Dr Lin performed over 6000 surgeries
Postoperative sweating phenomenon is a reflex response between sympathetic system and Hypothalamus, it is absolutely not a compensatory mechanism that other parts of human body take over the sweating function of hands after operation. This is the reason why Dr. Lin insisted to use the term of reflex sweating instead of compensatory sweating. Hypothalamus is the center of Autonomic Nervous System, which influences human mind, mentality and endocrine system. Dr. Lin emphasized, “Endoscopic Sympathetic Surgery helps us open a gate to Autonomic Nervous System”.
http://www.sweathand.com/introduce_e.htm
http://www.sweathand.com/introduce_e.htm
Partial cardiac sympathetic denervation after bilateral thoracic sympathectomy in humans
Upper thoracic sympathectomy is used to treat several disorders. Sympathetic nerve fibers emanating from thoracic ganglia innervate the heart.
METHODS: Nine patients with previous upper thoracic sympathectomies (four right-sided, one left-sided, four bilateral) underwent thoracic 6-[18F]fluorodopamine scanning between 1 and 2 hours after injection of the imaging agent. In each case, a low rate of entry of norepinephrine into the arm venous drainage (norepinephrine spillover) verified upper limb sympathectomy. Data were compared with those from the interventricular septum of patients with cardiac sympathetic denervation associated with pure autonomic failure and from normal volunteers. RESULTS: All four patients with bilateral sympathectomy had low septal myocardial 6-[18F]fluorodopamine-derived radioactivity (2,673 +/- 92 nCi-kg/cc-mCi at an average of 89 minutes after injection) compared with normal volunteers (3,634 +/- 311 nCi-kg/cc-mCi at 83 minutes, N = 22, P = .007) and higher radioactivity than in patients with pure autonomic failure (1,320 +/- 300 nCi-kg/cc-mCi at 83 minutes, N = 7, P = .003).
CONCLUSIONS: Bilateral upper thoracic sympathectomy partly decreases cardiac sympathetic innervation density.
METHODS: Nine patients with previous upper thoracic sympathectomies (four right-sided, one left-sided, four bilateral) underwent thoracic 6-[18F]fluorodopamine scanning between 1 and 2 hours after injection of the imaging agent. In each case, a low rate of entry of norepinephrine into the arm venous drainage (norepinephrine spillover) verified upper limb sympathectomy. Data were compared with those from the interventricular septum of patients with cardiac sympathetic denervation associated with pure autonomic failure and from normal volunteers. RESULTS: All four patients with bilateral sympathectomy had low septal myocardial 6-[18F]fluorodopamine-derived radioactivity (2,673 +/- 92 nCi-kg/cc-mCi at an average of 89 minutes after injection) compared with normal volunteers (3,634 +/- 311 nCi-kg/cc-mCi at 83 minutes, N = 22, P = .007) and higher radioactivity than in patients with pure autonomic failure (1,320 +/- 300 nCi-kg/cc-mCi at 83 minutes, N = 7, P = .003).
CONCLUSIONS: Bilateral upper thoracic sympathectomy partly decreases cardiac sympathetic innervation density.
Heart Rhythm. 2005 Jun ;2:602-9 15922266
Jeffrey P Moak, Basil Eldadah, Courtney Holmes, Sandra Pechnik, David S Goldstein
http://lib.bioinfo.pl/pmid:15922266
Jeffrey P Moak, Basil Eldadah, Courtney Holmes, Sandra Pechnik, David S Goldstein
http://lib.bioinfo.pl/pmid:15922266
Holter changes resulting from right-sided and bilateral infrastellate upper thoracic sympathectomy
RESULTS: Heart rate was 77 +/- 8 beats per minute before surgery on the 24-hour recording and significantly decreased after bilateral (67.8 +/- 6.5 beats per minute; p < 0.05) but not after unilateral right sympathectomy. Consistently spectral analysis variables significantly changed after bilateral surgery but showed no right-sided dominance. Little effect of sympathectomy was found on the QT interval, which tended to decrease after bilateral sympathectomy. CONCLUSIONS: Patients should be informed of the bradycardia resulting from sympathectomy.
