tag:blogger.com,1999:blog-572759674654955422024-03-12T18:35:20.638-07:00Corposcindosis(Split-Body Syndrome)
The Effects of Thoracic Sympathectomy in HumansUnknownnoreply@blogger.comBlogger36125tag:blogger.com,1999:blog-57275967465495542.post-82918054899549323202014-05-29T14:07:00.000-07:002017-08-30T11:59:54.968-07:00Abstract<b>Corposcindosis</b> – literally “Split Body Syndrome” – (abb. CS) - An autonomic neuropathy in which sympathetic nervous system function has been divided into two distinct body regions: An upper region that is paralyzed, and a lower region that is still functional and potentially hyperactive.<br />
<br />
The word Corposcindosis is derived from corpus (body), scindo (to divide or sever) and osis (a <br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://i.imgur.com/x9L8xDO.gif?1" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="240" data-original-width="320" src="https://i.imgur.com/x9L8xDO.gif?1" /></a></div>
disease process). The typical etiology (cause) of CS is surgical sympathectomy in the upper thoracic region (ETS surgery), but could also manifest as a result of injury or disease of the thoracic sympathetic nerve ganglia.<br />
<br />
<br />
The CS model generates a great number of falsifiable predictions about physiological changes in autonomic function, most of which have been reported anecdotally in the oral history. Several of these changes have been empirically confirmed in humans, several others have been confirmed in animal studies only, none have been refuted, several have not been studied at all.<br />
<br />
Bilateral thoracic sympathectomy involving the T2 ganglion invariably results in full-blown corposcindosis, and is easily recognizable under thermal imaging. Bilateral thoracic sympathectomy not involving the T2 ganglion may or may not result in full-blown corposcindosis.<br />
<br />
<h2>
<span style="font-size: large;">Symptoms</span></h2>
<h3>
Primary immediate regional (above the nipple line) symptoms</h3>
Primary regional (above the nipple line) symptoms of corposcindosis may include: anhidrosis (inability to sweat), increase (up to 12 degrees F) in skin temperature, decreased heart rate and contraction strength, diminished baroreflex response, diminished lung volume, decreased carbon dioxide transfer out of blood, loss of vasoconstriction, loss of goose bumps, increased fat cell count, diminished lypolysis (fat burning), increased bone resorption, decreased osteoblast formation, confused stem cell function within bone marrow, delayed skin healing, calcification of arteries, chronic pain and parethesia.<br />
<br />
<h3>
Cannon effects (denervation supersensitivy)</h3>
Over time, as some denerved receptors become supersensitive to catecholamines, symptoms may include: rapid weak heart beat (Post Orthostatic Tachycardia Syndrome), additional pain syndromes, hypersensitivity to sound and/or light, and many other possible supersensitivity effects.<br />
<br />
<h3>
Compensatory regional (below the nipple line) symptoms</h3>
Compensatory regional (below the nipple line) symptoms may include: hyperhidrosis (excessive sweating), loss of libido, plus several other possible hyperactive sympathetic responses.<br />
<br />
<h3>
Changes to systemic function</h3>
Changes to systemic function may include: poor thermoregulation in response to both hot and cold, loss of selective brain cooling, diminished exercise capacity, and lowered endocrine function.<br />
<br />
<h3>
Primary psychiatric effects</h3>
Primary psychiatric symptoms may include: diminished subjective experience of strong emotions, such as fear, thrills, and excitement; diminished alertness.<br />
<br />
<h3>
Secondary psychiatric effects</h3>
Secondary psychiatric symptoms may include: anger, depression, suicide and suicidal thoughts.<br />
<br />
<h2>
<span style="font-size: large;">Disease Classification</span></h2>
Corposcindosis is a disease in every sense of the word. Corposcindosis presents the interruption, cessation, and disorder of body functions, systems, organs, glands, and muscles. Corposcindosis has a proven etiolgy - ETS surgery. Corposcindosis has an identifiable group of signs and symptoms, and presents consistent anatomical alterations. The word "disabled" and "disabling" appear in the literature with reference to the effects of thoracic sympathectomy in humans. The National Institutes of Health have included thoracic sympathectomy in their list of "neurocardiologic disorders".<br />
<br />
Corposcindosis is definable, predictable, measurable, photographable, preventable, incurable and disabling. Subjectively, ETS surgery patients may consider their corposcindosis to be “life ruining”, “hateful” and “disturbing”.<br />
<br />
QED.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-30946836169544965592013-06-27T20:12:00.005-07:002013-06-27T20:12:48.861-07:00ETS Surgery Cache<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Cache";
var wgTitle = "Cache";
var wgAction = "view";
var wgArticleId = "1357";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2307;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="http://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><!--
<rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#"
xmlns:dc="http://purl.org/dc/elements/1.1/"
xmlns:trackback="http://madskills.com/public/xml/rss/module/trackback/">
<rdf:Description
rdf:about="http://editthis.info/corposcindosis/Cache"
dc:identifier="http://editthis.info/corposcindosis/Cache"
dc:title="Cache"
trackback:ping="http://editthis.info/corposcindosis/trackback.php?article=Cache" />
</rdf:RDF>
-->
<br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<a href="http://www.blogger.com/null" id="top" name="top"></a>
<br />
<br /><div id="bodyContent">
<a class="external text" href="http://editthis.info/corposcindosis/Dumont" rel="nofollow" title="http://editthis.info/corposcindosis/Dumont">Pascal Dumont published article on "Complications" which mentions Corposcindosis with definition. </a>
<br />
<a class="external text" href="http://corposcindosis.0catch.com/" rel="nofollow" title="http://corposcindosis.0catch.com/">link to html cache site</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/FischelCDROM" rel="nofollow" title="http://editthis.info/corposcindosis/FischelCDROM">Richard Fischel MD PhD Hyperhidrosis CD-ROM</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/AhnTalk" rel="nofollow" title="http://editthis.info/corposcindosis/AhnTalk">Samuel S. Ahn MD Hyperhidrosis Q & A</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/Grey%27s_Anatomy" rel="nofollow" title="http://editthis.info/corposcindosis/Grey's_Anatomy">Grey's Anatomy ETS Episode</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/Brat_Dialog" rel="nofollow" title="http://editthis.info/corposcindosis/Brat_Dialog">songboy1234 answers surgeon's questions</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/Addenbrooke_Consent_Form" rel="nofollow" title="http://editthis.info/corposcindosis/Addenbrooke_Consent_Form">Addenbrooke Hospital ETS Consent Form</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/TroubleShooters" rel="nofollow" title="http://editthis.info/corposcindosis/TroubleShooters">Jim Garza MD Hidden Camera CBS2 News Houston</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/ISSS_Questionnaire" rel="nofollow" title="http://editthis.info/corposcindosis/ISSS_Questionnaire">ISSS Questionnaire</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/Hashmonai_ETS_Pathophysiology" rel="nofollow" title="http://editthis.info/corposcindosis/Hashmonai_ETS_Pathophysiology">Hashmonai ETS Pathophysiology</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/Losing_Nerves" rel="nofollow" title="http://editthis.info/corposcindosis/Losing_Nerves">"Losing Nerves" - Time Magaizine article from 1947</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/Sympathectomy_Failure" rel="nofollow" title="http://editthis.info/corposcindosis/Sympathectomy_Failure">"Sympathectomy Failure" - Article by H. Hooshmand, M.D.</a>
<br />
<a class="external text" href="http://editthis.info/corposcindosis/MedlinePlusHyperhidrosis" rel="nofollow" title="http://editthis.info/corposcindosis/MedlinePlusHyperhidrosis">MedlinePlus Hyperhidrosis Page</a>
<br />
<!--
NewPP limit report
Preprocessor node count: 1/1000000
Post-expand include size: 0/2097152 bytes
Template argument size: 0/2097152 bytes
Expensive parser function count: 0/100
-->
<!-- Saved in parser cache with key corposcindosis:pcache:idhash:1357-0!1!0!!en!2!edit=0 and timestamp 20130427074816 -->
<br />
</div>
</div>
</div>
</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-53422545834530985142013-06-26T10:27:00.002-07:002013-06-26T10:27:41.384-07:00Other Compensatory HyperactivityWhile the exact mechanics of compensatory hyperactivity are not
known, the phenomenon exists without a doubt in regard to sweating. Thus
we can suppose that, whatever the mechanism, other sympathetically
innervated effectors in the still-innervated zone may exhibit a similar
hyperactive response, especially if those effectors are similar to sweat
glands in that they are either
<br />
<ul>
<li> distributed throughout the innervated and denervated areas and/or
</li>
</ul>
<ul>
<li> innervated only by the SNS, and not the PSNS
</li>
</ul>
Blood vessels are distributed throughout the body, and most of them
have only sympathetic innervation. Adipose Tissue is also widely
distributed. Will either of these exhibit compensatory hyperactivity in
the still-innervated areas? If so, what would sympathetic hyperactivity
cause?
<br />
The kidneys are thought to only have sympathetic innervation, not
parasympathetic. They are expected to remain fully innervated after
ETS, but could they experience sympathetic hyperactivity? If so, how
might that affect their function?
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-67366389256648645392013-06-26T10:16:00.002-07:002013-06-26T10:23:04.490-07:00Sexual Function<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Compensatory_Changes";
var wgTitle = "Compensatory Changes";
var wgAction = "view";
var wgArticleId = "1294";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2470;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="http://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<div id="bodyContent">
Anecdotal complaints of loss of libido are quite common among both male and female ETS patients. Consider this blog entry from Kevan Wylie M.D.:
<br />
<blockquote>
<blockquote>
“I have a patient who had a T2 sympathectomy and is now free of facial flushing, Goosebumps and sweating in the upper limbs. However, he also claims complete loss of libido. How can this be the case and has anyone any suggestions for managing this man in his early 30’s? His adrenal and pituitary function is normal other than a raised growth hormone of 34 (IGF-1 normal).
Kind regards
Kevan R Wylie MD
Consultant in Sexual Medicine
Porterbrook Clinic,
Sheffield.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Wylie" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Wylie">Wylie</a>)
</blockquote>
</blockquote>
The MDs who responded to Dr. Wylie’s post suggested the patient’s loss of libido was due to purely psychological reasons, but this begs the question. Why would ETS lead to psychological problems? The CS model offers ample reasons for that, but there may be a purely physical explanation as well.
<br />
Perhaps the loss of libido is another example of compensatory hyperactivity of the SNS in the still-working lower part of the body. Unlike most blood vessels, which have only sympathetic innervation, the vessels in the sex organs also have parasympathetic. Sexual arousal is associated with co-activation of both the SNS and PSNS.<br />
<br />
In men, an erection requires a surge of parasympathetic activity in the penis. Similarly, in women, clitoral erection and vaginal lubrication are initiated and maintained by parasympathetic dominance. If the SNS was operating hyperactively, this could prevent the PSNS dominance required for a strong erection and adequate lubrication. Even if sexual arousal is still mechanically possible, it is certainly plausible that a shift in the balance between SNS and PSNS could cause the patient to just “feel wrong” down there.<br />
<br />
On the other hand, to achieve orgasm, the co-activation must shift to favor the SNS. If indeed SNS hyperactivity is present in the lower body, the CS model would predict greater difficulty achieving orgasm, but a more intense sensation if achieved.<br />
<br />
A 1991 dog study entitled “The sympathetic role as antagonist of erection” stated “Our results suggest that an elevated central sympathetic tone may be one of the causes of psychogenic impotence.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Diederichs1991" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Diederichs1991">Diederichs et al. 1991</a>)<br />
<br />
Given the persistence of anecdotal complaints, human clinical study is warranted, provided patients are given adequate warning prior to surgical sympathectomy.
