Quantitative Autonomic Testing

Disorders associated with dysfunction of autonomic nervous system are quite common yet frequently unrecognized. Quantitative autonomic testing can be invaluable tool for evaluation of these disorders, both in clinic and research. There are number of autonomic tests, however, only few were validated clinically or are quantitative. Here, fully quantitative and clinically validated protocol for testing of autonomic functions is presented. As a bare minimum the clinical autonomic laboratory should have a tilt table, ECG monitor, continuous noninvasive blood pressure monitor, respiratory monitor and a mean for evaluation of sudomotor domain. The software for recording and evaluation of autonomic tests is critical for correct evaluation of data. The presented protocol evaluates 3 major autonomic domains: cardiovagal, adrenergic and sudomotor. The tests include deep breathing, Valsalva maneuver, head-up tilt, and quantitative sudomotor axon test (QSART). The severity and distribution of dysautonomia is quantitated using Composite Autonomic Severity Scores (CASS). Detailed protocol is provided highlighting essential aspects of testing with emphasis on proper data acquisition, obtaining the relevant parameters and unbiased evaluation of autonomic signals. The normative data and CASS algorithm for interpretation of results are provided as well.     

Autonomic nerve terminals in relation to contractile and non-contractile structures in the conduit coronary artery of the dog

The ramus interventricularis anterior (RIA), its first- and second-order branch were prepared for EM (perfused with glutaraldehyde under pressure, or simply fixed with KMnO4). No nerve fibres were found in the tunica media of either of the three consecutive segments. In the tunica adventitia axons with varicosities were found at a distance from the tunica media of 0.5-15 microns (about 50% 0.5-4.5 microns) in the RIA, 0.4-12 microns (about 50% 0.5-3.4 microns) in the first-order branch and 0.3-6.0 microns (about 50% 0.3-2.3 microns) in the second-order branch. Varicosities contain small, dense-cored vesicles (35-60 nm) and large, dense-cored vesicles (70-90 nm, exceptionally up to 120 nm); the other type contains small, clear vesicles (35-60 nm) and few large, dense-cored vesicles (70-90 nm). The remarkably large distance between the nerve terminals and smooth muscle cells fits well with the small range of sympathetic control of the conduit coronary artery. Close apposition of nerve terminals to fibroblasts (30-200 nm) was revealed in all three consecutive coronary portions. Moreover, terminal axons often lose the Schwann cell cover on the abluminal site and face the fibroblast.     

直肠癌功能性扩大根治术

目的:探讨直肠癌保留植物神经的扩大根治术的相关问题,旨在提高生存质量。方法:分别从植物神经的解剖、生理、手术方法及效果等方面,结合我院的经验与国内外的发展现状,分析总结功能性直肠癌扩大根治手术的方法,注意事项及其疗效等。结果:136例功能性直肠癌扩大根治手术与一般根治手术相比,术后排尿,性功能等方面,有明显的改善,而没有增加术后局部复发率及降低生存率。结论:功能性扩大根治手术明显降低了男性直肠癌患者的术后排尿和性功能障碍发生率,并且没有增加局部复发率及降低生存率。合理选择手术指证下应用功能性扩大根治手术,适合于DukesA、B、C期的病人,能显著改善患者术后的生存质量。功能性扩大根治手术是治疗直肠癌最理想的术式。     

Autonomic actions of cocaine

The development of our knowledge of the physiological, pharmacological, and biochemical actions of cocaine has in essence occurred in parallel with the development of our knowledge about the function of the autonomic nervous system. Cocaine is a sympathomimetic compound with potent local anesthetic properties. The principal hypothesis accepted to date to explain the sympathomimetic effects of cocaine is that this drug inhibits neuronal monoamine neurotransmitter reuptake by binding to a transporter or uptake site thereby increasing the effective concentration of neurotransmitter at adrenergic receptor sites. Much of the available evidence for this hypothesis has come from studies utilizing in vitro or in situ techniques. There have been relatively fewer studies examining the impact of cocaine on the autonomic nervous system in the intact animal. In addition, few studies have examined the effects of cocaine on central autonomic function. Past studies concerning the mechanism of action of cocaine are reviewed and recent data addressing the cardiovascular, respiratory, and central autonomic effects of cocaine are discussed.     

Autonomic responses to stress

Forty-eight male subjects with no previous meditative experience engaged in either progressive relaxation (PR), a meditative treatment designed to induce the relaxation response (RR), or a no-treatment control experience (C) during four sessions on consecutive days. Negative expectations regarding the effectiveness of each technique for reducing physiological responses to stress were induced for half of the subjects in each treatment condition, and positive expectations were induced for the other half. Subjects viewed a stressful film following practice of their technique during the first and fourth sessions. Heart rate and electrodermal responding were recorded continuously during practice of the techniques and during the stressful film throughout the first and fourth sessions. Results indicated lowered heart rate levels prior to the film for subjects in the PR-positive expectancy condition and during the film for subjects in the RR-positive expectancy condition. It is suggested that subjects' expectancies concerning meditation may affect cardiovascular responding during stress, although meditative treatments in general do not appear to reduce stress responding as effectively as previously suggested.This research is based upon a master's thesis submitted by the first author to the graduate school at Northern Illinois University. The research was supported in part by a grant to the second author from the graduate school at Northern Illinois University. Portions of the article were presented at the convention of the Midwestern Psychological Association in Chicago, 1978.