Ann Thorac Surg. 2002 Dec ;74 (6):2076-81 12643398
Pierre Abraham, Jean Berthelot, Jacques Victor, Jean-Louis Saumet, Jean Picquet, Bernard Enon Department of Vascular Investigation and Sports Medicine, University Hospital, Angers, France
Pierre Abraham, Jean Berthelot, Jacques Victor, Jean-Louis Saumet, Jean Picquet, Bernard Enon Department of Vascular Investigation and Sports Medicine, University Hospital, Angers, France
THE EFFECT OF CERVICAL SYMPATHECTOMY ON POSTERIOR PITUITARY OXYTOCIC ACTIVITY IN RATS UNDER CHRONIC STRESS.
Sympathectomy-induced alterations of immunity
Many studies have demonstrated that ablation of the sympathetic nervous system (SNS) alters subsequent immune responses. Researchers have presumed that the altered immune responses are predominantly the result of the peripheral phenomenon of denervation. We, however, hypothesized that chemical sympathectomy will signal and activate the central nervous system (CNS). Activation of the CNS was determined by immunocytochemical visualization of Fos protein in brains from male C57BL/6 mice at 8, 24, and 48 h following denervation. A dramatic induction of Fos protein was found in the paraventricular nucleus (PVN) of the hypothalamus and other specific brain regions at 8 and 24 h compared to vehicle control mice. Dual-antigen labeling demonstrates that corticotrophin releasing factor (CRF)-containing neurons in the PVN are activated by chemical sympathectomy; however, neurons containing neurotransmitters which may modulate CRF neurons, such as vasopressin, tyrosine hydroxylase, and adrenocorticotropin, do not coexpress Fos. Our findings suggest an involvement of the CNS in sympathectomy-induced alterations of immunity.
Tracy A. Callahan, Jan A. Moynihan and Diane T. Piekut
Brain, Behavior, and Immunity
Volume 12, Issue 3, September 1998, Pages 230-241
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WC1-45JK31F-F&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_version=1&_urlVersion=0&_userid=10&md5=d3d36bb1041938df0f68d43389b44414
Tracy A. Callahan, Jan A. Moynihan and Diane T. Piekut
Brain, Behavior, and Immunity
Volume 12, Issue 3, September 1998, Pages 230-241
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WC1-45JK31F-F&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_version=1&_urlVersion=0&_userid=10&md5=d3d36bb1041938df0f68d43389b44414
Oxytocin and adrenaline after sympathectomy
It is suggested that sympathetic nerves to vascular smooth muscle have a function or functions other than transmitter release and that when crushed nerves regenerate the functions do not recover at the same rate.
Sybil Lloyd and Mary Pickford
J Physiol Vol 192, Issue 1 pp 43-52
Copyright © 1967 by The Physiological Society
J Physiol Vol 192, Issue 1 pp 43-52
Copyright © 1967 by The Physiological Society
| |
http://jp.physoc.org/cgi/content/abstract/192/1/43
defects in regulation of heat production, sweat and vasoconstriction - sympathectomy creates the same effect as high level spinal cord lesions
A number of workers have studied the altered vasomotor responses after sympathectomy. Usually consistently elevated basal flow was described after sympathectomy. However, reports have varied as to the changes in response to vasodilator and vasoconstrictor stimuli. Goetz found that flow to the toe did not respond to either constrictor or dilator stimuli after sympathectomy and that in some cases blood flow was decreased in response to vasodilator stimuli and increased in response to vasoconstrictor stimuli.
These authors could not correlate the changes in blood flow with changes in blood pressure. Ahmad reported a case of hyperhidrosis with homolateral sympathectomy in whom local
warming of the sympathectomized hand to 41 C caused vasoconstriction, while the nor-
mally innervated hand responded with vasodilation.