<br />
<a href="http://www.blogger.com/null" id="Other_Compensatory_Hyperactivity" name="Other_Compensatory_Hyperactivity"></a></div>
</div>
</div>
</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-7185968203762869452013-06-26T09:46:00.004-07:002013-06-26T09:50:32.628-07:00Welcome to My Nightmare<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Welcome_to_my_Nightmare";
var wgTitle = "Welcome to my Nightmare";
var wgAction = "view";
var wgArticleId = "1405";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2154;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="http://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<div id="bodyContent">
<div id="contentSub">
</div>
<!-- start content -->
<br />
by Britton Johnson<br />
<br />
1.4.03<br />
<br />
I am a Single, Caucasian, Male in my thirties that had ETS by Dr Reisfeld approximately March of 1998. I had cuatory of the T2. I am a pilot for an Airline in the United States. I have a degree in Business and Sociology. I have always been extremely fit and successful in athletics. I was ranked number one in the USA in two swimming events when I was in age group swimming, then State champion and holder of 7 records in High School. Later, I went on to swim under scholarshp at a major NCAA Division 1 college finishing top in the conference. I point this out to let you know I am very in touch with my body. In reaching for maximum performance I have always played it very conservative with regard to what I put into my body (used to avoid even taking aspirin) and how I treat it. If so much as a freckle were to show up on my lower back I would know about it. Later, I will contrast my previous good health with where I have arrived after ETS. Of course the question begging to be asked is if I am so sensitive to anything potentially harmful to my body why did I get ETS.<br />
<br />
It all started sometime back in 1996 when I happened upon a talk radio show while driving in my car. A so-called authority on medicine was taking calls and somebody called to ask about an overactive sweating problem. The 'Doc' quickly labeled it as hyperhidrosis and said that there were procedures that could easily cure this problem. I jotted down my newfound word 'hyperhidrosis' and decided to look into it when I got back home. I, in some stressful situations, when it was warm in the room, had been know to start sweating profusely from the face and if my face was sunburned I would blush easily. I did a search on the Internet under 'hyperhidrosis' and came up with a small handful of doctors web sites (nothing like this site had yet immerged). At the time Dr. Reisfield’s site indicated in a nutshell that he had more experience than most the other doctors in this field in the United States. I called and was greeted by a friendly receptionist that was all too happy to send me some literature.<br />
<br />
The literature, just like any good marketing package started immediately into the benefits. This followed with testimonials of some former patients. I specifically remember two guys telling of blushing/sweating prior to surgery then after this "minimally invasive procedure" going out to test their new found cured self. One gentleman unabashedly talked of walking up to a beautiful woman and saying something embarrassing that would normally cause him to blush but this time he was all giddy inside because that blushing problem that had previously caused so much trouble was gone, vanished, magically removed and all from a thirty minute procedure on each side.<br />
<br />
It sounded like this surgery was extremely safe (how much damage could a little ol thirty minute procedure do anyway) and it targeted only this specific troublesome nerve that just got carried away some times and wasn’t working like a normal nerve should work anyway. Wow, this seemed too good to be true (just remember if it seems too good to be true!!) I talked to the doc over the phone several times and other than the short list of side effects (kind of like the small print at the bottom of advertisements that nobody reads) this surgery sounded safer, with a better chance of positive outcome, than when a podiatrist removes a bunion from someone’s big toe. At least that was the impression I, and I’m sure many others were left with after an initial consultation. If I had read one post by Magnus Carlson, or 'Steve Austin' or any of those people that have not faired so well (by the way I do believe only a fraction of the dissatisfied ETS’ers find their way to this site contrary to what has been speculated by other posters here) there is NO WAY IN HELL I WOULD HAVE TOUCHED THIS SURGERY WITH A TEN FOOT POLE!<br />
<br />
I do not believe my side effects are as bad as some I have read about but for me it has still been very disappointing watching me, Mr. Healthy, begin to crumble physically and not be able to carry out activities that used to give me so much joy and made life fulfilling (more on this later). I would also like to point out that I did ask Dr. Reisfield if there were any new procedures on the horizon and if it would be worth waiting. He said no and that this was an established procedure that had been successful. I have not yet asked him but I do not believe it was that many months later that he shifted to the clamping method (still not a good idea in my opinion but better than cutting/cauterizing).<br />
<br />
I must say I am disappointed with Dr. Reisfeld because most of the info he provided (including a handful of recently cauterized patients that had little time to show much side effects - they were still at this point saying it seemed worth it) suppressed the real possible dangers. Even when such things as Horners were discussed it was quickly pointed out that he had done X number of patients and only one Horner patient had shown up, "very rare". That is not to say that Dr. Reisfeld isn’t friendly because he is. I just don’t believe he was up front as he should have been and it would have given me a more 'fair and balanced' education and had he dispensed numbers to me of those who I’m sure he had talked to who were unhappy with the procedure I probably would have taken a different course of action. I believe there are surgeons who push the procedure more than Dr. R. and are counting the beans it will take to buy that next house, yacht, etc. more than he. Doctors, even those who get started with the right intentions (to help their fellow man), often times fall into this trap (read the book Off the Pedestal). I know of an incompetent plastic surgeon that pushed many people to have procedures that he should not have performed. In a nutshell he visible screwed them up for life and one of them got so distraught and angry that they took the life of the surgeon.<br />
<br />
<br />
I will follow this post with another installment listing the backward trend of my health, where I am at now, what I have done to tolerate the many (not just Compensatory sweating) side effects and where I am thinking about going from here. Btw, I pointed out that the side effects are not just Compensatory sweating because some of you eager to get this procedure seem to think that a "a little extra sweat on your back is a fair price to pay for no more blushing/sweating". The C.S. usually is only the beginning and you should talk to those who STILL have blushing with a whole list of new ailments. Kinda hard to stop and smell the roses when your getting beat over the head with unnerving (no pun intended) side effects. For now try sticking a rusty nail in your eye and twisting it for a while, then try simultaneously concentrating on a thought or idea outside of yourself or perhaps giving all your attention to that loved one that has come to rely on your support.<br />
<br />
Where do I begin? In a nutshell, I went from a motivated, spirited high achiever to a dull, lifeless shell of myself. Don’t get me wrong, I am still a fighter and I will fight and do everything in my power to get back as near my former self as possible but it is difficult and discouraging to deal with the side effects associated with ETS. Though I cannot accurately describe how ETS has changes my life I will try to give an open and descriptive evaluation of how it has affected me these past three years. Those of you with similar problems will hopefully relate and know that you aren’t the only one going through this.<br />
<br />
My first post under this heading already described how I arrived at ETS so I will pick right up with my experience after 'going under the knife/burner'. Right after the surgery I had severe CS that many have mentioned. For several weeks I literally had to get up several times a night to change my sweat soaked clothes and I would put towels on top of my bed to keep from soaking the sheets and mattress. If I took a warm shower or bath (used to love a good bath) forget about it!! The elevated body temperatures only further fueled this sweating phenomenon. Three years later the night sweats are still sometimes there but not as bad, perhaps because I have adjusted my lifestyle to accommodate it better. Now if the room gets warmer than aprox 70 degrees the sweat starts streaming. I used to like curling up in a nice warm bed sometimes with an electric blanket turned all the way up but now I have to keep my house/ hotel room like a refrigerator to keep from creating a sess pool of sweat. As I’m sure many of you have discovered, the idea of another warm body nearby can cause an anxious situation. I am not married and for personal religious reasons wont be having 'relations' until I am married. It is sad that the idea of sharing a bed with my future mate causes me much concern and instead of really looking forward to it, as I should, I think of the whole experience with a black rain cloud hovering overhead. I will have to explain this whole situation before honeymoon night, a burden that frankly I could do without. Unfortunately CS is just the tip of the iceberg regarding side affects associated with my ETS surgery. Below I will recount some of the other side affects as they were noticed after ETS and how they affect my daily life.<br />
<br />
Along with CS encountered during sleep I have also experienced a healthy dose (no pun) of CS at work. Often times I will need to get into an aircraft that has been unattended for several hours and the cockpit will be quite warm. After firing up the Auxiliary Power Unit and getting some AC going my body sometimes wont cool down and the sweat will not have stopped over an hour later. My lower back and legs are usually affected the worst and when covered with sweat I will sometimes lean forward to keep my shirt from sticking to the back of the seat. No doubt more than a few Co-Pilots have wondered what I am doing. At least when I used to get a little sweat on my face I could blow the air from the gasper fan directly on my face and cool it in seconds. The lower back covered with clothes is another story. Anyway, you get the idea on the inconveniences on CS. GS, that is Gustatory Sweating (which I was told was very rare), has caused major changes in what I eat, when I eat and generally my quality of life. My whole sense of smell is now hyper sensitive. I guess if I were a bloodhound this would be a good thing. Unfortunately now 90% of all scents that I used to enjoy cause all kinds of problems. If I am on a date and a girl wears even a minimal amount of perfume my eyes go crazy with irritation, I can get a headache and generally I am more focused on staying away from what has now become an allergen than getting close to the girl. After dating a girl for a while I have requested that they not wear heavy perfume and though they no doubt think I am really strange for making this request, if they are nice they will go along with it. Speaking of allergies, this is the one thing that pesters me night and day. At least if I get into a room of optimal temperature the CS will be put at bay for a moment. The allergies that I NEVER had prior to this surgery started out relatively mild along with the GS but have progressed to something that now sometimes seems unbearable. Can I just say that my eyes, even as I write this, are itchy and constantly burn! They either seem too dry or are so watery that I have to use tissue to periodically dry the outside of my eyes. I had no idea when I had this surgery that the sympathetic nerve chain was so strongly tied into the functioning of all the glands (i.e., pituitary, thyroid, adrenal, etc.). About one year after my ETS I got a little cyst on the left side of my neck that grew to the size of a marble. I went to two dermatologists that basically said these things appear when the glands are doing weird things or are over/under producing. I believe that as a result of the glandular changes tied to ETS I got that cyst and this disturbance is also responsible for the sudden appearance of severe allergies. By the way I have tried everything including OTC and prescription allergy medications and some have helped a little but my eyes are almost always irritated and this can understandably make me irritable. Oh yea, its always fun trying to help an allergy doctor, dermatologist, GP, etc understand how the damage to your nerves ties into the side affects you want them to treat and why your nerves are damaged. Damage control is getting old but this is my body and life as long as I remain on earth so I’ll press forward. But I digress. I now know that the production of cortisones from the adrenals play a big part in allergies and I just recently started taking an adrenal booster, which contains Adrenal (bovine), Siberian ginseng, licorice root. Apparently Licorice root has long been known to help boost production of the cortisones from the adrenal gland and I may experiment more with it. Also I will be looking into the combination of herbs suggested by the website Madonna posted. By the way, the adrenal boost formula has seemed to help my burning eyes a little.<br />
<br />
<br />
I think I am getting a little ahead of myself. I forgot to mention that I was getting slight sweating on my face in even moderately stressful situations (this wouldn’t have happened before ETS- then only sweat while under much stress and warm temp). At first this sweat which I felt was tied to GS seemed mostly like phantom sweating because I would feel it happening then look at my face to see only a few very small beads of sweat. Later this increased an overall damp look on my face and was made worse if I tried to wear any lotion at all on my face. By the way, I always used to wear a slight amount of lotion on my face prior to ETS to keep my skin youthful. I can’t go anywhere near ANY lotions now (not even the most neutral, unscented, "Hypoallergenic" types) without causing havoc with my allergies and this GS/ stress associated sweating. It is all very unnatural and disturbing to say the least. When I told Dr. Reisfield about this sweating situation he suggested that the nerve may have grown back some and was causing this new sweating. He thought another cautory might be in order. It’s scary to think I actually considered this for a while. Thank goodness I didn’t let the cautory iron back in to do more damage!<br />
<br />
<br />
Ok, let me go through a few more side effects more rapidly. 'Pins and needles' on face and head. Thermoregulatory problems. Isn’t it nice to be really hot when others are cold and vice versa. Facial pain (primarily just below my left eye). This later turned into a pretty nasty left eye twitch that lasted about six months- the nerves seemed confused and were all reacting sporadically. With my severe sensitivities to scent, etc one of the things that I loved more than anything in the world has become lost to me. As I explained earlier, I swam at a high level for most of my life (started age group swimming when I was 5 and swam through and beyond college) right up until I had ETS. I used to love the serenity and peace that swimming brought. There was something about the rhythm in breathing and the simultaneous movement of arms and legs, water moving across the body. Not only would my body get a great workout but also I would get a chance to clear my mind. The effects of a good swimming workout left me very confident and gave me a calm I cannot describe but it is much like what is referred to as runners high. Now not only do I not achieve a runners high but there seems to be an inverse affect from aerobic exercise. Many times I feel worse and 'empty' after exercising. On top of that, the chlorine now caused my eyes to burn so bad and skin to 'crawl' discouraging me against even getting near the water. CS is also worse for 24 hours after swimming. Let me remind you that I have never had a reaction to chlorine or allergies and now after ETS both of these are showstoppers regarding the sport I used to love.<br />
<br />
<br />
I had a very low heart rate (even for a very fit athlete) after the surgery and actually fainted a couple times during my first year when getting up quickly. Once I got out of bed rapidly and knew I was going down so I grabbed one of my very expensive speakers to brace. I woke up a few seconds later to find myself on the floor with my speaker nearby, its face torn off and ruined. I have no history of fainting spells nor does my family. Over the last couple years my heart rate has come back closer to normal. I believe this is partly due to my relentless pursuit of fitness (which has been very difficult with out the normal drive and associated runners high mentioned earlier). Last year I ran a marathon. I now sweat on my face when I run (assuming I have not been using the robinal to suppress the gustatory/stress related sweat mentioned earlier).<br />
<br />
My skin is very pale to the point of looking not healthy. My first couple years after ETS I had several people ask me if I was OK. I said I was fine, why? They said I didn’t look well, pale and clammy like a diabetic. I am NOT diabetic by the way. I started using self-tanner and now kind of have it down to an art once to twice a week. By the way, for some reason, when I put it on my back it seems to slightly decrease the amount of CS. The only brand I have ever tried is SEA & SKI Sunless deep dark self-tanning lotion. Try it out and see if it helps. Also, it is interesting to note that if I have a small amount of sun for prolonged periods, like when I fly, my face actually get more pale not more tan- I used to tan fairly easy when I was flying, The only way for me to get a normal looking tan now is to go out in direct sunlight for many hours with tanning oil on my face. I have had the same success with sun beds. I still try to avoid lots of sun to prevent premature aging even though ETS with my dry skin, screwed up glands and inability to wear lotion have thrown a large wrench in that plan.
<br />
My face gets dry but has started producing slightly more oil, which seems to help with the lack of 'normal' moisture especially when I am using the robinal. I have about 20 tubes of Neutrogena lip moisture spread everywhere from my car to my flight bag for my lips. It contains no fragrance and is easier on my newfound allergies.<br />
<br />
Noticed slight shaking/trembling hands at about month 6 and asked Dr R about it. He said this was new to him. Circulation is decreased to digits. When I wake in the morning my hands are a little numb and tingly but better than they were during my first year where I woke a couple times to have no feeling to an arm. This is scary. I believe running has help return my heart rate and circulation.
