• Title/Summary/Keyword: 교감신경절제

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Renal Sympathetic Denervation Induces Acute Myocardial Inflammation through Activation of Caspase-1 and Interleukin-1β (교감신경절제술(RDN) 후 caspase-1과 interleukin-1β 활성화로 인해 유발된 염증성 급성심근손상)

  • Lee, Dong Won;Kim, Il Young;Kwak, Ihm Soo
    • Journal of Life Science
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    • v.28 no.2
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    • pp.240-246
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    • 2018
  • Efferent and afferent sympathetic nerves are closely related to the development of hypertension and heart failure. Catheter-based renal sympathetic denervation (RDN) is implemented as a strategy to treat resistant hypertension. We investigated whether RDN procedure causes inflammatory damage on myocardium in the early phase of sympathetic denervation. Twenty-five female swine were divided into 3 groups: normal control (Normal, n=5), sham-operated control (Sham, n=5), and RDN groups (RDN, n=15). The RDN group was further subdivided into 3 subgroups according to the time of sacrifice: immediately (RDN-0, n=5), 1 week (RDN-1, n=5), and 2 weeks (RDN-2, n=5) after RDN. There were no significant changes in the clinical parameters between the normal control and sham-operated group using contrast-media. In the myocardium, inflammatory cytokines, $IL-1{\beta}$ and $TNF-{\alpha}$ increased at the first week, and then decreased at the second week after RDN. Anti-inflammatory cytokine, IL-10 increased immediately, and then decreased at the second week after RDN. Caspase-1 activity and apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) expression increased immediately after RDN until the second week. However, nucleotide-binding oligomerization domain, leucine rich repeat and pyrin domain containing protein 3 (NLRP3) expression did not show any significant differences among the groups. The RDN can cause acute myocardial inflammation through activation of caspase-1 and $IL-1{\beta}$. We should pay attention to protecting against early inflammatory myocardial damage after RDN.

Clinical Outcomes of Thoracic Sympathicotomy for Palmar Hyperhidrosis (수부 다한증에서 흉부교감신경 절제술의 성적)

  • Lee, Jang-Hoon;Lee, Jung-Cheul
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.89-94
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    • 2008
  • Background: Thoracoscopic R3 sympathicotomy can effectively treat palmar hyperhidrosis. Here, we evaluated post-operative outcomes of patients receiving a thoracoscopic R3 sympathicotomy due to palmar hyperhidrosis. Material and Method: From January 2001 to December 2006, 225 patients were treated with a R3 sympathicotomy, and follow up was completed for 200 patients, with an average follow up period of 51.7 ($11{\sim}80$) months. We measured postoperative hand sweating according to four grades; dry (grade 1), proper (grade 2), light sweating (grade 3), heavy sweating (grade 4) and evaluated patient satisfaction using 4 grades: very good (grade 0), good (grade1), regular (grade 2), and deficient (grade 3). Result: There were no differences in clinical parameters between the compensatory sweating group and the non-compensatory sweating group. There was a 83.5% compensatory sweating rate. The degree of compensatory sweating related to the patient's body mass index and was influenced by the season, environmental temperature, and emotional stress. Conclusion: The satisfaction rate was 61.5%, and the degree of satisfaction related to the development of compensatory sweating. Therefore, reducing compensatory sweating would increase patient satisfaction with R3 sympathicotomies.

The Role of Sympathetic Activity in the Early Phase of Liver Regeneration after Partial Hepatectomy (간-부분절제(肝-部分切除) 후 나타나는 재생과정(再生過程)에서 교감신경계(交感神經系)의 역할(役割)에 관(關)한 연구(硏究))

  • Choi, Sang-Hyun;Lee, Joong-Geun;Park, Chung-San;Chun, Boe-Gwun;Chun, Yeon-Sook
    • The Korean Journal of Pharmacology
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    • v.26 no.2
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    • pp.177-183
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    • 1990
  • This study was undertaken to confirm whether or not the sympathetic nervous system takes part in the liver regeneration after partial hepatectomy. The male Sprague-Dawley rats were pretreated with I.P. injection of guanethidine 25 mg/kg: single dose (G-1); multiple doses once a day for 3 days (G-3), for 5 days (G-5), or for 6 days (G-6). The rats were subjected to partial hepatectomy $(70.4{\pm}1.99%)$ under light anesthesia of diethyl ether. 1) The systolic blood pressure of control rat was $98.0{\pm}3.9\;mmHg$ and was not affected by G-1. But after the pretreatment with G-3, G-5 or G-6, the pressure was markedly decreased by over 25 %. 2) Both of plasma norepinephrine and epinephrine levels showed the marked increases 3 hrs after the hepatectomy. However, the increases are entirely inhibited by G-1 or G-6. 3) All the liver contents of putrescine, spermidine and spermine showed the significant increases 6 hrs after the hepatectomy and were not affected by G-1 or G-6 with the exception of the inhibition of putrescine increase by only G-6. The present results suggest that the sympathetic activation appeared after partial hepatectomy seems not to play an important role in rat liver regeneration.