Pollock and co-workers observed what they called "defects in regulation of heat production, sweat and vasoconstriction" in patients with spinal cord lesions. They believed these defects to be due to interruption of "impulses from suprasegmental levels." In 1953 Armin, Grant, and co-workers demonstrated increased reactivity to vasoconstrictor stimuli in the denervated rabbit's ear and referred to a similar phenomenon in the human finger after sympathectomy.
The results, however, of studies on surgically sympathectomized patients are quite clearcut.
In none of the limbs studied after sympathectomy could an increase in blood flow be produced reflexly by warming; in the majority of instances the opposite response, a decrease in blood flow, was observed. The regularity with which these carefully sympathectomized limbs fail to respond to a vasodilator stimulus suggests that this procedure might be useful as a test for completeness of sympathectomy.
The vasomotor responses to the Gibbon-Landis procedure (reflex response to warming)
were studied in hemiplegic patients, subjects with "high transection" of the cord, and in
sympathectomized patients. The response in hemiplegic patients was vasodilator in nature
just as in the 3 control groups (young normal subjects, elderly subjects without demonstrable
vascular disease, and patients with arterio-sclerosis). One patient with documented tran-
section of the cord above T5 behaved like subjects after surgical sympathectomy. The differences in response in 3 other paraplegic patients may be due to differences in location
and extent of their cord lesions. Basal blood flow was higher in sympathectomized limbs
than in comparable controls. Of 11 sympathectomized limbs tested for vasodilatation in
response to the Gibbon-Landis procedure, 4 showed no response, while 7 responded with decrease in blood flow (vasoconstriction).
1957;15;518-524 Circulation Dorothy Andrews
WERTHEIMER, ARTHUR J. LEWIS, J. MURRAY STEELE and WALTER REDISCH, FRANCISCO T. TANGCO, LOTHAR
Vasomotor Responses in the Extremities of Subjects with Various Neurologic Lesions: I. Reflex Responses to Warming
These authors could not correlate the changes in blood flow with changes in blood pressure. Ahmad reported a case of hyperhidrosis with homolateral sympathectomy in whom local
warming of the sympathectomized hand to 41 C caused vasoconstriction, while the nor-
mally innervated hand responded with vasodilation.
Pollock and co-workers observed what they called "defects in regulation of heat production, sweat and vasoconstriction" in patients with spinal cord lesions. They believed these defects to be due to interruption of "impulses from suprasegmental levels." In 1953 Armin, Grant, and co-workers demonstrated increased reactivity to vasoconstrictor stimuli in the denervated rabbit's ear and referred to a similar phenomenon in the human finger after sympathectomy.
The results, however, of studies on surgically sympathectomized patients are quite clearcut.
In none of the limbs studied after sympathectomy could an increase in blood flow be produced reflexly by warming; in the majority of instances the opposite response, a decrease in blood flow, was observed. The regularity with which these carefully sympathectomized limbs fail to respond to a vasodilator stimulus suggests that this procedure might be useful as a test for completeness of sympathectomy.
The vasomotor responses to the Gibbon-Landis procedure (reflex response to warming)
were studied in hemiplegic patients, subjects with "high transection" of the cord, and in
sympathectomized patients. The response in hemiplegic patients was vasodilator in nature
just as in the 3 control groups (young normal subjects, elderly subjects without demonstrable
vascular disease, and patients with arterio-sclerosis). One patient with documented tran-
section of the cord above T5 behaved like subjects after surgical sympathectomy. The differences in response in 3 other paraplegic patients may be due to differences in location
and extent of their cord lesions. Basal blood flow was higher in sympathectomized limbs
than in comparable controls. Of 11 sympathectomized limbs tested for vasodilatation in
response to the Gibbon-Landis procedure, 4 showed no response, while 7 responded with decrease in blood flow (vasoconstriction).