<br />
Hair. Hmmm, this is a very strange one. I did notice some thinning my first couple years but the loss has tapered off some. This is partly due to a phenomenon I noticed while spending some time poolside (prior to me throwing in the towel on swimming). If I spend much time at all outside in direct sunlight with my head not covered, that night and the next day I notice a dramatic increase in hair loss when I brush my hair. If I keep my head covered and out of the sun (I would wrap a t-shirt around my head when training for my marathon last year) my hair does much better. I attribute this with the unbalanced gland thing again but I do not know how or why the sun plays into it. I just know what I have observed. Let me also state for the record I was a lifeguard for 5 years of my life and had no such phenomenon prior to ETS.<br />
<br />
I want to touch on the allergies thing again. I cannot emphasize how much ETS has messed me up in this area. I believe I now have asthma, which causes a shortness of breath (not good when trying to train/run a marathon). I have had a hellashus chesty cough pretty much from day one post ETS to the present that baffles most GP’s. I am going to see a respiratory specialist soon to get his take. My nose is constantly stuffed up and sometimes I get a slight bloody nose- had a bloody nose once my whole life prior to ETS. I already mentioned my eyes….Oh my eyes, I wish the burning would go away and they would clear again. Take this for what it is worth but prior to ETS I had very white/blue eyes and people would actually comment on my eyes. Now my eyes look cloudy (unless I put some eye drops in, which is not a good idea- eyes will get addicted to the stuff that whitens and make things worse) and slightly sickly. I am more light sensitive now and feel very uncomfortable outside without dark sunglasses. Even then the peripheral light can be bothersome. For those of you who think that it is pure co-incidence that I got these severe allergies the same exact time that I had ETS I say to you NONSENSE! I have no history of allergies like this, nor my family. What has happened to me is a direct result of ETS and the disarray of signals that balance out every part of my internal chemistry. This is the only reasonable explanation and I will not be insulted by anyone not intimate with my health, history and present condition. So Tom don’t open your mouth!<br />
<br />
Finally, I will touch on two final effects that are much harder to qualify. I have throughout my life always been gifted with a creative edge. From the time I was an infant I had a free flowing stream of creative thoughts and ideas. Sometimes this is in the form of witty insight other times the ability to grasp deep thought provoking ideas on the fly. If anything I may have entered the wrong career field even though I do like the challenges of flying and wouldn’t trade it for the world. I now feel that a part of the creative me has been lost and is dead. I feel certain emptiness now where there used to be an intensity that could rarely ever be diminished. The 'killer instinct' and 'flight or flight' impulses no doubt benefited me during my competitive years as a swimmer. I miss this part of me and am sad when I have to consciously think of what I am going to say without the 'instinct' kicking in. Music (something I have always loved dearly everything from rock to classical) has also become less rewarding. I feel this is partly due to the many distractions related to side effects but also a diminished response to the excitement and "feeling" that music used to bring to me. Yes I attribute these losses all to a "simple 30 minute procedure that will reduce sweating on the face and hands with very few side effects".<br />
<br />
Where do I go from here? I will definitely have a reversal. I have mixed feeling with Dr R because I feel he could and should have done more to screen me as a poor candidate for the original ETS. I have communicated with him off and on the past year regarding reversal and talked to a couple of his reversal patients. It is too early to tell how much improvement they will see but one of his reversal patients thinks he has achieved a pretty good result. Anyway the verdict is still out. I will have the reversal with Dr. Lin or Dr.T.T. I am a little worried about being three years post op, but am hesitant to get rushed into something again only to find out that a "new technology that helps the body regenerate nerves 98% has just been released" one month after I have my reversal. I anticipate a reversal within the next 6 months though<br />
<br />
P.S.- Sorry about the typos/missing words. I just tried to get this thing on “paper” on quickly and painlessly as possible. Who likes writing a story on how their live has been ruined?<br />
<br />
<a class="external text" href="http://I am a Single, Caucasian, Male in my thirties that had ETS by Dr Reisfeld" rel="nofollow" title="http://p069.ezboard.com/Welcome-to-my-nightmare-Restored-Post-found-92405/fetsandreversalsfrm12.showMessage?topicID=4.topic">source</a></div>
</div>
</div>
</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-499248285557601142013-06-19T17:20:00.001-07:002013-06-27T14:10:58.414-07:00Eyes and Eyelids<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Changes_to_Individual_Effectors,_part_3";
var wgTitle = "Changes to Individual Effectors, part 3";
var wgAction = "view";
var wgArticleId = "1291";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2467;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="http://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><br />
<h2>
<a href="http://www.blogger.com/null" id="Eyes_and_Eyelids" name="Eyes_and_Eyelids"></a></h2>
<h2>
<a href="http://www.blogger.com/null" id="Innervation_of_the_Eyes" name="Innervation_of_the_Eyes"></a><span class="mw-headline" style="font-size: large;">Innervation of the Eyes</span><span style="font-size: large;"> </span></h2>
The eyes and eyelids have both sympathetic and parasympathetic innervation. Two sets of muscles surround the pupils – radial and sphincter. Radial muscles, which have mostly sympathetic innervation, dilate the pupil; while sphincter muscles, which have mostly parasympathetic innervation, serve to constrict.<br />
<br />
The pupils will respond to changes in lighting by attempting to allow a more-or-less constant amount of light onto the retina, constricting if the light is too bright, dilating when it gets darker. Pupils also respond to various emotions; dilating with passionate love, for example.<br />
<br />
<a class="image" href="http://www.blogger.com/corposcindosis/File:Thyroid.gif" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Thyroid.gif"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Thyroid.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Thyroid.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Bone_pic_1.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Bone pic 1.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Bone_remodel_pic.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Bone remodel pic.jpg"></a>Pupil responses to emotion operate in a classic reciprocal fashion, as sympathetic tone goes up, parasympathetic goes down, and the pupil dilates. Curiously, pupil responses to light are almost entirely mediated by the PSNS. An increase in parasympathetic tone constricts the pupil, withdrawal dilates it.<br />
<br />
Eyelids operate both voluntarily and autonomically. An increase in sympaththetic tone will serve to open the eyelid extra wide, for extra visibility and alertness. This is also a body language cue of sexual attraction.
<br />
<a href="http://www.blogger.com/null" id="Horner.E2.80.99s_Syndrome" name="Horner.E2.80.99s_Syndrome"></a><br />
<h2>
<span class="mw-headline"> <span style="font-size: large;">Horner’s Syndrome </span></span></h2>
The eyes and eyelids receive post-ganglionic innervation from about C1-T1, just above the level normally targeted in ETS surgery. If T1 is accidentally damaged, sympathetic innervation to the eyes and eyelids may be interrupted, resulting in “Horner’s Syndrome”.<br />
<br />
Horner’s Syndrome is characterized by an overly constricted pupil, and a drooping eyelid. The eyeball may sink lower in the eye socket, and suffer soreness, redness and a lack of moisture.
<br />
<!--
NewPP limit report
Preprocessor node count: 20/1000000
Post-expand include size: 0/2097152 bytes
Template argument size: 0/2097152 bytes
Expensive parser function count: 0/100
-->
<!-- Saved in parser cache with key corposcindosis:pcache:idhash:1291-0!1!0!!en!2!edit=0 and timestamp 20130419230758 -->
<br />
<script type="text/javascript">if (window.runOnloadHook) runOnloadHook();</script>
<script type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script>
<script type="text/javascript">
var pageTracker = _gat._getTracker("UA-600316-1");
pageTracker._initData();
pageTracker._trackPageview();
</script><!-- Served in 1.655 secs. --><!-- Cached 20130419230759 -->
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-942687777936628112013-06-18T08:06:00.002-07:002017-09-24T14:44:53.742-07:00Discussion and Conclusions<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Discussion_and_Conclusions";
var wgTitle = "Discussion and Conclusions";
var wgAction = "view";
var wgArticleId = "1295";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2471;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="https://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><!--
<rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#"
xmlns:dc="http://purl.org/dc/elements/1.1/"
xmlns:trackback="http://madskills.com/public/xml/rss/module/trackback/">
<rdf:Description
rdf:about="http://editthis.info/corposcindosis/Discussion_and_Conclusions"
dc:identifier="http://editthis.info/corposcindosis/Discussion_and_Conclusions"
dc:title="Discussion and Conclusions"
trackback:ping="http://editthis.info/corposcindosis/trackback.php?article=Discussion_and_Conclusions" />
</rdf:RDF>
-->
<br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<a href="http://www.blogger.com/null" id="top" name="top"></a>
<br />
<div id="bodyContent">
<div id="contentSub">
</div>
The effects of thoracic sympathectomy in humans will only be fully understood when humans are fully understood. Many of the direct effects of thoracic sympathetic denervation such as anhidrosis, reduction in cardiac output, and loss of vascular tone, have been well known for many decades. Other aspects of this neuropathy, such as its effects on immune function and bone metabolism, are only now beginning to be studied on humans.<br />
<br />
So far, the corposcindosis theory holds up quite well to empirical confirmation. The predictions generated by the model are falsifiable. Of the 24 predictions about changes to individual effectors, 12 have been confirmed in human studies, 7 confirmed in animal studies only, while 5 remain unstudied. Of 9 predictions about changes to systemic function, 5 have been confirmed in human studies, 2 are confirmed in animal studies only, and 2 are unstudied. None of the predictions are falsified by any of the available data, and this research is summarized in the accompanying <a class="external text" href="http://editthis.info/corposcindosis/Tables" rel="nofollow" title="http://editthis.info/corposcindosis/Tables">tables</a>.<br />
<br />
There are a great number of ETS “hyperhidrosis” papers in which the author/surgeons made no empirical measurements of any kind, relying instead on subjective patient questionnaires (see <a class="external text" href="http://editthis.info/corposcindosis/ISSS_Questionnaire" rel="nofollow" title="http://editthis.info/corposcindosis/ISSS_Questionnaire">ISSS Questionnaire</a>). These questionnaires are typically gathered in the first few weeks after surgery, and only cover the subject of sweating, nothing else. Often they euphemistically refer to compensatory hyperhidrosis as “compensatory sweating”, and then attempt to divide patients in to categories “mild”, “moderate” and “severe” compensatory sweating. Evidently there are no objective distinctions that allow for these categories, so this appears to be merely a method of generating low statistical numbers. Many surgeons, touting their particular surgical method over the others, claim rates of “severe compensatory sweating” as some low number, like “1%”, leading the patient to believe that only 1% of patients get “compensatory sweating”, when in fact, the correct number is approximately 100%, and a more correct term is “compensatory hyperhidrosis”.<br />
<br />
Mailis and Furlan express disappointment at the state of the literature. They say, “The practice of surgical and chemical sympathectomy is based on poor quality evidence, uncontrolled studies and personal experience. Furthermore, complications of the procedure may be significant . . .” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Mailis2003" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Mailis2003">Mailis et al. 2003</a>).<br />
<br />
Significant indeed. Corposcindosis (Split Body Syndrome) is the predictable result of thoracic sympathectomy, and patients often find it disturbing. Sentiments such as “ETS surgery ruined my life” are common among patients. Prior to undergoing surgical sympathectomy for any reason, patients should be warned about corposcindosis, i.e. all of the proven consequences to the heart, lungs, blood vessels, arrector pili muscles, and sweat glands. They should be informed of ramifications to overall systemic function, including loss of strong emotion, reductions in alertness, thermoregulatory capability, and exercise capacity. Finally, based on sound theory and animal data, there is strong reason to suspect that sympathectomy alters bone metabolism, immune function, and thyroid function, but these aspects are largely unstudied and unknown in humans. As such, sympathectomy remains highly experimental, and patients should be informed accordingly.
<br />
It is recommended that surgeons begin various types of clinical studies designed to measure differences in all of the different body systems known and strongly suspected to be affected by thoracic sympathectomy. This knowledge is important, and long overdue.
<br />
<a href="http://www.blogger.com/null" id="The_ETS_Surgeon.27s_Dilemma" name="The_ETS_Surgeon.27s_Dilemma"></a><br />
<h2>
<span class="mw-headline">The ETS Surgeon's Dilemma</span></h2>
Clearly, if patients complaining of cosmetic conditions such as excessive sweating or facial blushing were informed about all the potential consequences of ETS surgery, very few (if any) would consent. Thus, the pool of prospective participants in the recommended clinical trials would be drastically reduced, if not eliminated altogether. Surgeon incomes would be expected to suffer. This is “The ETS Surgeon’s Dilemma”.
<br />
The conflict can be characterized as the individual patient’s right to give informed consent versus "society’s" right to further its knowledge, push back the frontiers of ignorance, and continue the grand experiment that is medicine.
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Is_Corposcindosis_a_Disease.3F" name="Is_Corposcindosis_a_Disease.3F"></a><br />
<h2>
<span class="mw-headline">Is Corposcindosis a Disease?</span></h2>
University of Ontario Health Glossary offers three possible definitions of "disease", and corposcindosis easily meets all three, including all of the criteria in number 2:
<br />
<ol>
<li>An interruption, cessation, or disorder of body functions, systems, or organs. Synonym: illness, morbus, sickness.
</li>
<li>A morbid entity characterized usually by at least two of these criteria: recognized etiologic agent(s), identifiable group of signs and symptoms, or consistent anatomical alterations. See also: syndrome.
</li>
<li>Literally, dis-ease, the opposite of ease, when something is wrong with a bodily function (<a class="external text" href="http://www.med.uwo.ca/ecosystemhealth/education/glossary.htm#D" rel="nofollow" title="http://www.med.uwo.ca/ecosystemhealth/education/glossary.htm#D">Ontario Health Glossary</a>)
</li>
</ol>
Current mainstream literature does not include "corposcindosis", or any disease-name for the effects of ETS. "Anhidrosis" is an established disease-name; and is but one of many proven, unhealthy, abnormal, disorderly interruptions and cessations of body functions, systems, organs, glands, and muscles. Corposcindosis has an identifiable group of signs and symptoms; and is caused by a recognized etiologic agent - ETS surgery. Yet mainstream literature does not dare refer to the effects of ETS as a disease. Why not? Is it simply that whatever surgeons do is theraputic by definition? Did we learn nothing from the experience of lobotomy? (see <a class="external text" href="http://www.psychosurgery.org/" rel="nofollow" title="http://www.psychosurgery.org/">psychosurgery.org</a>)<br />
<br />
Neuropathy is neuropathy, regardless of what initiates the nerve damage. This point was made in a 2005 paper on diabetic neuropathy:
<br />
<blockquote>
The occurrence of peripheral vasomotor instability and peripheral sudomotor neuropathy is termed "autosympathectomy.” The patient with autosympathectomy has peripheral vasomotor reflexes similar to those in a nondiabetic patient after sympathectomy. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Aring2005" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Aring2005">Aring et al. 2005</a>)
</blockquote>
Mailis and Furlan titled their 2000 survery, "Are We Paying a High Price for Surgical Sympathectomy?". They state:
<br />
<blockquote>
Surgical sympathectomy, irrespective of approach, is accompanied by several potentially disabling complications. <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Furlan2000" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Furlan2000">Furlan et al. 2000</a>
</blockquote>
Reasonable people must agree that "disabling complications" is equivalent to a disease state, especially when there are potentially "several" of them. Corposcindosis is a disease.
