Although the pelvic autonomic plexus may be considered a mixture of sympathetic and parasympathetic nerves, little information on its composite fibers is available. Using 10 donated elderly cadavers, we investigated in detail the topohistology of nerve fibers in the posterior part of the periprostatic region in males and the infero-anterior part of the paracolpium in females. Neuronal nitric oxide synthase (nNOS) and vasoactive intestinal polypeptide (VIP) were used as parasympathetic nerve markers, and tyrosine hydroxylase (TH) was used as a marker of sympathetic nerves. In the region examined, nNOS-positive nerves (containing nNOS-positive fibers) were consistently predominant numerically. All fibers positive for these markers appeared to be thin, unmyelinated fibers. Accordingly, the pelvic plexus branches were classified into 5 types: triple-positive mixed nerves (nNOS+, VIP+, TH+, thick myelinated fibers + or -); double-positive mixed nerves (nNOS+, VIP-, TH+, thick myelinated fibers + or -); nerves in arterial walls (nNOS-, VIP+, TH+, thick myelinated fibers-); non-parasympathetic nerves (nNOS-, VIP-, TH+, thick myelinated fibers + or -); (although rare) pure sensory nerve candidates (nNOS-, VIP-, TH-, thick myelinated fibers+). Triple-positive nerves were 5-6 times more numerous in the paracolpium than in the periprostatic region. Usually, the parasympathetic nerve fibers did not occupy a specific site in a nerve, and were intermingled with sympathetic fibers. This morphology might be the result of an "incidentally" adopted nerve fiber route, rather than a target-specific pathway.
Adrenergic Fibers ; Aged* ; Cadaver* ; Female ; Humans ; Hypogastric Plexus* ; Male ; Myelin Sheath ; Nerve Fibers* ; Nitric Oxide Synthase Type I ; Tyrosine 3-Monooxygenase ; Vasoactive Intestinal Peptide

sympathetic fibers. Therapy of Frey syndrome includes drugs, radiographic treatment, and surgical treatment; however, in most cases, treatment is not satisfactory. This is a case report on a 24-year-old male patient with Frey syndrome caused by the fracture reduction with retromandibular approach after multiple facial traumas and spontaneous healing without any special treatment.]]>
Adrenergic Fibers ; Humans ; Male ; Mandibular Condyle ; Regeneration ; Sweat ; Sweat Glands ; Sweating ; Sweating, Gustatory ; Young Adult

The sudden hemodynamic disturbance in the perioperative period can occur because of various surgical and anesthetic reasons but hemodynamic collapse due to noxious stimulus of periosteum stripping has not been described. We report two cases of severe hypotension and bradycardia during periosteum stripping in orthopedic surgery under subarachnoid block even though the block level was adequate. In our patients, hemodynamic collapse occurred specifically at a moment when surgeons manipulated periosteum and fall in blood pressure and heart rate was sudden in onset. The hemodynamic disturbance did not appear to be related to vagally mediated or due to blockade of sympathetic fibers but appeared to be related to periosteal nociceptors.
Adrenergic Fibers ; Anesthesia, Spinal ; Blood Pressure ; Bradycardia ; Heart Rate ; Hemodynamics ; Humans ; Hypotension ; Nociceptors ; Orthopedics ; Perioperative Period ; Periosteum

Traditional Chinese acupuncture has a history of over 2500 years. It is effective in the treatment of many conditions with few side effects. The best known mechanism is via endogenous opiates and their receptors. In addition to opioids, researchers have focused on the role of central monoamimergic systems. Acupuncture therapy is used not only to relieve pain but also to treat various medical conditions in traditional Chinese medicine (TCM). Some experiments have revealed a relationship between acupuncture and the autonomic nervous system (ANS). Besides, electroacupuncture (EA) can modulate the imbalance between innate and acquired immune systems. This review is focusing on the mechanistic studies of acupuncture that my colleagues and I have performed in Taiwan in recent years. We found that EA analgesia was closely related to not only the serotonergic neurons but also the adrenergic neurons in the central nervous system. The electrophysiological recordings suggested the involvement of the cerebral cortex in acupuncture. Local somatothermal stimulation inhibited the motility of sphincter of Oddi and internal anal sphincter through nitrergic neural release of nitric oxide. Mild local heat stress upregulated hepatic gene expression of heat shock protein 70 and protected the liver from subsequent ischemia-reperfusion injury. These studies supplement the knowledge of the mechanism of acupuncture.
Acupuncture Therapy ; methods ; Adrenergic Fibers ; metabolism ; physiology ; Animals ; Cerebral Cortex ; metabolism ; physiology ; Electroacupuncture ; methods ; Humans ; Medicine, Chinese Traditional ; Moxibustion ; methods ; Neurons ; metabolism ; physiology ; Pain Management ; Proteomics ; Serotonin ; metabolism ; Signal Transduction ; physiology ; Taiwan