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Norepinephrine-Induced Rekindling of Mechanical Allodynia in Sympathectomized Neuropathic Rat (교감신경절제 받은 신경병증성 통증 쥐 모델에서 Norepinephrine에 의해 유도된 기계적 이질통의 Rekindling의 기전)

  • Moon, Dong-Eon
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.318-325
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    • 1996
  • Background: Sympathectomy relieves pain in sympathectically maintained pain, and subcutaneous injection of norepinephrine(NE) can rekindle mechanical allodynia. However, the mechanism of rekindling is not clear. The purpose of this study is to investigate which subtype of $\alpha$-adrenoceptor is involved in NE-induced rekindling of mechanical allodynia in sympathectomized neuropathic rats. Methods: Neuropathic injury was produced by tightly ligating the left L5 and L6 spinal nerves of 36 male Sprague-Dawley rats and bilateral lumbar sympathectomy was done at two weeks postoperatively. Starting at 7 days after sympathectomy, rekindling of mechanical allodynia was induced by NE and clonidine injected into the left paw, which was reversed by pretreatment of phentolamine and idazoxan. Mechanical allocynia was quantified by measuring the frequency of foot lifts to two von Frey filaments applied to the paw. Results: All tested rats displayed well-developed signs of mechanical allodynia at the left paw that were abolished by a bilateral lumbar sympathectomy. Subcutaneous (s.c.) injection of NE (0.05 ${\mu}g$) into the affected paw of sympathectomized neuropathic rats rekindled previous mechanical allodynia. These effects could be mimicked by an ${\alpha}_2$-receptor agonist clonidine, but not by an ${\alpha}_1$-receptor agonist phenylephrine. The NE-induced rekindling of mechanical allodynia was significantly reduced by prior s.c. injection of a mixed $\alpha$-receptor antagonist phentolamine (20${\mu}g$) and ${\alpha}_2$-receptor antagonist idazoxan(20${\mu}g$), but not by a ${\alpha}_1$-receptor antagonist terazosin (20${\mu}g$). The pretreatment of idazoxan produced dose-related inhibition of NE-induced rekindling of mechanical allodynia. The rekindling induced by ${\alpha}_2$-receptor agonist clonidine (5${\mu}g$) was also reversed by prior s.c. injection of ${\alpha}_2$-receptor antagonist idazoxan (20${\mu}g$). Conclusion: Subcutaneous injection of NE into the paw of sympathectomized neuropathic rats rekindles mechanical allodynia, which is reversed by an ${\alpha}_2$-, but not by an ${\alpha}_1$-receptor antagonist. Therefore, rekindling of mechanical allodynia in sympathectomized neuropathic rats is mediated by ${\alpha}_2$-adrenoceptor.

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Peripheral Periarterial Sympathectomy for the Treatment of Raynaud's Phenomenon(Case Report) (말초 동맥 교감 신경 절제술을 이용한 레이노드 현상의 치료(증례 보고))

  • Lee, Kwang-Suk;Park, Jong-Woong;Suh, Dong-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.6 no.1
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    • pp.111-116
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    • 1997
  • The treatment of chronic digital pain and cold intolerance due to Raynaud's phenomenon is quite difficult especially it is combined with scleroderma. Several surgical trial such as cervicothoracic sympathectomy have been attempted for the medically unresponsible Raynaud's phenomenon, but their results were unsatisfactory. We have tried peripheral periarterial sympathectomy for the 44 years old female patient who had medically unresponsible severe Raynaud's phenomenon with scleroderma. Periarterial adventitial stripping was performed at the level of wrist, superficial palmar arch, common digital artery and proper digital artery about 1.5-2 cm in length. Preoperative angiography and radioactive angiography were done and preoperatively and postoperatively the blood flow was measured by the desk top computer-aided histogram. Both hands digital pain were markedly reduced after operation and blood flow increased as compaired with the preoperative measure.

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Surgical Treatment of Peripheral Artery Occlusive Disease (말초동맥 폐쇄질환에 대한 외과적 고찰)

  • 김해균;윤용한;이두연;문동석;이택연;홍윤주
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.262-265
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    • 1998
  • A retrospective analysis was performed on the 72 cases of peripheral artery occlusive disease treated at Yonsei Medical School Yongdong Severance Hospital, from March 1, 1990, through July 31, 1992, focusing on the operative procedures, surgical results and perioperative complications. The etiologic causes of vascular obstruction were atherosclerosis in 28 cases, Buerger's disease in 31, traumatic orgin in 7, operative complications in 4, and malignancy and arteritis in one case each. Treatment modalities, actually performed include bypass graft.(27), infusion of PGE1 (23), Embolectomy (16), Sympathectomy (4) and end-to-end anastomosis (2). There were 21 satisfactory cases and 9 unsatisfactory cases of atherosclerotive occlusive disease, defining the operative outcome as“satisfactory”if the obstructive symptoms disappeared completely and “unsatisfactory”if they did not. The patients of TAO induced Buerger's disease with preoperative Foutain class III or IV were surgically converted to class 0 in 14 cases, class I in 12 and class II in 3.