<br />
QED
<br />
<!--
NewPP limit report
Preprocessor node count: 3/1000000
Post-expand include size: 0/2097152 bytes
Template argument size: 0/2097152 bytes
Expensive parser function count: 0/100
-->
<!-- Saved in parser cache with key corposcindosis:pcache:idhash:1295-0!1!0!!en!2!edit=0 and timestamp 20130425015136 -->
</div>
</div>
</div>
</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-58304786298111292892013-06-18T07:48:00.005-07:002017-09-04T18:37:36.953-07:00Mental and Emotional Fucntion<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Changes_to_Systemic_Function,_part_2";
var wgTitle = "Changes to Systemic Function, part 2";
var wgAction = "view";
var wgArticleId = "1293";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2469;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="https://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><br />
<h1>
<span class="mw-headline"> </span></h1>
Anecdotal accounts of lowered mental alertness, and loss of strong emotions abound in the oral history of ETS. For example, airline pilot and ETS patient "Britton Johnson" writes:
<br />
<blockquote>
I have throughout my life always been gifted with a creative edge. From the time I was an infant I had a free flowing stream of creative thoughts and ideas. Sometimes this is in the form of witty insight other times the ability to grasp deep thought provoking ideas on the fly. If anything I may have entered the wrong career field even though I do like the challenges of flying and wouldn-t trade it for the world. I now feel that a part of the creative me has been lost and is dead. I feel certain emptiness now where there used to be an intensity that could rarely ever be diminished. The 'killer instinct' and 'flight or flight' impulses no doubt benefited me during my competitive years as a swimmer. I miss this part of me and am sad when I have to consciously think of what I am going to say without the 'instinct' kicking in. Music (something I have always loved dearly everything from rock to classical) has also become less rewarding. I feel this is partly due to the many distractions related to side effects but also a diminished response to the excitement and "feeling" that music used to bring to me. Yes I attribute these losses all to a "simple 30 minute procedure that will reduce sweating on the face and hands with very few side effects". <a class="external text" href="http://corposcindosis.blogspot.com/2013/06/welcome-to-my-nightmare.html" rel="nofollow" title="http://editthis.info/corposcindosis/Welcome_to_my_Nightmare">Britton Johnson 2003</a>
</blockquote>
It's not difficult to imagine ETS leading to lowered alertness. After ETS, catecholamines are low, there is a loss of sympathetic tone on the cerebral artery, and baroreflex is low. This means less blood to the brain, and less adrenaline in the blood that is there. But what about this subjective loss of strong emotions? Music less rewarding? Could it be?<br />
<br />
Roz Carroll MA, is supervisor at Chiron Centre for Body Pshychotherapy. She has given a series of lectures, one entitled "The Autonomic Nervous System: Barometer of Emotional Intensity and Internal Conflict". Carrol presents the concept of "autonomic splitting", in which misdirected autonomic signals are blamed for a variety of psychological dysfunction. She gives a nice overview of the ANS role in psychophysiology, and is masterful at integrating information from various disciplines.
<br />
<blockquote>
"I believe that the functioning . . . of the autonomic nervous system is fundamentally bound up with preserving the dynamic integrity of the self." <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Carroll2001" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Carroll2001">Carroll2001</a>
</blockquote>
Carrol's thesis offers strong theoretical support for a crucial role of the sympathetic nervous system in human emotion.
<br />
<a href="http://www.blogger.com/null" id="Brain_Studies_After_Pure_Autonomic_Failure" name="Brain_Studies_After_Pure_Autonomic_Failure"></a><br />
<h2>
<span class="mw-headline"> Brain Studies After Pure Autonomic Failure </span></h2>
A team of British scientists led by Hugo Critchley is interested in the role of the autonomic nervous system in human emotion, and have been doing very interesting studies on people with pure autonomic failure (PAF). Certain diseases can eat away at the autonomic nervous system, causing the gradual loss of more and more autonomic nerve function.<br />
<br />
As we might expect, the PAF patients reported feeling unemotional. "On statements designed to probe subjective emotional experience, there was a trend for PAF patients to rate themselves as feeling less emotional than controls". (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Critchley2001" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Critchley2001">Critchley et al. 2001</a>) Later we will discuss if, and to what extent data on PAF patients might apply to ETS patients.<br />
<br />
Normal and PAF subjects were asked to perform four different sets of tasks effortless exercise, effortful exercise, effortless arithmetic, and effortful arithmetic. The researchers took PET scans of their brains. When compared to controls, the PAF patients showed significantly less activity in the posterior cingulate and medial parietal lobe, while at the same time showed significantly greater activity in the anterior cingulate.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://i.imgur.com/CUYwzPB.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/CUYwzPB.png" /></a></div>
<br />
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<div style="text-align: left;">
<span style="color: blue; font-size: small;">
<b>PET Scans Showing Differences in Brain Activity Between (a) PAF and (b) Controls During Interaction with Effort.</b></span> </div>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<i>(a) Significantly greater anterior cingulate activity (circled, peak x, y, z coordinates, 8, 10, 36, Z= 4.48, p <0.05, corrected for volume of regions predicted by the theoretical model to support second-order representations of bodily states, that is, cingulate, thalamus, superior colliculi) in PAF subjects compared to controls, mapped onto three consecutive axial sections of a standard template image derived from one subject. Vertical (z) coordinates are shown above each slice image.</i>
<br />
<i>(b) Significantly greater posterior cingulate/medial parietal lobe activity (circled, peak x, y, z coordinates, 56, 38, Z= 4.51, p <0.05, corrected for predicted regions) in controls relative to PAF subjects, mapped onto three consecutive axial sections of a standard template image derived from one subject.</i>
<br />
<br /></blockquote>
</blockquote>
</blockquote>
</blockquote>
PAF patients do not have brain damage. They have damage to their autonomic nervous systems. What these PET scans show us then, is that loss of autonomic nerve function down in the effector organs somehow changes how the brain works. What is known about the function of these particular brain areas?<br />
<br />
Activity in the posterior cingulate is thought to prevent distractibility. "This function of the posterior cingulate cortex appears to entail an inhibition of parietal cortices, probably for preventing distractibility." (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Small2003" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Small2003">Small et al. 2003</a>) Activity in the medial parietal lobe, on the left side, is associated with language receptiveness. So the PAF patients could be expected to be more distractible, and less receptive to language.<br />
<br />
The anterior cingulate is known to be associated with autonomic responses. (see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bush2000" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bush2000">Bush et al. 2000</a>). Could the increased activity in this area observed in PAF patients be a hyperactive response to the loss of input signals from effectors?<br />
<br />
Obviously emotion-driven brain changes bring about body state changes. What Critchley and colleagues discovered is that the body state changes, in turn, feedback this information to various brain centers. Emotions are dependent upon body state changes. These scientists came right out and said so. The opening sentence in their report was:
<br />
<blockquote>
Changes in bodily states, particularly those mediated by the autonomic nervous system, are <i>crucial</i> to ongoing emotional experience(<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Critchley2001" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Critchley2001">Critchley et al. 2001</a>, emphasis added)
</blockquote>
The British researchers had more questions, so the next year they did another study. This time they did classic fear conditioning on PAF patients and controls, and took pictures of their brains with Magnetic Resonance Imaging (MRI).<br />
<br />
Classic fear conditioning is done by combining a painful sensation, such as an electric shock, with a neutral sensation, such as the sound of a tone. The subject becomes conditioned to fear the tone, even when the shock is not present. It has been shown from earlier rat studies that the brain organs amygdala and insula show greater electrical activity and characteristic electrical patterns after fear conditioning. (see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Ledouxwebsite" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Ledouxwebsite">Ledoux website</a>).<br />
<br />
So Critchley took MRI pictures of the patients' amygdalas and insulas before and after the fear conditioning, and showed that in humans, like rats, normal subjects would show increased activity of the amygdala after fear conditioning. The PAF patients, however, failed to develop the characteristic changes observed in control subjects. Again, we see that the brain-ANS interface is very much a "two-way street". The brain informs the ANS, but the ANS informs the brain also.<br />
<br />
<div class="center">
<div class="floatnone">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://i.imgur.com/3wHvnww.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/3wHvnww.jpg" /></a></div>
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Reduced Activity in PAF Patients Relative to Controls After Classic Fear Conditioning</b>
<br />
</span></center>
<i>Reduced Activity in PAF patients, relative to controls, during conditioning to unmasked stimuli. The influence of autonomic arousal on conditioning was determined by random effects comparison of regional brain activity associated with positive conditioned stimulus versus negative conditioned stimulus in controls and PAF subjects who demonstrated behavioral conditioning. Significant differential activity between the groups is shown superimposed upon a normalized structural template image.</i>
<br />
<br /></blockquote>
</blockquote>
</blockquote>
</blockquote>
"Absent autonomic responsivity, and therefore blunting of arousal-related representations, is associated with attenuated conditioning-related activity in insula, amygdalae, and right anterior hippocampus." (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Critchley2002" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Critchley2002">Critchley, et al. 2002</a>)
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Pure_Autonomic_Failure_vs._ETS" name="Pure_Autonomic_Failure_vs._ETS"></a><br />
<h2>
<span class="mw-headline"> Pure Autonomic Failure vs. ETS </span></h2>
Bear in mind now that these brain studies were done on Pure Autonomic Failure patients, not ETS patients. PAF patients have a (more or less) complete loss of autonomic function, compared with the regional loss of sympathetic function in ETS. Still, recall Goldstein's neurocardiology work.<br />
<br />
Goldstein studies both PAF and ETS, and plots ETS patients just where we would expect - in the middle - more functional than PAF, but less functional than normal. It seems reasonable to think the changes in brain function documented by Critchley would follow the same pattern - that ETS would produce the same <i>types</i> of brain changes as seen in PAF, but to a<i> lesser degree</i>. Perhaps Dr. Critchley would like to study ETS patients, and we call on him to do so.
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="ETS_as_Psychosurgery" name="ETS_as_Psychosurgery"></a><br />
<h2>
<span class="mw-headline"> ETS as Psychosurgery </span></h2>
In consideration of Critchley then, and accepting the notion that his results are applicable to the corposcindosis model, two more predictions are made.
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will lower alertness.</b>
<br />
<br />
<b>Empirical Status: Confirmed.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will reduce the experience of strong emotions.</b>
<br />
<br />
<b>Empirical Status: Confirmed.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
<br />
The empirical confirmation for the previous two predictions comes from Finland, where we find the Privatix psychiatric clinic. Founded by surgeon/psychiatrist Timo Telaranta, Privatix specializes in performing ETS surgery to treat psychiatric conditions such as anxiety and panic disorders. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Teleranta2003" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Teleranta2003">Teleranta 2003</a>)<br />
<br />
Paivi Pohjavaara, a researcher at the University of Oulu, Finland, did a statistical analysis on 169 Telaranta patients who had undergone ETS surgery to treat psychiatric conditions from 1995-2000. Patients were given subjective questionnaires before, and then at various points in time after surgery (1 month, 6 months, 1 year, and annually after that). The questions were designed to quantify the patients' subjective experience of concepts such as "alertness", and "fear of observation". The changes produced by sympathectomy were derived by simply subtracting the "after" numbers from the "before" numbers.<br />
<br />
<div class="center">
<div class="floatnone">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://i.imgur.com/2uOHL3s.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/2uOHL3s.png" /></a></div>
</div>
</div>
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Changes in Psychic Symptoms after ETS</b>
<br />
</span></center>
<i>Changes in the psychic symptoms of social phobia presented as remainders of equation: (preoperative symptom severity) minus (postoperative symptom severity).</i>
<br />
<br /></blockquote>
</blockquote>
</blockquote>
The simple table conveys what has happened. These patients are less alert, less embarrassed, experience less fear, and less anxiety than they did before ETS. (see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Pohjavaara2004" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Pohjavaara2004">Pohjavaara 2004</a>)
<br />
Los Angeles surgeon Farshad Malekmehr also offers ETS surgery for social phobia and anxiety. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#MalekmehrSite" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#MalekmehrSite">Malekmehr website</a>) His website presents a diagram which is instructive.<br />
<br />
<div class="center">
<div class="floatnone">
<br />
<div class="separator" style="clear: both; text-align: center;">
<a class="image" href="http://www.blogger.com/corposcindosis/File:BreakCycle.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="BreakCycle.png"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Privatix_table.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Privatix table.png"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:FearMRI.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="FearMRI.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:PET_PAF.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="PET PAF.png"></a><a href="https://i.imgur.com/EqSYiga.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/EqSYiga.png" /></a></div>
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Cycle of Social Phobia</b>
<br />
</span></center>
</blockquote>
</blockquote>
</blockquote>
Whether intended or not, Malekmehr's diagram makes for a simple schematic representation of the concepts empirically explored by Critchley and the British team. "COGNITIVE SYMPTOMS" would occur in the brain, and "PHYSICAL SIGNS" would occur in the effectors. ETS would indeed "break the cycle", interrupting not only the brain signals <i>to</i> effectors, but also the (now diminished or non-existent) feedback information <i>from</i> effectors back to the brain.<br />
<br />
In December 2006, Bracha et al. have published a paper whose title makes a very insightful analogy:
<br />
<blockquote>
"A surgical treatment for anxiety-triggered palmar hyperhidrosis is not unlike treating tearfulness in major depression by severing the nerves to the lacrimal glands."
</blockquote>
Bracha's analogy is harshly critical of ETS, to be sure, but does not go far enough. It would be a better analogy if severing the nerves to the lacrimal glands also affected a dozen other body systems. Still, the authors sound alarm bells:
<br />
<blockquote>
"Referring an anxious patient with palmar hyperhidrosis to surgery without first completing a proper trial of psychotropic medication <b>may constitute malpractice</b> especially if the patient experiences some of the more severe surgical complications which can occur during sympathectomy" (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bracha2006" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bracha2006">Bracha et al. 2006</a> emphasis added)
</blockquote>
<!--
NewPP limit report
Preprocessor node count: 19/1000000
Post-expand include size: 0/2097152 bytes
Template argument size: 0/2097152 bytes
Expensive parser function count: 0/100
-->
<!-- Saved in parser cache with key corposcindosis:pcache:idhash:1293-0!1!0!!en!2!edit=0 and timestamp 20130417150101 -->
<br />
<script type="text/javascript">if (window.runOnloadHook) runOnloadHook();</script>
<script type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script>
<script type="text/javascript">
var pageTracker = _gat._getTracker("UA-600316-1");
pageTracker._initData();
pageTracker._trackPageview();
</script><!-- Served in 9.375 secs. --><!-- Cached 20130417150101 -->
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-32286425836430279462013-06-18T07:46:00.002-07:002013-06-26T09:34:50.684-07:00Immune Function<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Changes_to_Systemic_Function,_part_2";
var wgTitle = "Changes to Systemic Function, part 2";
var wgAction = "view";
var wgArticleId = "1293";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2469;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="http://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><br />
<h2>
<span class="mw-headline"> SNS as Interface Between Brain and Immune System </span></h2>
In 2000, a team of U.S Government scientists at the National Institutes of Health released a treatise entitled "The Sympathetic Nerve - An Integrative Interface between Two Supersystems: The Brain and the Immune System." They began by pointing out that all of the immune organs have rich sympathetic innervation. "Lymphoid organs, similar to blood vessels, receive predominantly sympathetic/noradrenergic and sympathetic/neuropeptide Y (NPY) innervation." (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Elenkov2000" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Elenkov2000">Elenkov et al. 2000</a>; see also Madden et al., 1995).<br />
<br />
Elenkov points out numerous effects that NE is known to have on immune function, and spends a good deal of time trying to distinguish between effects produced by NE in the blood and NE delivered by sympathetic nerve terminals. We recall that ETS surgery will lower both. The authors find significant neural release of NE in all of the immune organs.