PURPOSE: Carbon monoxide (CO) is produced during the degradation of hemoglobin to heme (iron protoporphyrin) and present in various tissues including brain. CO is believed to activate soluble guanylate cyclase to exert its action on the smooth muscles. the effects of CO and its relationships to adrenergic or cholinergic mechanisms were studied using the isolated rabbit corpus cavernosal strips, and the effects of CO and NO were further investigated. MATERIALS AND METHODS: Using adult New Zealand rabbits, the corpus cavernosal strip was carefully prepared from rabbit penis and suspended in an 10ml organ bath containing Tyrode solution. When a stable tension level of the strip had been attained, drugs were added to the organ bath the change of motility of the strip was recorded on a computerized polygraph. RESULTS: The NO donor, sodium nitroprusside (SNP) and CO caused a dosedependent relaxation of the cavernosal strip of the rabbit penis. Pretreatment of SNP and CO had no effect on contraction induced by adrenergic drugs and the effects of SNP and CO was not affected by atropine. The relaxation effects of SNP were inhibited by NO scavenger pyrogallol, inhibitor of soluble guanylate cyclase 1H-[1,2,4] oxadiazolo[4,3-a] quinoxalin-1-one (ODQ) and methylene blue. The relaxation effects of CO were significantly inhibited by ODQ and methylene blue. the relaxation effects by acetylcholine were inhibited by NO synthase inhibitor L-nitroarginine methyl ester (NAME) and deendothelialization, but not affected by zinc protoporphyrin (ZnPP), the heme oxidase inhibitor. On the immunostaining of heme oxidase (HO) in corpus cavernosal smooth muscle strip, the positive staining for HO was observed in the perivascular nerve fibers. CONCLUSIONS: The relaxation effect of NO was confirmed, and CO exerts an endothelium dependent relaxing effect on the cavernosal strip of the rabbit penis similar to NO. This action is seem to be mediated by soluble guanylate cyclase, and the actions of CO is also mediated by similar guanylate cyclase system.
Acetylcholine ; Adrenergic Agents ; Adult ; Atropine ; Baths ; Brain ; Carbon Monoxide* ; Carbon* ; Endothelium ; Guanylate Cyclase ; Heme ; Humans ; Male ; Methylene Blue ; Muscle, Smooth ; Nerve Fibers ; Nitric Oxide ; Nitric Oxide Synthase ; Nitroprusside ; Oxidoreductases ; Penis ; Pyrogallol ; Rabbits ; Relaxation ; Tissue Donors ; Zinc

BACKGROUND: A right thoracoscopic thoracic sympathicotomy involves the removal of T2 and T3 sympathetic chains. Since part of the sympathetic fibers to the heart traverse these two ganglia, we examined the hemodynamic changes during a thoracoscopic thoracic sympathicotomy in primary hyperhidrosis. METHODS: Noninvasive cardiac output monitoring was done on the both side of the neck and chest. A physiograph for measuring of continuous blood flow was taken from the right index finger and a thermometer was placed in the right palm. Following endotracheal intubation was done with double lumen endotracheal tube, anesthesia was maintained with isoflurane. Sympathicotomies were done for T2-3 during one lung ventilation. Heart rate (HR), mean arterial pressure (MAP), systemic vascular resistance index (SVRI), cardiac index (CI), accelerated contractility index (ACI), end-diastolic index (EDI), and temperature were recorded at arrival, before sympathicotomy, after sympathicotomy at 1, 2, 3, 4 and 5 minuets. The blood flow of the right index finger was recorded before and after the sympathicotomy. RESULTS: Concurrent with initiation of the sympathicotomy, MAP and SVRI were reduced, but the CI was elevated. It was accompanied with right palmar temperature elevation and an increase in the blood flow of the right index finger. CONCLUSIONS: A thoracoscopic thoracic sympathicotomy reduces MAP and SVRI and elevates CI, palmar temperature, and blood flow. We concluded that the hemodynamic changes during a thoracoscopic thoracic sympathicotomy seems to be the peripheral vasodilatation.
Adrenergic Fibers ; Anesthesia ; Arterial Pressure ; Cardiac Output ; Fingers ; Ganglia ; Heart ; Heart Rate ; Hemodynamics* ; Hyperhidrosis* ; Intubation, Intratracheal ; Isoflurane ; Neck ; One-Lung Ventilation ; Thermometers ; Thorax ; Vascular Resistance ; Vasodilation

