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The effect of unilateral superior cervical sympathetic ganglionectomy on the contralateral ganglion was investigated in Sprague-Dawley male rats employing histological and morphometrical procedures. Neuronal cells showed cell enlargement and no change in the nuclear size and the cell number. Neuronal hypertrophy was due to innervation by some fibers of the contralateral half of organs which had been innervated by the ipsilateral ganglion.

The effect of superior cervical sympathetic ganglionectomy (SCGx) on FSH, LH and GH cells of the adenohypophysis was investigated in normal and ovariectomized prepubertal female rats by immunohistochemistry and morphometry. At 2 weeks after SCGx in normal rats, FSH and LH cells increased in number and in immunostaining density: these indicate augmentation of their functional activity. These increases almost disappeared at 4-8 weeks after SCGx. After ovariectomy FSH and LH cells showed reduction of immunoreactive density, cell enlargement, vacuolation and increase of cell number. SCGx suppressed the morphological changes of both cells. GH cell number decreased at 2 weeks after SCGx in normal and ovariectomized rats, but after 4-8 weeks, the number was restored. The present data indicate that cervical sympathetic nervous system exerts a different influence on endocrine system, which depends on the types and activities of the cells in adenohypophysis. Sympathetic nervous system can play an important role of maintaining and regulating of the secretory function of the adenohypophysis.

It is well known that contractive agents of smooth muscle have denervation supersensitivity. But, the existence of denervation supersensitivity in relaxed ones does not become so clear. We investigated these supersensitivity, especially prostacyclin (PGI2). We made the denervated artery by lumbar sympathetic ganglionectomy in mongrel dogs. Namely, saphenous and dorsal pedal arteries were denervated by this ganglionectomy. And we studied the changes of these arterial tensions by magnus apparatus. Dose-response (D-R) curves of denervated arteries for KCl and noradrenaline (NE) shifted to left against control arteries. Next, we studied effects of PGI2. At first, we measured ED50 of KCl and NE contraction. And, we produced the half contraction on each artery by using ED50 of KCl and NE. Lastly, PGI2 was added on the half contractive arteries to study relaxed changes. D-R curves of denervated arteries for PGI2 shifted to left, too. These denervated arteries acquired the supersensitivity for PGI2. Clinically, if we use relaxants after organ transplantation, these drugs may be very effective for the perfusion of the grafts.

To investigate roles of the sympathetic nervous system in the local release of VIP, pharmacological alpha (phenoxybenzamine), beta (propranolol) adrenergic blockade or surgical sympathectomy by the ganglionectomy of splanchnic plexus was performed in anesthetized dogs. Portal and venous plasma VIP levels during intrajejunal infusion of 0.1 N HCl solution at a rate 1.5 ml/min for 20 minutes were observed before and after these procedures. The plasma VIP levels during the intrajejunal HCl infusion were significantly increased after blocking of alpha-adrenoceptors and surgical sympathectomy but showed no change after blocking of beta-adrenoceptors. These results suggest the inhibitory mechanism of the sympathetic nervous system on the local release of VIP from the canine small intestine. In addition, the increase of portal blood flow and bile secretion, and the elevation of bicarbonate concentration in the secreted bile during the intrajejunal HCl infusion were significantly higher after surgical sympathectomy than before, and plasma VIP levels were also significantly higher.

An 18-year-old male with a right brachial plexus injury caused by a motorcycle accident was admitted on October 13, 1988. A detailed examination revealed that the brachial plexus was totally injured. The axon reflex test suggested that the lesion sites were postganglionic in the C5 and C6 nerves, and preganglionic in the C7, C8 and Th1. On December 14, 1988, intercostal nerve cross-anastomosis was performed in the hope that a lost motor function of the right upper extremity could be restored as a first step. An electromyogram 6 months after this anastomotic operation demonstrated synkinesis between the biceps brachialis and the intercostal muscles during deep inspiration. Fifteen months after this operation, active voluntary muscle discharges which were higher than before in amplitude, were provoked. The right elbow flexion was gradually restored independently of respiration. On the other hand, intractable pain with a persistent severe tingling sensation appeared approximately one week after the injury on the lesioned upper extremity. The pain rapidly increased in severity. The DREZ-tomy from C5 to Th1 was performed on March 7, 1989. This has brought complete relief of the intractable pain. A brief discussion was given concerning some aspects of the brachial plexus avulsion and DREZ-tomy.

The effect of superior cervical ganglionectomy (SCG) on cerebral blood flow and metabolism was investigated in moyamoya disease. Measurement of cerebral blood flow and metabolism was performed in 12 cases (15 operations) of moyamoya disease during SCG. Mean age was 65.2 years (from 3 to 38). 4 were male and eight were female. Ischemic cases were 8 and hemorrhagic cases were 4. At encephalo-duro-anterio-synangiosis, a Laser Doppler flow meter and probes for measuring cortical tissue oxygen and carbon dioxide were set out to allow measurement from identical sites on the surface of the brain over the cortex. Moreover, an electromagnetic flow meter was placed on the common carotid artery. And the mean arterial blood pressure was also measured from femoral artery. After the electrode had been stabilized, continuous recordings were made of cerebral blood flow and metabolism during SCG. The mean arterial blood pressure fell slightly post operatively, but the changes in blood pressure were considered not to be significant enough to affect blood flow. Cortical CBF did not change immediately after SCG. However it increased gradually to 118.8% of preoperation level 30 minutes later respectively, and the difference was observed significant. The carotid blood flow and the tissue oxygen developed a tendency to increase after 30 minutes, but the tissue carbon dioxide did not changed. The present study indicates that superior cervical ganglionectomy is the useful procedure to increase in cerebral blood flow immediately after the operation on patients with moyamoya disease.

Bilateral vertebral angiograms were taken in 125 cases with severe vertigo and dizziness during the period between April 1983 and March 1986. Various kinds of morphological abnormalities were found. Most impressive findings were kinking and coiling at the first portion of the vertebral artery, which was corrected by operation in 54 cases out of 100 cases. This method is accompanied with stellate ganglionectomy and completed by rolling the subclavian artery forwards and downwards with ligation. The follow-up results were evaluated one to four years after operation. Symptoms were cured in 50 cases out of 54. The postoperative course was satisfactory. It was emphasized in this paper that our operation was very useful for patients with severe and recurrent vertigo.