<br />
Which immune organs are denerved in thoracic sympathectomy? Does it follow the skin pattern? What types of changes in function might we expect in the denerved region, and how might these regional changes affect the whole system?<br />
<br />
NIH scientist Esther Sternberg is one of the foremost authorities on the role of the autonomic nervous system in the immune system. She is worth quoting at length:
<br />
<blockquote>
"Interactions between the immune and nervous systems play an important role in modulating host susceptibility and resistance to inflammatory disease. Neuroendocrine regulation of inflammatory and immune responses and disease occurs at multiple levels:<br />
<ul>
<li> <b>systemically</b>, through the anti-inflammatory action of glucocorticoids released via hypothalamic-pituitary-adrenal axis stimulation;<br />
</li>
<li> <b>regionally</b>, through production of glucocorticoids within and <b>sympathetic innervation of immune organs</b> such as the thymus;<br />
</li>
<li> <b>locally</b>, at sites of inflammation.<br />
</li>
</ul>
Recent studies indicate that physiological levels of glucocorticoids are immunomodulatory rather than solely immunosuppressive, causing a shift in patterns of cytokine production from a TH1- to a TH2 type pattern. <b>Interruptions of this loop at any level </b>and through multiple mechanisms, whether genetic, or<b> through <i>surgical</i> or pharmacological</b> interventions, can render an inflammatory resistant host susceptible to inflammatory disease." (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Sternberg2001" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Sternberg2001">Sternberg, 2001</a> emphasis added)
</blockquote>
Sternberg presents ample theoretical justification for the notion that sympathectomy would alter immune function at all three levels - local, regional and systemic. Systemic changes could certainly arise due to the lowered blood catecholamines, and regional function would be altered according to direct denervation of any immune organs innervated via the upper thoracic sympathetic ganglia. Any local response anywhere would encounter the lowered system levels. Local responses in the denerved region would also encounter denerved immune structures, which could be expected to affect inflammation and healing, among other functions.
<br />
<a href="http://www.blogger.com/null" id="Healing" name="Healing"></a><br />
<h2>
<span class="mw-headline"> Healing </span></h2>
Thus, in consideration of Elenkov and Sternberg, the CS model predicts:
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will slow skin healing in the denerved area.</b>
<br />
<br />
<b>Empirical status: Confirmed in rats, unstudied in humans.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
A team of Brazilian scientists decided to test the effects of sympathectomy on skin healing. The methods were straightforward. They sympathectomized rats, gave them skin cuts, and reported:
<br />
<blockquote>
"Sympathetic denervation accelerates wound contraction but delays reepithelialization (skin healing) in rats-. -Sympathetic denervation affects cutaneous wound healing, probably by a decrease in neurogenic inflammation during the initial phase of healing and the absence of catecholamines throughout the final phase." (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Souza2005" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Souza2005">Souza et al. 2005</a>)
</blockquote>
<br />
<br />
<a href="http://www.blogger.com/null" id="Tumor_Necrosis_Factor" name="Tumor_Necrosis_Factor"></a><br />
<h2>
<span class="mw-headline"> Tumor Necrosis Factor </span></h2>
Tumor Necrosis Factor, or TNF, is a cytokine which helps to kill malignant tumors. Our Norwegian orthodontists went looking into immune metabolism in rat teeth. They infected rats with bacteria which causes sores. They did a one-sided sympathectomy, to see if they could infer the role of the sympathetic nerves here. The result was that sympathetic nerves have an inhibitory effect on IL-1alpha . . .and a stimulatory effect on TNF-alpha in the intact rat pulp. (Bletsa et al. 2004)
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will reduce the production of Tumor Necrosis Factor.</b>
<br />
<br />
<b>Empirical status: Confirmed in rats, unstudied in humans.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<blockquote>
"We showed that IL-1alpha was increased but not TNF-alpha . . .on the sympathectomized side. Both IL-1alpha and TNF-alpha were expressed in unexposed pulp. <b>TNF-alpha was significantly decreased in the denervated incisor pulp</b>, whereas the level of IL-1alpha remained unchanged." (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bletsa2004" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bletsa2004">Bletsa et al. 2004</a>, emphasis added)
<br />
<br />
"Accumulating evidence suggests that the sympathetic nervous system modulates inflammatory responses and bone remodeling."(<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Haug2003" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Haug2003">Haug et al. 2003</a>)
</blockquote>
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will increase the rate at which tumors develop.</b>
<br />
<br />
<b>Empirical status: Confirmed in rats, unstudied in humans.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<blockquote>
"Tumor onset time following implantation of MNB cells was significantly increased in animals sympathectomized as either neonates or as adults."
(<a class="external text" href="http://www.editthis.info/corposcindosis/References#Fink_1987" rel="nofollow" title="http://www.editthis.info/corposcindosis/References#Fink_1987">Fink et al. 1987</a>)
</blockquote>
<a href="http://www.blogger.com/null" id="Mental_and_Emotional_Function" name="Mental_and_Emotional_Function"></a><br />
<script type="text/javascript">if (window.runOnloadHook) runOnloadHook();</script>
<script type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script>
<script type="text/javascript">
var pageTracker = _gat._getTracker("UA-600316-1");
pageTracker._initData();
pageTracker._trackPageview();
</script><!-- Served in 9.375 secs. --><!-- Cached 20130417150101 -->
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-20338888506936126132013-06-18T07:45:00.000-07:002017-09-24T14:30:26.622-07:00Endocrine Function<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Changes_to_Systemic_Function,_part_2";
var wgTitle = "Changes to Systemic Function, part 2";
var wgAction = "view";
var wgArticleId = "1293";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2469;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="https://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<div id="bodyContent">
<a class="image" href="https://i.imgur.com/MDDw8qX.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="CaridacExercise2,3.jpg"></a>The control center regulates the blood levels of many hormones. Among these is adrenaline, released by the adrenal medulla. The adrenal medulla often operates in concert with the sympathetic nervous system, and the two together are sometimes viewed as one system, the "sympatho-adrenal axis". Thus we might instinctively guess that sympathectomy could somehow affect adrenaline levels in the blood, even without an obvious direct connection. This guess would prove to be correct, as ETS has been shown to lower adrenaline levels in the blood (see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Nakamura2002" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Nakamura2002">Nakamura 2002</a>, <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05/references.html#Nakamura2005" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Nakamura2005">2005</a>).<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/MDDw8qX.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="547" data-original-width="466" height="640" src="https://i.imgur.com/MDDw8qX.jpg" width="544" /></a></div>
<div class="separator" style="clear: both; text-align: center;">
</div>
<a class="image" href="http://www.blogger.com/corposcindosis/File:CardiacExercise1.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="CardiacExercise1.jpg"></a><br />
<div class="center">
<div class="floatnone">
</div>
</div>
<div style="text-align: left;">
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<span style="color: blue; font-size: small;">
<b>Effects of ETS on Plasma Levels of Noradrenaline and Adrenaline at Baseline and at Submaximal Exercise.</b>
</span>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<div class="" style="clear: both; text-align: center;">
*p<0.05 vs before ETS; **p<0.01 vs before ETS.</div>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
</div>
</div>
</div>
</div>
</div>
<br />
<pre> </pre>
<a class="image" href="http://www.blogger.com/corposcindosis/File:CardiacExercise1.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="CardiacExercise1.jpg"></a>Noradrenaline is released by sympathetic nerve terminals, so it is not surprising that blood levels of this catecholamine are reduced. However, most adrenaline is released into the bloodstream by the adrenal medulla, which is not directly affected by ETS. However, the adrenal medulla is part of the sympatho-adrenal axis, under the control of the hypothalamus, as discussed earlier. Dr. Nakamura had reported back in 1998 that ETS increases the blood level of a peptide called "atrial natriuretic peptide". So in the 2002 exercise paper he theorizes as to how this might offer clues to the mysterious low adrenaline levels:
<br />
<blockquote>
"The sympathetic ganglion is not a simple relay station but a site modulated by short inter-neurons and a variety of neurotransmitters and receptors. Therefore, [T2-T3] ETS might have modified the sympathetic regulation of adrenaline secretion from the adrenal medulla. [T2-T3] ETS increases the plasma level of atrial natriuretic peptide, which has widespread sympatholytic activity. [T2-T3] ETS might have influenced the amount of adrenaline secreted from the adrenal medulla via changes in humoral factors such as atrial natriuretic peptide."(<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Nakamura2002" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Nakamura2002">Nakamura 2002</a>)
</blockquote>
Nakamura subsequently conducted a study on atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), and concluded "The plasma concentrations of ANP and BNP increased after ETS, independent of hemodynamic changes, and apparently because of the release of the inhibitory effects of the cardiac sympathetic nerves on natriuretic peptide secretion." (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Nakamura2005" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Nakamura2005">Nakamura 2005</a>)<br />
<br />
In other words, normally, the SNS inhibits the production of these peptides, so ETS surgery logically would cause them to increase. In turn, the peptides normally inhibit adrenaline production, so the increase in peptides brought on by ETS would further inhibit adrenaline production. Whatever the mechanism, it is now empirically confirmed that ETS surgery lowers blood levels of adrenaline. This could certainly help explain the "lowered alertness" and "chronic fatigue" reported so prevalently in the oral histories. Lowered alertness is also directly reported in empirical literature,, as we shall see in the section on mental functioning.
<br />
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will lower catecholamine levels in the blood.</b>
<br />
<br />
<b>Empirical Status: Confirmed.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<script type="text/javascript">if (window.runOnloadHook) runOnloadHook();</script>
<script type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script>
<script type="text/javascript">
var pageTracker = _gat._getTracker("UA-600316-1");
pageTracker._initData();
pageTracker._trackPageview();
</script><!-- Served in 9.375 secs. --><!-- Cached 20130417150101 -->
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-60056676318142767622013-06-18T07:42:00.003-07:002017-09-10T13:13:28.948-07:00Exercise Function<div id="globalWrapper">
<div id="column-content">
<div id="content">
<a href="http://www.blogger.com/null" id="top" name="top"></a>
<br />
<div id="bodyContent">
Bilateral T2-T4 sympathectomy reduces the systolic blood pressure without affecting diastolic blood pressure and lowers the heart rate at rest and during exercise. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kestenholz2002" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kestenholz2002">Kestenholz et al. 2002</a>)<br />
<br />
Baroreflex comes into play during exercise. Exercise increases the oxygen demand by muscles. The control center must respond by shifting to a higher level of homeostasis. Sympathetic tone is elevated. The heart rate increases, the contraction strength increases. Blood pressure goes up. Surface blood vessels constrict, while vessels in the deeper tissue dilate, diverting blood toward the large muscles and vital organs. All of this goes toward delivering more oxygen to muscles and organs.<br />
<br />
Baroreceptors detect the elevated blood pressure, and deliver this message to the control center input. If the blood pressure goes high enough, baroreflex is able to override the oxygen demand message, causing the control center to "put the breaks on" a bit, by withdrawing some sympathetic tone, and increasing parasympathetic. This serves to set an upper limit on how high the blood pressure is allowed to go.
<br />
<a href="http://www.blogger.com/null" id="Cardiac_Response_to_Exercise_After_ETS" name="Cardiac_Response_to_Exercise_After_ETS"></a><br />
<h2>
<span class="mw-headline"> Cardiac Response to Exercise After ETS </span></h2>
In 2002 a group of Japanese surgeons studied the cardiac effects of ETS at rest and during light exercise. Maximal exercise was not studied. Below are their charts, showing reductions in essentially every measure.
<br />
<br />
<br />
<div class="center">
<div class="floatnone">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/negNR1N.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/negNR1N.jpg" /></a></div>
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Changes in Hemodynamic Variables with Exercise after ETS</b>
<br />
</span></center>
<i>CI, cardiac index; HR, heart rate; MAP, mean arterial pressure; RPP, rate-pressure product; SI, stroke index; SVR, systemic vascular resistance. *p<0.05 vs before ETS; **p<0.01 vs before ETS.</i>
</blockquote>
</blockquote>
</blockquote>
The authors measured heart rate, arterial pressure, stroke volume and vascular resistance. Cardiac index is found by multiplying rate by stroke and adjusting for body size. Stroke index is stroke volume adjusted for body size. Rate-pressure-product is found by multiplying rate by pressure. These values were taken at rest (baseline) and during light exercise, both before ETS, and one year after ETS. This chart shows the percentage of change from baseline that occurs during exercise.
<br />
Clearly, ETS surgery reduces every aspect of cardiac response to exercise.
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Combination_of_Individual_Changes" name="Combination_of_Individual_Changes"></a><br />
<h2>
<span class="mw-headline"> Combination of Individual Changes </span></h2>
<a class="image" href="http://www.blogger.com/corposcindosis/File:CardiacExercise1.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="CardiacExercise1.jpg"></a>We see that ETS surgery will significantly reduce every aspect of cardiac response to exercise. We've seen that, typically the patient is unable to raise heart rate above approx. 135 bpm (see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#ReisfeldSiteFAQ" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#ReisfeldSiteFAQ">Reisfeld</a>). This is analogous to having a regulator on a car engine, limiting the maximum speed that it can go. Thus, "putting the breaks on" via baroreflex becomes somewhat of a moot point. Cardiac denervation has ensured that heart rate is already limited well <i>below</i> the limit that would be established via baroreflex anyway, so on a first approximation baroreflex response to exercise is rendered useless. A certain amount of sympathetic withdrawal is no longer possible, because high sympathetic tone is not present to be withdrawn. However, parasympathetic effects are expected to be intact, thus unnaturally dominant.<br />
<br />
We have seen that ETS surgery reduces lung volume, and reduces the efficiency of carbon dioxide transfer out of the blood. We have seen that blood vessels are less able to redistribute blood into deep tissue. We have seen that blood catecholamine levels are lowered. We have seen that the brain is not selectively cooled during exercise.<br />
<br />
Put all of this together, and the following prediction appears self-evident:
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will reduce overall exercise capacity.</b>
<br />
<br />
<b>Empirical Status: Unstudied.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
We call for empirical research into the effects of thoracic sympathectomy on exercise capacity. Patients should be warned about reductions to every aspect of cardiac function, diminished lung volume, etc.