BACKGROUND: Recent findings suggest that a coupling between the somatic and sympathetic nervous system is critical not only for the development but also for the maintenance of pain behavioral changes. However, studies on the effect of sympathetic efferent system on sensory receptors in the visceral organ that is more dependent on the autonomic nervous system are lacking. This study examined whether norepinephrine (NE) had an influence on the mechanoreceptors in the feline urinary bladder. METHODS: Ten adult male cats were used and anesthetized with alpha-chloralose and artificially ventilated. A cannula with the pressure transducer was inserted through the urethra to apply mechanical stimuli and monitor the pressure of bladder. A tiny cannula inserted into the bilateral side branches of vesical arteries were used as a route for a NE (10A.M 9:40 01-10-08 bilaterally) injection. Nerve fiber recordings were obtained from the distal stump of the pelvic nerve. RESULTS: After the NE injection, the response of mechanoreceptors (n = 13) to the isotonic pressure stimulus (50 - 60 mmHg) decreased significantly (p < 0.05) in terms of sensitivity (i.e., ratio of nerve activity change to urinary bladder pressure change). The responses to pressure stimuli after an injection of an alpha1 adrenoceptor blocker (terazosin) reversed the effect of NE. The responses of mechanoreceptors to isotonic pressure stimulus were not affected significantly by NE with preinjection of an alpha2 adrenoceptor blocker (yohimbine). CONCLUSIONS: These results suggest that NE may have influence on the sensitivity of mechanoreceptors in the normal feline urinary bladder via an alpha1 adrenoceptor.
Adrenergic alpha-1 Receptor Antagonists ; Adult ; Animals ; Arteries ; Autonomic Nervous System ; Catheters ; Cats* ; Chloralose ; Humans ; Male ; Mechanoreceptors* ; Nerve Fibers ; Norepinephrine* ; Sensory Receptor Cells ; Sympathetic Nervous System ; Transducers, Pressure ; Urethra ; Urinary Bladder*

We investigated the adrenergic sensitivity of afferent fibers in the L4 dorsal roots of rats with a unilateral ligation of the L5-L6 spinal nerves. About 12% of nociceptive fibers on the affected side were excited by sympathetic stimulation or by intra-arterial injection of norepinephrine which did not affect A beta-fiber activity. Sympathetic excitation of nociceptive fibers was suppressed by alpha 1-antagonist prazosin, while it was unaffected by alpha 2-antagonist yohimbine. Most of these fibers were excited by intra-arterial injection of alpha 1-agonist phenylephrine, without being affected by an injection of alpha 2-agonist clonidine. Sympathetic excitation was blocked by lidocaine applied near the receptive fields of recorded fibers. The results suggested that some nociceptors remaining intact after partial nerve injury become sensitive to sympathetic activity by the mediation of alpha 1-adrenoceptors in the peripheral endings.
Animal ; Male ; Nerve Fibers/physiology* ; Nociceptors/physiology* ; Norepinephrine/pharmacology ; Pain/physiopathology* ; Rats ; Rats, Sprague-Dawley ; Receptors, Adrenergic, alpha-1/physiology*

Thoracic sympathicotomy has been used safely and successfully to treat essential hyperhidrosis. However, it has been difficult to treat compansatory hyperhidrosis after thoracic sympathicotomy and focal hyperhidrosis. The sweat glands were innervated by post-ganglionic sympathetic fibers with acetylcholic serving as the transmitter. Botulinum A toxin has been reported to block neuro-transmission at the cholinergic autonomic nerve terminals. Prospecting its effect for the sweat gland, we treated 5 patients with focal hyperhidrosis with botulinum A toxin. Three patients received bilateral thoracic sympathectomy (1 case) and sympathicotomy(2 case) via VAT. The hyperhidrosis area was marked with betadine and was subdivided into squares of 2x2 cm(4cm(2)) each. Botulinum A toxin was injected intracutaneously in a dosage of 2.5U/0.1ml(100U/4ml) /4cm(2). A total dose of 100U of Botulinum A toxin was injected into the affected sites. Subjective assessment of sweat production by the patients using a visual analogue scale showed a 20~70% improvement. During the follow-up period, no toxic effects were observed.
Adrenergic Fibers ; Autonomic Pathways ; Botulinum Toxins, Type A* ; Follow-Up Studies ; Humans ; Hyperhidrosis* ; Povidone-Iodine ; Sweat ; Sweat Glands ; Sympathectomy

During the microsurgery or during the postoperative period, the occurrence of the vascular spasm increases the failure rate of microvascular anastomosis,and in cases of trauma, the thrombogenic possibility is increased by the endothelial damage. The author thought that the vascular freezing of crushed vessels could improve the patency rate of microvascular anastomosis. Vascular freezing destroys most of the cells in the intima and media. There by causing degeneration of adrenergic fibers. Even though regeneration occurs after 2-3 weeks, regeneration in the smooth muscle layer is still incomplete. So vascular freezing has beneficial effects on relief of vasospasm. Fifteen Sprague-Dawley rats weighing approximately 300 g each were inflicted with crushing injury on the femoral arteries of the right side and the crushing injury with vascular freezing on the femoral arteries of the left side. The gross and histologic findings, as well as the patency rates, were observed at the postoperative 2nd, 10th, and 30th day,and the results were compared between the crushed and crush-freezing groups. The left side (crush-freezing group) showed less vasospasm and less thrombogenesis than the right side (crushed group). There were no significant differences in the patency rate between the crushed group and crush-freezing group. Vascular freezing is suggested to be effective on a potentially thrombogenic, endothelial damaged vessel as a prophylactic treatment method against vasospasm. Clinical application of vascular freezing awaits further experimentation.
Adrenergic Fibers ; Endothelium* ; Femoral Artery ; Freezing* ; Microsurgery ; Muscle, Smooth ; Postoperative Period ; Rats, Sprague-Dawley ; Regeneration ; Spasm