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Surgical Treatment for Primary Pulmonary Paraganglioma - A case report - (폐에 발생한 원발성 부신경절종의 수술치험 - 1예 보고 -)

  • Lee Choong-Won;Bang Jung-Heui;Roh Mee-Sook;Kim Ki-Nam;Choi Phil-Jo
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.718-721
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    • 2006
  • We describe the case of primary pulmonary paraganglioma in a 37-year-old woman who presented recurrent, severe cough. Computed tomography revealed a lobulated inhomogeneous enhanced mass with endobronchial protruding lesion suspected to be lung neoplasm, located in the upper lobe of the left lung. Bronchoscopic biopsy showed chronic inflammation with granulation tissue which was not in accord with the radiologic findings. Subsequently, a left lower sleeve lobectomy was peformed. Histological analysis of the resected tumor proved to be compatible with pulmonary paraganglioma. Primary pulmonary paragangliomas are very uncommon tumors. So we report this case with literature review.

The Effect of Chemical Sympathectomy on Moxibustion-Induced Immunomodulation in the Rat Spleen (백서의 비장에서 화학적 교감신경절제가 뜸(구(灸))자극으로 유도된 면역변조에 미치는 영향)

  • Han, Jae-Bok;Oh, Sang-Duck;Lee, Ki-Seok;Choi, Ki-Soon;Cho, Young-Wuk;Ahn, Hyun-Jong;Bae, Hyun-Soo;Min, Byung-Il
    • IMMUNE NETWORK
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    • v.2 no.2
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    • pp.109-114
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    • 2002
  • Background: To investigate the role of sympathetic nervous system (SNS) in moxibustion-induced immunomodulation, the effects of chemical sympathectomy on moxibustion-induced changes in splenic NK cell cytotoxicity, T and B cell proliferation were studied in Sprague-Dawley male rats. Methods: Chemical sympathectomy was achieved with intraperitoneal injection of 6-hydroxydopamine 50 mg/kg/day for 3 successive days. Direct moxibustion (6-minute interval, 9 moxa ball, each of which weighing 0.007 g and burning for 40 seconds) was applied on unilateral anterior tibial muscle region where Zusanli (ST36) acupoint is located, once a day for 7 successive days. NK cell cytotoxicity was measured by $4hr-^{51}Cr$ release assay. Mitogen-induced lymphocyte proliferation was analyzed by [$^3H$]-thymidine incorporation assay. Results: NK cell cytotoxicity was suppressed by moxibustion, more in sympathectomized rats than in vehicle-treated rats. T cell proliferation induced by concanavalin A was not affected by moxibustion. B cell proliferation induced by lipopolysaccharide showed no significant change in vehicle-treated rats, but an increase in sympathectomized rats by moxibustion. Sympathectomy alone induced augmentation of NK cell cytotoxicity and suppression of T cell proliferation. Conclusion: These results suggest that SNS has no direct relation with moxibution-induced immunomodulation but has an important role in the mechanism to keep the homeostasis of immune system by tonically inhibiting excessive changes of various immune components.

Thoracic Sympathectomy for Facial Hyperhidrosis (안면다한증에서의 흉부교감신경 절제술)

  • Kim, Hae-Gyun;Lee, Du-Yeon;Baek, Hyo-Chae;Jo, Hyeon-Min
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1129-1132
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    • 1996
  • Excessive sweating of the face has a strong negative impact on the quality of life for many persons. We have experienced 10 patients with facial hyperhidrosis among the 150 essential hyperhidrosis patients They were 9 male and 1 fatale patients and their age range was 20 to 47 years(mean age 33.8 years). All patients, except one, received bilateral thoracic sympathectomy via VATS. One patient was done via minithoracotomy due to severe pleural adhesion. During the followup period, there was no recurence of facial sweating. Hone of the patients showed Horne 's syndrome.

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Complex Regional Pain Syndrome after Thoracoscopic Sympathectomy in a Patient with Hyperhidrosis -A case report- (다한증 환자에서 흉강경 하 흉부교감신경 절제술 후 발생한 복합부위 통증 증후군 -1례보고-)

  • Kweon, Jong-Bum;Sim, Sung-Bo;Won, Yong-Soon;Park, Kuhn;Lee, Jae-Kwang;Kwack, Moon-Sub;Kim, Jong-Lul;Yoon, Keon-Jung
    • Journal of Chest Surgery
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    • v.33 no.6
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    • pp.528-530
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    • 2000
  • Thoracoscopic sympathectomy is a common technique used to treat plamar hyperhiodrosis. The complications of thoracoscopic sympathectomy are rare. Recently, we experienced a complex regional pain syndrome(CRPS) after thoracoscopic sympathecotomy in a patient with hyperhidrosis. The treatment of this complication was chemical epidural sympathetic block and conservative pain control. The result of this treatment was good. The patient was recovered after one month.

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