</div>
</div>
</div>
</div>
<script type="text/javascript">if (window.runOnloadHook) runOnloadHook();</script>
<script type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script>
<script type="text/javascript">
var pageTracker = _gat._getTracker("UA-600316-1");
pageTracker._initData();
pageTracker._trackPageview();
</script><!-- Served in 9.375 secs. --><!-- Cached 20130417150101 -->
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-69384884944323532822013-06-18T07:37:00.001-07:002013-06-27T13:38:31.874-07:00Glossary
<br />
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>atrophic - </b><span style="font-size: small;">[ey-<b>trof</b>-ic] <i>adjective - </i>decreasing in size, especially referring to muscle mass</span><b> </b></span><br />
<br />
<span style="font-size: 14.0pt;"><b>compensatory hyperhidrosis</b></span>
[com-<b>pen</b><span style="font-weight: normal;">-suh-tor-ee </span><b>hi</b><span style="font-weight: normal;">-per-hi-</span><b>droh</b><span style="font-weight: normal;">-sis] <i>noun</i></span> – a side effect of ETS characterized by
extreme sweating below the nipple line</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>corposcindosis</b></span>
[<b>kor</b><span style="font-weight: normal;">-poh-sin-</span><b>doh</b><span style="font-weight: normal;">-sis] <i>noun</i></span> – an autonomic neuropathy
in which sympathetic nerve function has been divided into two distinct bodily
regions – an upper region that is paralyzed, and a lower region that is still
functional and potentially hyperactive. </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>endoscopic</b></span>
[en-duh-<b>skop-</b><span style="font-weight: normal;">ik] <i>adjective – </i></span>utilizing
an endoscope (a surgical instrument with a small camera connected to a video
display)</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>ETS<span style="mso-spacerun: yes;"> </span></b></span><b>(endoscopic thoracic
sympathectomy)</b><span style="font-weight: normal;"> <i>noun –</i></span> a
surgical procedure, utilizing an endoscope, in which part of the sympathetic
chain in the upper thoracic region is destroyed. </div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>ganglion</b></span> [<b>gang</b><span style="font-weight: normal;">-glee-on] <i>noun -</i></span> a mass of nerve cell
bodies, typically linked by synapses, and often forming a swelling on a nerve
fiber</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>homeostasis</b></span> [<span class="pron">hoh-mee-</span><span class="ital-inline">oh</span><span class="pron">-</span><span class="boldface"><b>stey</b></span><span class="pron">-sis] <i>noun</i></span><span class="pron"> -</span> the tendency of a system, especially the physiological
system of higher animals, to maintain internal stability, owing to the
coordinated response of its parts to any situation or stimulus that would tend
to disturb its normal condition or function<br />
<br />
<span style="font-size: 14.0pt;"><b>hypertrophic</b></span> [hie-per-<b>trof</b>-ic<span style="font-weight: normal;">] <i>adjective – </i></span>increasing in size, especially referring to muscle mass</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>neuropathy</b></span>
[nur-<b>ah</b><span style="font-weight: normal;">-puh-thee] <i>noun – </i></span>a
disease of the nervous system<br />
<br />
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>necrosis</b></span>
[nek-<b>roh-</b>sis<span style="font-weight: normal;">] <i>noun – </i></span>cell death</div>
</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>side effect</b></span> <i>noun
- </i><span style="font-style: normal;">any effect of a drug, chemical, or
surgery that is in addition to its intended effect, especially an effect that
is harmful or unpleasant</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>sympathectomy</b></span>
[sim-puh-<b>thek</b><span style="font-weight: normal;">-tuh-mee]<span style="mso-spacerun: yes;"> </span><i>noun -</i></span> a surgical
procedure in which some part of the sympathetic chain is destroyed</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>sympathetic chain</b></span>
[sim-puh-<b>thet</b><span style="font-weight: normal;">-ik cheyn] <i>noun </i></span>–
a portion of the sympathetic nervous system, comprised of two chains of nerve
ganglia, running along either side of the spine</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>thermoregulation</b></span>
[<span class="pron"><b>thur</b></span><span class="pron">-moh-reg-y</span><span class="ital-inline">uh</span><span class="pron">-</span><span class="boldface"><b>ley</b></span><span class="pron">-sh</span><span class="ital-inline">uh] <i>noun -</i></span><span class="ital-inline"> the regulation of body temperature</span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-size: 14.0pt;"><b>thoracic</b></span> [thaw-<b>ras-</b><span style="font-weight: normal;">ik] <i>adjective – </i></span>in the chest area</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-72392692594172942132013-06-18T07:36:00.000-07:002017-08-28T22:40:41.408-07:00Brain(this page still under construction)<br />
<h2>
<span style="font-size: large;">
Bloodflow to the Brain</span></h2>
The constriction of arteries is under sympathetic control. Post sympathectomy, we would expect an immediate loss of constriction in the cerebral artery, thus more blood delivered to the brain. This is confirmed in the 1999 study by Jeng which found:<br />
<br />
<blockquote class="tr_bq">
Patients who underwent T-2 sympathectomy demonstrated a significant
increase in blood flow volume and flow velocities of the Corotid Artery (CA) and Middle Cerebral Artery (MCA),
especially on the left side. Asymmetry of sympathetic influence on the
hemodynamics of the CAs and MCA was noted. (<a href="http://corposcindosis.blogspot.com/2013/05/references.html#jeng1999">Jeng et. al 1999</a>). </blockquote>
Another human study measured a blood flow increase of 40-50% in both gray and white
brain matter after sympathectomy. <br />
<br />
However, Cannon's Law would suggest that over time, the arteries will become super-sensitive to neurotransmitters, and that small amounts of blood-born adrenaline will serve to constrict the arteries, and restrict blood flow to the brain. Russian researchers appear to have made such a finding in rat studies. <br />
<blockquote class="tr_bq">
The effect of cerebral ischemia was virtually indistinguishable from the action of Cervical Sympathectomy itself. (<a href="http://corposcindosis.blogspot.com/2013/05/references.html#gonorova1982">Govorova 1982</a>)</blockquote>
"Cerebral ischemia" simply means a condition where there is insufficient blood flood to meet the metabolic demands. Japanese researchers also noticed troubling results in the brains of sympathectomized rats:<br />
<blockquote class="tr_bq">
After a 1-hour study, the specific gravity
of the cerebral tissue in the treated group significantly decreased;
electron microscopic studies at that time revealed brain edema. It is
suggested that depletion of brain noradrenaline levels causes a
disturbance in cerebral microvascular tone and renders the cerebral
blood vessels more vulnerable to hypertension. (<a href="http://corposcindosis.blogspot.com/2013/05/references.html#Kobayashi1991">Kobayashi 1991</a>) </blockquote>
<h2>
<span style="font-size: large;">
Learning and Task Completion </span></h2>
<br />
A 1976 study on rats raised some interesting questions. It was
discovered that sympathectomy reduced a rat's ability to learn to escape
and avoid. (see <a href="http://corposcindosis.blogspot.com/2013/05/references.html#Lord1976">Lord 1976</a>)<br />
<br />
<h2>
<span style="font-size: large;">Pineal Gland and Melatonin</span></h2>
<div class="separator" style="clear: both; text-align: center;">
</div>
<blockquote class="imgur-embed-pub" data-id="a/PgF2b" lang="en">
<a href="https://imgur.com/PgF2b"></a></blockquote>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwNN1tZL98BEnwuIZCIRKj0EEjJf2NZHiT_ACH1w00y0HT7FLcHaAXTp5em5CXXhInos-FLmuHhz2tkb7zMyUhelWpcVykiSrcgjfuvyL575V-Fp6r-W3zOj5yAESYc8jxZj-dg-9BU_o/s1600/PinealGlandChart.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="400" data-original-width="482" height="265" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwNN1tZL98BEnwuIZCIRKj0EEjJf2NZHiT_ACH1w00y0HT7FLcHaAXTp5em5CXXhInos-FLmuHhz2tkb7zMyUhelWpcVykiSrcgjfuvyL575V-Fp6r-W3zOj5yAESYc8jxZj-dg-9BU_o/s320/PinealGlandChart.JPG" width="320" /></a></div>
<br />
<blockquote class="tr_bq">
The amount of 6-sulphatoxymelatonin, the chief metabolite of melatonin, in the urine was measured in nine patients, who were subjected to bilateral sympathectomy at the second thoracic ganglionic level for treatment of hyperhidrosis of the palms. All patients showed before surgery had a normal 6-sulphatoxymelatonin excretion with a peak in the excretion during the night time. After the sympathectomy, the high night time excretion was clearly abolished in five patients but remained high in four patients. This indicates that the segmental locations of the preganglionic sympathetic perikarya in the spinal cord, stimulating the melatonin secretion in the pineal gland in humans, vary between individuals. (<a href="http://corposcindosis.blogspot.com/2013/05/references.html#Moeller2006">Moeller 2006</a>)</blockquote>
<br />
<h2>
</h2>
<h2>
<span style="font-size: large;">
Direct Brain Effects vs. Body State Changes</span></h2>
Owing to the work of psychiatrist / surgeon Timo Telaranta and others, thoracic sympathectomy has been shown effective in diminishing the subjective experience of alertness, fear and excitement. His Privatix clinics in Finland and Italy have operated on thousands of patients suffering from panic disorders, schizophrenia, and other psychiatric conditions. To what extent is this attributable to changes in bodily effectors, and to what extent is brain function altered per se?Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-10797313006687513552013-06-18T07:32:00.002-07:002017-09-23T16:07:45.442-07:00Compensatory Hyperhidrosis<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Compensatory_Changes";
var wgTitle = "Compensatory Changes";
var wgAction = "view";
var wgArticleId = "1294";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2470;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="https://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><!--
<rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#"
xmlns:dc="http://purl.org/dc/elements/1.1/"
xmlns:trackback="http://madskills.com/public/xml/rss/module/trackback/">
<rdf:Description
rdf:about="http://editthis.info/corposcindosis/Compensatory_Changes"
dc:identifier="http://editthis.info/corposcindosis/Compensatory_Changes"
dc:title="Compensatory Changes"
trackback:ping="http://editthis.info/corposcindosis/trackback.php?article=Compensatory_Changes" />
</rdf:RDF>
-->
<br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<a href="http://www.blogger.com/null" id="top" name="top"></a>
<br />
<br />
<div id="bodyContent">
The most well-documented symptom of corposcindosis is “compensatory hyperhidrosis”. While patients cannot sweat at all above the nipple line, they tend to sweat profusely on the rest of the body.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/LFTzMIu.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/LFTzMIu.jpg" height="400" width="306" /></a></div>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/9HpnASF.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/9HpnASF.jpg" height="400" width="400"> </a></div>
<div class="separator" style="clear: both; text-align: center;">
<a class="image" href="http://www.blogger.com/corposcindosis/File:ChestCH.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="ChestCH.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:FootCH.JPG" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="FootCH.JPG"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:BackCH.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="BackCH.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:BreakCycle.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="BreakCycle.png"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Privatix_table.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Privatix table.png"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:FearMRI.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="FearMRI.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:PET_PAF.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="PET PAF.png"></a><a href="https://i.imgur.com/LFLHhuQ.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/LFLHhuQ.jpg"></a></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Compensatory Hyperhidrosis</b>
<br />
</span></center>
<i>The most common areas for compensatory hyperhidrosis are the abdomen, lower back, crotch, and the backs of the legs. Complaints of soaked underwear or shirts are common. Patients report sweating at lower temperatures than before surgery, greater volumes of perspiration, and longer times waiting for sweating to stop.</i>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<a href="http://www.blogger.com/null" id="Mechanism_for_Compensatory_Hyperhidrosis" name="Mechanism_for_Compensatory_Hyperhidrosis"></a><br />
<h2>
<span class="mw-headline"> Mechanism for Compensatory Hyperhidrosis </span></h2>
Compensatory hyperhidrosis is also referred to as “compensatory sweating” and “reflex sweating”. The mechanism of this surgically-induced excessive lower body sweating is “poorly understood” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kopelman2000" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kopelman2000">Kopelman et al. 2000</a>). Some hypotheses have been advanced:
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="The_.22compensatory_cooling.22_hypothesis" name="The_.22compensatory_cooling.22_hypothesis"></a><br />
<h3>
<span class="mw-headline">The "compensatory cooling" hypothesis</span></h3>
The body cannot sweat on part of the body, so it compensates for the loss of evaporative cooling in that area by creating more evaporative cooling in another area.<br />
<br />
Given the nature of the autonomic nervous system to maintain homeostasis by compensating in response to stressors, this hypothesis has an immediate plausibility. However, under this hypothesis, simply wetting the head and shoulders with water (imitating the lost sweating) would be expected to relieve compensatory hyperhidrosis. Several ETS patients have reported that compensatory hyperhidrosis occurs regardless of putting water on the head and shoulders.
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="The_.22reflex.22_hypothesis" name="The_.22reflex.22_hypothesis"></a><br />
<h3>
<span class="mw-headline">The "reflex" hypothesis</span></h3>
Nerve impulses from the lower body travel upwards along the sympathetic chain and encounter dead ends and scar tissue, which causes a rebounding or reflexive signal to be sent back down the chain, stimulating excessive lower-body sweating.
<br />
The CS model generates a third hypothesis that may explain or at least contribute to the phenomenon:
<br />
<a href="http://www.blogger.com/null" id="The_.E2.80.9Cfalse_message.E2.80.9D_hypothesis" name="The_.E2.80.9Cfalse_message.E2.80.9D_hypothesis"></a><br />
<h3>
<span class="mw-headline">The “false message” hypothesis</span></h3>
“The local and mean skin temperature are important for providing sensory input [to the control center]” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kenney" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kenney">Kenney</a>). Recall that thermoreceptors located in the denerved area are surrounded by skin that is up to 12 degrees F hotter than normal (see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Gyftokostas1992" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Gyftokostas1992">Gyftokostas et al. 1992</a>). Messages about environment temperature are exaggerated, leading to exaggerated sweating response.
<br />
We call for more empirical research on total body sweating, and the etiology of compensatory hyperhidrosis. Patients should be warned about compensatory hyperhidrosis.
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Total_Body_Perspiration" name="Total_Body_Perspiration"></a><br />
<h2>
<span class="mw-headline"> Total Body Perspiration </span></h2>
While historically used to treat a variety of complaints, currently the most common indication for ETS surgery is “hyperhidrosis”, that is excessive sweating. Patient consent is ordinarily premised around a desire to “reduce” the excessive sweating. (see <a class="external text" href="http://editthis.info/corposcindosis/Addenbrooke_Consent_Form" rel="nofollow" title="http://editthis.info/corposcindosis/Addenbrooke_Consent_Form">Addenbrooke consent form</a>). A natural curiosity would lead us to wonder whether the surgery actually reduced the total amount of sweating, or in fact increased it. Thusfar, only one study has attempted to answer that question.