1957;15;518-524 Circulation Dorothy Andrews
WERTHEIMER, ARTHUR J. LEWIS, J. MURRAY STEELE and WALTER REDISCH, FRANCISCO T. TANGCO, LOTHAR
Vasomotor Responses in the Extremities of Subjects with Various Neurologic Lesions: I. Reflex Responses to Warming
CS is a serious complication and a significant number of patients may regret undergoing the operation
CS with different severity occurred in 35 patients (87.5%). Six patients (15%) regretted undergoing the operation due to the extent and severity of the CS seriously affecting their quality of life. Thoracoscopic sympathectomy is a simple procedure with a high success rate. However, CS is a serious complication and a significant number of patients may regret undergoing the operation; a careful selection of patients and comprehensive explanation are advisable.
Libson S, Kirshtein B, Mizrahi S, Lantsberg L.
Libson S, Kirshtein B, Mizrahi S, Lantsberg L.
Department of Surgery "A," Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Surg Laparosc Endosc Percutan Tech. 2007 Dec;17(6):511-3
same hospital, same team: 51% of the patients claim decreased quality of life
"The severity of the CS was also lower in children: it was absent or mild in 54.3% of the children versus 38.0% of the others, and moderate or severe in 45.7 versus 62%, respectively (P = 0.004). Fifty-one percent of the participants claimed that their quality of life decreased moderately or severely as a result of CS."
Steiner Z, Cohen Z, Kleiner O, Matar I, Mogilner J.
Steiner Z, Cohen Z, Kleiner O, Matar I, Mogilner J.
Department of Pediatric Surgery, Hillel Yaffe Medical Center, PO Box 169, Hadera 38100, Israel.
Pediatr Surg Int. 2008 Mar;24(3):343-7. Epub 2007 Nov 13
http://www.ncbi.nlm.nih.gov/pubmed/17999068?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed41% of the patients claim quality of life decreased
41% of the participants claimed that their quality of life decreased moderately or severely as a result of CS. Only (sic!) 19.6% would not have undergone the operation in retrospect; there was a significant interesting difference regarding this issue between adults (31.4%) and children (8.8%). The extent of the CS did not change with time in 70% of the patients. It exacerbated in 10% and it diminished in 20%, usually within the first 2 postoperative years. CONCLUSIONS: Thoracoscopic sympathectomy relieves hyperhidrosis in most cases. Patients prefer relief from palmar hyperhidrosis even at the cost of a high rate of CS.
J Pediatr Surg. 2007 Jul;42(7):1238-42.
Steiner Z, Kleiner O, Hershkovitz Y, Mogilner J, Cohen Z.
J Pediatr Surg. 2007 Jul;42(7):1238-42.
Steiner Z, Kleiner O, Hershkovitz Y, Mogilner J, Cohen Z.
Department of Pediatric Surgery, Hillel Yaffe Medical Center, Hadera 38100, Israel.
CS severe in 35% of patients
Compensatory sweating occurred in 89% of patients and was so severe in 35% that they often had to change their clothes during the day. The frequency of compensatory sweating was not significantly different among the three groups, but severity was significantly higher after Th2-4 sympathectomy for axillary hyperhidrosis (p = 0.04). Gustatory sweating occurred in 38% of patients, and 16% of patients regretted the operation. CONCLUSIONS: Compensatory and gustatory sweating were remarkably frequent side effects after thoracoscopic sympathectomy for primary hyperhidrosis.
We encourage informing patients thoroughly about these side effects before surgery.
We encourage informing patients thoroughly about these side effects before surgery.
Department of Cardiothoracic Surgery, Skejby Sygehus, Aarhus University Hospital, Aarhus,
Ann Thorac Surg. 2004 Aug ;78 (2):427-31 15276490
Ann Thorac Surg. 2004 Aug ;78 (2):427-31 15276490
T2 results in complete sympathectomy
Removal of only the second dorsal sympathetic. ganglion is stated to result in as complete sympathectomy, in so far. as central connections are concerned.
Annual Review of Physiology
Vol. 6: 365-390 (Volume publication date March 1944)
(doi:10.1146/annurev.ph.06.030144.002053)
B A McSwiney
Annual Review of Physiology
Vol. 6: 365-390 (Volume publication date March 1944)
(doi:10.1146/annurev.ph.06.030144.002053)
Visceral Functions of the Nervous System
