 after peritoneal insufflation. This ventilatory setting was not changed throughout the operation. We evaluated the estimated plasma concentrations of propofol at the time of eye opening and recovery of orientation in each group using user interface of a Diprifusor (TM). RESULTS: In the laparoscopic group, PaCO2, and PetCO2 increased significantly at 5, 15, 30 minutes after carbon dioxide insufflation, but there was no significant difference in concentrations of propofol at eye opening and orientation after propofol TCI between the two groups. CONCLUSIONS: Hypercarbia induced by insufflation of carbon dioxide into peritoneum didn't give rise to an influence on awakening concentrations after propofol TCI during a laparoscopic cholecystectomy.
Anesthesia ; Anesthetics* ; Carbon Dioxide ; Cholecystectomy, Laparoscopic* ; Humans ; Insufflation ; Laparoscopy ; Metabolism ; Peritoneum ; Plasma ; Propofol* ; Splanchnic Circulation ; Sympathetic Nervous System ; Ventilation

OBJECTIVETo investigate the role of renal sympathetic nerves in renal sodium transport in ouabain-hypertensive rats (OHR).

METHODSSixteen male SD rats with sham renal denervation (Sham-RDNX) and 16 with renal denervation (RDNX) were randomly into normal control group and ouabain group to receive intraperitoneal injection of normal saline (1 ml/kg) and ouabain (27.8 µg/kg) once a day, respectively. Systolic blood pressure (SBP), heart rate and body weight were recorded weekly. Food consumption of the rats was determined twice a week. After a 4-week treatment, blood and 24 h urine samples were collected to measure the serum and urinary concentration of sodium, trace lithium and creatinine. Endogenous creatinine clearance rate (Ccr), fractional excretions of sodium (FENa), fractional excretions of lithium (FELi) and fractional reabsorption of sodium in the postproximal tubules (FDRNa) were calculated. Plasma renin activity was determined by radioimmunoassay. Norepinephrine was extracted from the renal tissue and assayed for norepinephrine content by HPLC.

RESULTSThe body weight, food intake and heart rate showed no significant difference among the 4 groups (P > 0.05). After 4 weeks, the SBP of control RDNX group (CDNX) was significantly lower than that of the control Sham-DNX group (Csham)(P < 0.05); the SBP of ouabain RDNX group (ODNX) was also significantly lower than that of ouabain Sham-DNX group (Osham) (P < 0.05); RNDX lowered SBP by about 10 mmHg in both ouabain groups and control groups. The SBP was significantly higher in Osham and ODNX groups than in the corresponding control groups (P < 0.01), also significantly higher in ODNX group than in Csham group (P < 0.01). Ccr showed no significant difference among the 4 groups(P > 0.05). FENa, FELi and FDRNa were significantly lower in ouabain groups than in the corresponding control groups (P < 0.05, P < 0.01, P < 0.05), but FENa, FELi and FDRNa of ODNX group were similar with those of Osham group (P > 0.05); FENa , FELi and FDRNa were similar between CDNX and Csham groups (P > 0.05). The plasma renin activity was comparable between the 4 groups (P > 0.05). Renal norepinephrine level was markedly reduced in RDNX group compared with that in Sham-RDNX group in both ouabain and control groups (P < 0.01).

CONCLUSIONThe increase of proximal tubule sodium reabsorption in OHR is not dependent on the renal sympathetic nerve.

Animals ; Hypertension ; chemically induced ; metabolism ; Kidney ; innervation ; Male ; Ouabain ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sodium ; metabolism ; Sodium Channels ; metabolism ; Sympathetic Nervous System ; physiology

OBJECTIVE: To investigate the impact of renal denervation on the blood pressure, plasma renalase content and expression of renalase and tyrosine hydroxylase (TH) in the idney of spontaneous hypertensive (SH) rats and to explore the role of renal denervation in lowering the blood pressure. METHODS: SH rats were randomly assigned into a baseline group, a surgery (renal denervation) group, a sham group and a control group (n=48). WKY rats matched in age (n=12) served as a baseline control group. All rats were housed until 12 weeks old. Then, the rats in the baseline group and the WKY group were sacrificed whose blood and kidney were collected for examination. In the renal denervation group, the sham group and the control group, the blood pressure was monitored continuously. One week and 6 weeks after the renal denervation, 6 rats in each group were sacrificed whose blood and kidney were collected. ELISA was employed to measure the plasma renalase and Western blot assay done to detect the expression of TH and renalase in the kidney. RESULTS: Compared with WKY rats, blood pressure significantly increased and TH protein expression markedly elevated (P<0.05) in SH rats in the baseline group, but plasma renalase content and protein expression of renalase in the kidney dramatically reduced (P<0.05). One week after the surgery, the mean arterial pressure and TH protein expression in the surgery group were lowered compared with the baseline group and dramatically reduced compared with the sham group and the control group (P<0.05). In the surgery group, the renalase level was markedly increased compared with the baseline group, the sham group, and the control group (P<0.05). Six weeks after the renal denervation, the mean arterial pressure and TH level in the surgery group were significantly increased but the renalase content and expression markedly reduced compared with those 1 week, but there were no marked differences among the surgery group, the sham group, and the control group (P>0.05). No pronounced differences in the above variables were found between the sham group and the control group at any time point (P>0.05). CONCLUSION Renal denervation can lower the blood pressure, which may attribute to the suppression of sympathetic nerves, increase in plasma renalase content and renalase expression in the kidney.
Animals ; Blood Pressure ; physiology ; Hypertension ; surgery ; Kidney ; enzymology ; innervation ; Male ; Monoamine Oxidase ; blood ; metabolism ; Rats ; Rats, Inbred SHR ; Sympathectomy ; methods ; Sympathetic Nervous System ; physiopathology ; Tyrosine 3-Monooxygenase ; metabolism