<br />
<blockquote>
“The effect of upper dorsal thoracoscopic sympathectomy on the total amount of body perspiration.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kopelman2000" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kopelman2000">Kopelman et al. 2000</a>)
</blockquote>
By 2000, Israeli surgeons Hashmonai, Kopelman and colleagues had noticed that “<b>compensatory hyperhidrosis is a disturbing sequela of this operation</b>”. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kopelman2000" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kopelman2000">Kopelman et al. 2000</a>, emphasis added). They conducted a very straightforward test on their ETS patients. They weighed the subjects, then sent them into the sauna to sweat for 10 minutes, then weighed them again to see how much water had been lost. This process was done before and after surgery.
<br />
<blockquote>
“The amount of perspiration induced by the sauna bath ranged from 60 to 480 g, with a mean value of 185.29 +/- 125.80 g, before the operation, and from 60 to 540 g, with a mean value of 265.88 +/- 154.05 g, after the operation (P = 0.0113).” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kopelman2000" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kopelman2000">Kopelman et al. 2000</a>).
</blockquote>
Total body sweating has increased 43% on average.<br />
<br />
Let’s see what these numbers actually describe. Body sweating has been divided into two distinct regions, an upper region comprising about 1/3 of total body surface which can no longer sweat at all, and a lower region comprising the remaining 2/3 of total body surface which now sweats so hyperactively that total body sweating is 43% higher than it was initially. Since the 43% total increase is being generated by only 67% of the body surface, that part of the body must have increased its sweating by 113%. (67% x 213% = 143%). In other words, the lower body now sweats more than twice as much as it did before surgery.<br />
<br />
Thus Koppelman casts serious doubt on the efficacy of ETS as hyperhidrosis treatment. If the goal is reduced sweating, thoracic sympathectomy is highly unlikely to achieve that. Research on total body sweating is called for. Patients should be warned that total body sweating is expected to go up, not down.
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Sexual_Function" name="Sexual_Function"></a><br /></div>
</div>
</div>
</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-47667455443123932982013-06-15T18:07:00.001-07:002017-09-23T15:57:41.498-07:00Thyroid<script type="text/javascript">/*<![CDATA[*/
var skin = "monobook";
var stylepath = "/skins";
var wgArticlePath = "/corposcindosis/$1";
var wgScriptPath = "/corposcindosis";
var wgScript = "/corposcindosis/";
var wgVariantArticlePath = false;
var wgActionPaths = {};
var wgServer = "http://editthis.info";
var wgCanonicalNamespace = "";
var wgCanonicalSpecialPageName = false;
var wgNamespaceNumber = 0;
var wgPageName = "Changes_to_Individual_Effectors,_part_3";
var wgTitle = "Changes to Individual Effectors, part 3";
var wgAction = "view";
var wgArticleId = "1291";
var wgIsArticle = true;
var wgUserName = null;
var wgUserGroups = null;
var wgUserLanguage = "en";
var wgContentLanguage = "en";
var wgBreakFrames = false;
var wgCurRevisionId = 2467;
var wgVersion = "1.15.1";
var wgEnableAPI = true;
var wgEnableWriteAPI = true;
var wgSeparatorTransformTable = ["", ""];
var wgDigitTransformTable = ["", ""];
var wgRestrictionEdit = ["sysop"];
var wgRestrictionMove = ["sysop"];
/*]]>*/</script>
<script src="https://code.jquery.com/jquery-1.6.1.min.js" type="text/javascript"></script>
<script src="/skins/common/wikibits.js?207" type="text/javascript"><!-- wikibits js </script><br />
<h2>
<span class="mw-headline"> <span style="font-size: large;">Sympathetic Innervation of Thyroid </span></span></h2>
The thyroid is located in the neck, and is a two sided gland responsible for releasing various hormones into the blood. It is predominantly controlled by Thyroid Stimulating Hormone (TSH) released by the pituitary, which in turn is regulated by the hypothalamus. This much has been known for some time. Additionally, the thyroid has sympathetic innervation, the role of which is less clear. The chemical iodide is absorbed by the thyroid, and converted into iodine, which is essential for proper thyroid function.
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/T8Wi8dT.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/T8Wi8dT.jpg" /></a></div>
<br />
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<b>Schematic of Sympathetic Innervation of the Thyroid</b>
</center>
</blockquote>
</blockquote>
</blockquote>
<a href="http://www.blogger.com/null" id="Thyroid_PET_Scan_After_ETS" name="Thyroid_PET_Scan_After_ETS"></a><span style="font-size: large;"><br /></span>
<br />
<h2>
<span class="mw-headline" style="font-size: large;"> Thyroid PET Scan After ETS </span></h2>
<div class="center">
<div class="floatnone">
</div>
</div>
<div class="separator" style="clear: both; text-align: center;">
<a class="image" href="http://www.blogger.com/corposcindosis/File:Thyroid.gif" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Thyroid.gif"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Thyroid.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Thyroid.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Bone_pic_1.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Bone pic 1.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Bone_remodel_pic.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Bone remodel pic.jpg"></a><a href="https://i.imgur.com/MyuVIM2.gif?1" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/MyuVIM2.gif?1"></a></div>
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<b>PET Scan of Neck After T2-T4 ETS </b>
</center>
</blockquote>
</blockquote>
</blockquote>
<i> Flourodopamine PET scan of the human neck after T2-T4 sympathectomy. The butterfly-shaped outline indicates the approximate location of the thyroid. According to NIH’s David Goldstein, who took the scan, the lack of yellow-orange-red color within the outline indicates total sympathetic denervation of the thyroid. A normal scan is sought for comparison.</i>
<br />
<br />
Thus we find evidence that the thyroid gland is innervated entirely between T2 and T4. More data are sought.
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Rat_Thyroid_Study" name="Rat_Thyroid_Study"></a><br />
<h2>
<span class="mw-headline"> <span style="font-size: large;">Rat Thyroid Study </span></span></h2>
What is the role of the SNS on thyroid function? Scientists at Northwestern University were puzzled, so they denerved rat thyroids on one side only. They injected a radioactive form of iodide known as 125I, so that the results on iodide uptake could be visualized.<br />
<br />
“Unilateral superior cervical ganglion decentralization led to a reduction in thyroid weight, in 125I uptake by thyroid tissue, and in TSH-induced stimulation of 125I uptake in decentralized hemithyroids. These results suggest that sympathetic activity in thyroid contributes to gland enlargement and may modulate tissue responsiveness to TSH.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#young2005" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#young2005">Young et al., 2005</a>).
<br />
<br />
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will reduce iodide uptake by the thyroid.</b>
<br />
<br />
<b>Empirical status: Confirmed in rats, unstudied in humans.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will reduce thyroid weight.</b>
<br />
<br />
<b>Empirical Status: Confirmed in rats, unstudied in humans.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
<br />
Iodine deficiency is associated with hypothyroidism (low thyroid function), thus:
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will cause hypothyroidism.</b>
<br />
<br />
<b>Empirical status: Unstudied.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
<br />
<br />
Some of the symptoms of hypothyroidism are similar to some of the common anecdotal complaints of ETS patients. From the Mayo Clinic website, we gather:
<br />
<a href="http://www.blogger.com/null" id="Symptoms_of_Hypothyroidism" name="Symptoms_of_Hypothyroidism"></a><br />
<h2>
<span class="mw-headline"><span style="font-size: large;"> Symptoms of Hypothyroidism</span> </span></h2>
<ul>
<li> Increased sensitivity to cold
</li>
<li> Constipation
</li>
<li> Pale, dry skin
</li>
<li> A puffy face
</li>
<li> Hoarse voice
</li>
<li> An elevated blood cholesterol level
</li>
<li> Unexplained weight gain
</li>
<li> Muscle aches, tenderness and stiffness
</li>
<li> Pain, stiffness or swelling in your joints
</li>
<li> Muscle weakness
</li>
<li> Heavier than normal menstrual periods
</li>
<li> Depression
</li>
</ul>
<a href="http://www.blogger.com/null" id="Eyes_and_Eyelids" name="Eyes_and_Eyelids"></a><br />
<script type="text/javascript">if (window.runOnloadHook) runOnloadHook();</script>
<script type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script>
<script type="text/javascript">
var pageTracker = _gat._getTracker("UA-600316-1");
pageTracker._initData();
pageTracker._trackPageview();
</script><!-- Served in 1.655 secs. --><!-- Cached 20130419230759 -->
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-47884947819296029452013-06-15T17:57:00.002-07:002017-09-23T15:48:38.547-07:00Bone<link href="/favicon.ico" rel="shortcut icon"></link>
<link href="/corposcindosis/opensearch_desc.php" rel="search" title="Corposcindosis (en)" type="application/opensearchdescription+xml"></link>
<link href="/corposcindosis/?title=Special:RecentChanges&feed=rss" rel="alternate" title="Corposcindosis RSS Feed" type="application/rss+xml"></link>
<link href="/corposcindosis/?title=Special:RecentChanges&feed=atom" rel="alternate" title="Corposcindosis Atom Feed" type="application/atom+xml"></link>
<title>Changes to Individual Effectors, part 3 - Corposcindosis</title>
<link href="/skins/common/shared.css?207" media="screen" rel="stylesheet" type="text/css"></link>
<link href="/skins/common/commonPrint.css?207" media="print" rel="stylesheet" type="text/css"></link>
<link href="/skins/monobook/main.css?207" media="screen" rel="stylesheet" type="text/css"></link><br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<div id="bodyContent">
<table class="toc" id="toc" summary="Contents"><tbody>
<tr><td><br /></td></tr>
</tbody></table>
<h2>
<span style="font-size: large;">
Samuel Ahn Statement</span></h2>
<br />
UCLA surgeon Samuel Ahn has theorized that ETS surgery would affect bone metabolism. At an educational conference in 2005, Ahn said:
<br />
<blockquote>
“Theoretically, if you cut the sympathetic nerves, you could interfere with bone metabolism . . .The reason I say that is because RSD [Reflex Sympathetic Dystrophy] is an over-activity of the sympathetic nerve. . . and we know that in RSD . . .we get a positive bone scan . . . because the bones are more active. So reverse this. If you take away the sympathetic drive to that bone area, you will decrease that metabolic activity in bone growth. And you could theoretically interfere with the bone metabolism and the bone strength. . .And that has been mentioned in the literature.” (edited for clarity, see Ahn 2005)
</blockquote>
<br />
<h2>
<span class="mw-headline" style="font-size: large;"> Bone Remodeling </span></h2>
Bones remodel themselves continually. They are constantly releasing calcium into the blood, while at the same time forming new bone from within. The cells which release calcium are called “osteo<i>clasts</i>”, and this process is called “resorption”. The cells which lay down new bone are called “osteo<i>blasts</i>”. In addition to laying down new bone, these osteoblasts also have the job of making new osteoclast cells.<br />
<br />
As with everything else, the control center is constantly trying maintain homeostasis of bone metabolism. “In the bone microenvironment, there is a dynamic balance between resorption and formation that maintains skeletal homeostasis”. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kondo2003" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kondo2003">Kondo et al. 2003</a>)<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/fwgWJxR.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/fwgWJxR.jpg" /></a></div>
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<b>Schematic of Bone Remodeling</b>
</center>
</blockquote>
</blockquote>
</blockquote>
</div>
</div>
</div>
</div>
<br />
<i>The control center (hypothalamus) receives signals from leptin in the blood. Acting on this information, it communicates to the osteoblast cells via the sympathetic nervous system.</i>
<br />
<br />
<br />
Ahn’s theorizing turns out to have tremendous merit. The notion that the sympathetic nervous system regulates bone metabolism has become accepted scientific fact. For example:<br />
<br />
“Bone remodeling, the mechanism by which vertebrates regulate bone mass, comprises two phases, namely resorption by osteoclasts and formation by osteoblasts; osteoblasts are multifunctional cells also controlling osteoclast differentiation. <b>Sympathetic signaling</b> via beta2-adrenergic receptors (b2-AR) present on osteoblasts <b>controls bone formation</b> downstream of leptin.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Elefteriou2005" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Elefteriou2005">Elefteriou et al. 2005</a>, emphasis added)<br />
<br />
“Bone formation and osteoblast function are regulated by the sympathetic nervous system (SNS)” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Takeda2002" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Takeda2002">Takeda et al. 2002</a>)<br />
<br />
A team of Norwegian scientists put it this way: “<b>Sympathetic nerves are <i>known</i> to modulate bone resorption and bone remodeling</b>.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bletsa2004" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bletsa2004">Bletsa 2004</a>, emphasis added)
<br />
Thus it appears obvious that sympathectomy is going to alter bone metabolism in some way, the question is, how exactly? And, it would also be nice to know which bones, exactly, become denerved in thoracic sympathectomy. There appears to be a great lack of empirical data on patterns of SNS innervation to bone and bone marrow. More research is called for, and patients should be warned about potential changes in bone metabolism before consenting to ETS surgery.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/9uDpi7a.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/9uDpi7a.jpg"></a></div>
<br />
<div class="center">
<div class="floatnone">
<br /></div>
</div>
<a class="image" href="http://www.blogger.com/corposcindosis/File:Bone_pic_1.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Bone pic 1.jpg"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Bone_remodel_pic.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Bone remodel pic.jpg"></a>Does bone denervation follow the skin pattern, thus denerving the top 1/3 of the body’s bone mass? It seems certain that all bone in the arms and hands would have to be denerved. But perhaps the skull, jaw, ear bones, and/or teeth receive sympathetic innervation from somewhere above T2-T4. More data are sought.<br />
<br />
“The distinct effects of SP and catecholamines on the bone cells together with their in vivo influences manifested by experimental denervation studies suggest that the sensory and sympathetic nerves play important roles in bone metabolism.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Imai2002" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Imai2002">Imai et al. 2002</a>)<br />
<br />
Yes, but what, exactly, is going to change about bone function in the denerved area?
<br />
<a href="http://www.blogger.com/null" id="Sympathectomy_and_Bone_Resorption" name="Sympathectomy_and_Bone_Resorption"></a><span style="font-size: large;"><br /></span>
<br />
<h2>
<span style="font-size: large;">
</span><span class="mw-headline"><span style="font-size: large;"> Sympathectomy and Bone Resorption</span> </span></h2>
“Higher numbers of osteoclasts and larger periapical lesions have been observed after sympathectomy in rats” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bletsa2004" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bletsa2004">Bletsa 2004</a>)<br />
<br />
“The sympathetic nervous system . . . has a significant effect on resorption by inhibiting preosteoclast differentiation and disturbing osteoclast activation. These data suggest that depletion of sympathetic mediators may disturb osteogenic cell-mediated osteoclast differentiation.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Cherruau1999" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Cherruau1999">Cherruau et al. 1999</a>)
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will increase bone resorption in the denerved area.</b>
<br />
<br />
<b>Empirical status: Confirmed in rats and gerbils, unstudied in humans.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
“Sympathectomy increases bone resorption in gerbilline middle ear bone” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Sherman2001" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Sherman2001">Sherman et al. 2001</a>).
<br />
Considering Sherman, a group of Norwegian orthodontists wanted to learn about resorption of teeth, so they performed sympathectomies on rats, (and gave them braces!)<br />
<br />
They found that “Sympathectomy causes increased root resorption after orthodontic tooth movement in rats”. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Haug2003" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Haug2003">Haug et al. 2003</a>)<br />
<br />
If sympathectomy changes bone resorption, how might it affect other aspects of bone metabolism?
<br />
<a href="http://www.blogger.com/null" id="Sympathectomy_and_Cytokine_Production" name="Sympathectomy_and_Cytokine_Production"></a><span style="font-size: large;"><br /></span>
<br />
<h2>
<span class="mw-headline" style="font-size: large;"> Sympathectomy and Cytokine Production </span></h2>
“Cytokines” are chemical messengers of the immune system, for example interluken, and tumor necrosis factor (TNF). Tumor Necrosis Factor helps kill tumors. Could sympathectomy affect the production of cytokines? The Norwegian orthodontists wondered the same thing, so the following year they did more rat sympathectomies to look for changes in the production of cytokines Interlukin 1 alpha and TNF alpha in their teeth.<br />
<br />
“This study suggests that sympathetic nerves have an inhibitory effect on IL-1alpha . . .and a stimulatory effect on TNF-alpha in the intact rat pulp.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bletsa2004" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bletsa2004">Bletsa 2004</a>)
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will result in increased production of Interluken 1 alpha.</b>
<br />
<br />
<b>Empirical Status: Confirmed in rats, unstudied in humans.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will result in decreased production of TNF-alpha.</b>
<br />
<br />
<b>Empirical status: Confirmed in rats, unstudied in humans.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<a href="http://www.blogger.com/null" id="Leptin" name="Leptin"></a><br />
<h2>
<span class="mw-headline"> <span style="font-size: large;">Leptin </span></span></h2>
Leptin is a hormone released by fat cells into the blood stream. It acts as a chemical messenger by interacting with receptors in the hypothalamus. Enough leptin in the blood tells the control center “we’re full, stop eating”. But leptin also regulates bone metabolism.<br />
<br />
Leptin regulates bone metabolism via the SNS, this much is clear. It has been suggested that perhaps there is a negative feedback loop, wherein the reverse is also true. Perhaps the SNS also is able to regulate leptin production in some way. Some doctors at a VA hospital in Iowa thought so, and reported in their 2003 paper “There is evidence that sympathoadrenal stimulation inhibits leptin mRNA expression and secretion from white adipose tissue through beta adrenergic mechanisms.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Mark2003" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Mark2003">Mark et al. 2003</a>)<br />
<br />
We’ve already learned that sympathectomy will increase fat cell count and mass, which would lead to an increase in leptin. Now we see evidence that the normal SNS inhibits the production of leptin, so sympathectomy would be predicted increase the production of leptin even disregarding the higher fat cell count and mass.
<br />
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will increase the production of leptin</b>
<br />
<br />
<b>Empirical Status: Not studied.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
What is the effect of leptin on bone metabolism? “Leptin is a powerful inhibitor of bone formation in vivo.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Elefteriou2004" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Elefteriou2004">Elefteiou et al. 2004</a>). This would tend to reinforce the bone resorption increase already noted. Calcium lost form bone must go somewhere, and that somewhere is into the blood. Considering this extra calcium, and considering the lowered blood catecholamines, we can offer the next prediction.
<br />
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will increase calcification of arteries.</b>
<br />
<br />
<b>Empirical Status: Confirmed in lumbar sympathectomy on humans, not studied in thoracic sympathectomy.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Sympathectomy_and_Monckeberg.E2.80.99s_Sclerosis" name="Sympathectomy_and_Monckeberg.E2.80.99s_Sclerosis"></a><span style="font-size: large;"><br /></span>
<br />
<h2>
<span class="mw-headline" style="font-size: large;"> Sympathectomy and Monckeberg’s Sclerosis </span></h2>
Back in 1983 a pair of surgeons were experimenting using lumbar sympathectomy to treat the circulation problems associated with diabetes. After 6-8 year follow up, they discovered that sympathectomy was causing a severe calcification of the arteries, a condition known as “Monckeberg’s Sclerosis”. It became especially clear to them because they had a number of patients who had only been sympathectomized on one side, and the incidence of the calcification was far higher on that side.<br />
<br />
“After unilateral sympathectomy the incidence of calcified arteries on the side of operation was significantly higher than that on the contralateral side (88% versus 18%, p less than 0.01). In conclusion, <b>sympathetic denervation is one of the causes of Monckeberg's sclerosis</b> regardless of diabetes mellitus.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Goebel1983" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Goebel1983">Goebel et al. 1983</a>, emphasis added)
<br />
<a href="http://www.blogger.com/null" id="Bone_Marrow_Stem_Cells" name="Bone_Marrow_Stem_Cells"></a><span style="font-size: large;"><br /></span>
<br />
<h2>
<span class="mw-headline" style="font-size: large;"> Bone Marrow Stem Cells </span></h2>
2006 saw the publication of an article entitled “Signals from the Sympathetic Nervous System Regulate Hematopoietic Stem Cell Egress from Bone Marrow”. Hematopoietic stem cells and progenitor cells, or HSPCs, are the precursors for red blood cells. We learn from the paper that “Hematopoietic stem and progenitor cells (HSPCs) reside in specific niches that control survival, proliferation, self-renewal, or differentiation in the bone marrow (BM). <b>The sympathetic nervous system regulates the attraction of stem cells to their niche.</b>” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Katayama2006" rel="nofollow" title="http://www.corposcindosis.blogspot.com/2013/05//references.html#Katayama2006">Katayama, et. al. 2006</a>, emphasis added).
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="background: #FFFF99; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will cause hematopoitec stem cells to not be attracted to their proper niches within bone marrow, in the denerved region.</b>
<br />
<br />
<b>Empirical Status: Not studied.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<a href="http://www.blogger.com/null" id="Thyroid_Gland" name="Thyroid_Gland"></a><br />
<br />
<script type="text/javascript">if (window.runOnloadHook) runOnloadHook();</script>
<script type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script>
<script type="text/javascript">
var pageTracker = _gat._getTracker("UA-600316-1");
pageTracker._initData();
pageTracker._trackPageview();
</script><!-- Served in 1.655 secs. --><!-- Cached 20130419230759 -->
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-83697150009566565242013-06-01T20:29:00.002-07:002013-06-01T20:33:02.602-07:00Grey's Anatomy Transcript<h2>
<span class="mw-headline">Transcript of Scenes Involving ETS Surgery</span></h2>
Episode: "Make Me Lose Control"
<br />
Author: Krista Vernoff
<br />
Medical Advisor: Karen Pike, MD
<br />
<br />
Pre Op room, Dr. KAREV and three female nurses surround the patient’s bed.
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
DR. KAREV <br />
Kelly Roche, 23 years old, in for a scheduled ETS for treatment of erythrophobia and hypopyrexia.<br />
<br />
FEMALE NURSE 1<br />
(Whispering) Erythrophobia?<br />
<br />
FEMALE NURSE 2<br />
(consulting dictionary) Blushing.<br />
<br />
FEMALE NURSE 3<br />
Do you have any questions about the procedure?<br />
<br />
KELLY<br />
Dr. Sh….(sigh, bright red cheeks) Dr. Sheppard explained everything, he
was very (gulp) helpful, he gave me some literatu . . .(fanning cheeks
furiously with hand) . . .sorry. . .<br />
<br />
<div class="center">
<div class="floatnone">
<a class="image" href="http://editthis.info/corposcindosis/File:GreysAnatomyPic004.jpg" title="GreysAnatomyPic004.jpg"><img alt="" border="0" height="238" src="http://editthis.info/images/corposcindosis/3/3a/GreysAnatomyPic004.jpg" width="432" /></a></div>
</div>
DR. KAREV<br />
Don’t be, half the patients that come through here have the hots for Sheppard.<br />
<br />
<br />
FEMALE NURSE 3<br />
(Glaring at Dr. KAREV) Dr. KAREV!?<br />
<br />
<br />
DR. KAREV<br />
Whaaat? It’s true.<br />
<br />
<br />
<hr />
DR. GREY<br />
<br />
Dr. Sheppard?<br />
<br />
<br />
DR. SHEPPARD<br />
<br />
Merideth! I heard. Is it true?<br />
<br />
<br />
DR. GREY<br />
<br />
Yeah, secret’s out. Dr. Sheppard, I . . .<br />
<br />
<br />
DR. SHEPPARD<br />
<br />
You don’t have to call me Dr. Sheppard.<br />
<br />
<br />
DR. GREY<br />
<br />
Dr. Sheppard, I want in on a surgical case. I can’t just do
nothing all day. And you owe me this. And I never ask you for anything
like this, so . . .<br />
<br />
<br />
DR. SHEPPARD<br />
<br />
I have, uh, ETS this afternoon. Go scrub in.<br />
<br />
<br /></blockquote>
</blockquote>
</blockquote>
</blockquote>
<hr />
(Pre Op, Doctor KAREV is feeling Kelly’s neck glands. Dr. Sheppard drops by)<br />
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
DR. SHEPPARD<br />
Hey Kelly.<br />
<br />
KELLY<br />
Dr. Shep . . . (face goes bright red) . . .Dr. Sheppard, (fanning face) God . . . sorry, damn it.<br />
<br />
<div class="center">
<div class="floatnone">
<a class="image" href="http://editthis.info/corposcindosis/File:GreysAnatomyETS1.jpg" title="GreysAnatomyETS1.jpg"><img alt="" border="0" height="333" src="http://editthis.info/images/corposcindosis/0/06/GreysAnatomyETS1.jpg" width="608" /></a></div>
</div>
DR. SHEPPARD<br />
<br />
Kelly?<br />
<br />
<br />
KELLY<br />
<br />
(feeling cheeks, trying to disappear) Yeah?<br />
<br />
<br />DR. SHEPPARD<br />
<br />
Kelly?<br />
<br />
<br />
KELLY<br />
<br />
mm hmm<br />
<br />
<br />
DR. SHEPPARD<br />
<br />
This might be the last time that ever happens. (reassuring smile)<br />
<br />
<br />
DR. KAREV<br />
<br />
Paralapse. H & H are stable, chest x-rays show no acute process.<br />
<br />
<br />
DR. SHEPPARD<br />
<br />
Good! (to Kelly) Are you ready to go?<br />
<br />
<br />
KELLY<br />
<br />
Are you kidding? I’ve been ready since the 3rd grade.<br />
<br />
<br />
DR. SHEPPARD<br />
<br />
Did you read the literature I gave you? Do you understand the possible side effects?<br />
<br />
<br />
KELLY<br />
<br />
Compensatory sweating of the back, abdomen, thighs and legs;
possible gustatory sweating; Horner’s syndrome occurs in less than one
percent of patients; brachial plexus injury, pneumothorax and hemothorax
are highly unlikely but possible side effects of the surgery.<br />
<br />
<br />
DR. SHEPPARD<br />
<br />
You did your homework! Take her to pre op. I’ll alert the O.R.<br />
<br />
<br />
DR. KAREV<br />
<br />
Do you know what all those words mean? Brachial plexus injury
could cause paralysis of the arms. Pneumothorax is a collapsed lung.<br />
<br />
<br />
KELLY<br />
<br />
I know.<br />
<br />
<br />
DR. GREY<br />
<br />
Are you sure you want to risk all of that over a little bit of blushing?<br />
<br />
<br />
KELLY<br />
<br />
Is that what you think this is? A little bit of blushing? Just a
school girl embarrassment? You both saw what happened when Dr. Shep . .
.when Dr. Sheppard was here, what did you think?<br />
<br />
<br />
DR. KAREV<br />
<br />
Well, I thought you liked him.<br />
<br />
<br />
KELLY<br />
<br />
I do, but do you think I want a . . .a roomful of doctors to know about it?<br />
<br />
<br />
DR. KAREV<br />
<br />
It’s not like were gonna tell. . .<br />
<br />
<br />
KELLY<br />
<br />
It’s not just you guys. It’s not just this once, it happens . . .
every time I have a feeling for anyone in my life . . . (fighting back
tears, blushing furiously) . . .I can’t be happy, I can’t feel anything
without everybody in the world knowing . . . (sensitive music enters) . .
.I can’t have a secret . . .can you imagine living that way your entire
life? (C.U. of Dr. Grey empathizing, music lyric “think I’m gonna walk
away . . .”)<br />
<br />
<br /></blockquote>
</blockquote>
</blockquote>
</blockquote>
<hr />
O.R. Dr. Sheppard is operating on Kelly, surrounded by Dr. Grey, nurses and equipment.
<br />
<div class="center">
<div class="floatnone">
<a class="image" href="http://editthis.info/corposcindosis/File:GreysAnatomyPic019.jpg" title="GreysAnatomyPic019.jpg"><img alt="" border="0" height="237" src="http://editthis.info/images/corposcindosis/c/cd/GreysAnatomyPic019.jpg" width="432" /></a></div>
</div>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
DR. SHEPPARD <br />
O.K. Dr. KAREV, if we’re going to stop her blushing . . .We have to
expose the sympathetic ganglion chain, which resides . . . where? (eyes
scan equipment).<br />
<br /></blockquote>
</blockquote>
</blockquote>
</blockquote>
<hr />
<br />
Recovery Room. Dr. Grey, Dr. KAREV and a nurse are at Kelly’s bedside.
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
KELLY<br />
(groggy) Hey.<br />
<br />
DR. GREY<br />
Hey.<br />
<br />
KELLY<br />
Is it over?<br />
<br />
DR. GREY<br />
Mm hmmm. The surgery was successful. We’re just doing a follow up. Dr. Sheppard will in to check on you in a while.<br />
<br />
KELLY<br />
(Not blushing) Say that again.<br />
<br />
DR. KAREV<br />
What?<br />
<br />
KELLY<br />
Say his name, Dr. Shep . . . (not blushing) Oh my God, look at my face.
(big smile). Dr. Shep. ..Dr. Sheppard (a look of pure worship).<br />
<br />
<div class="center">
<div class="floatnone">
<a class="image" href="http://editthis.info/corposcindosis/File:GreysAnatomyETS2.jpg" title="GreysAnatomyETS2.jpg"><img alt="" border="0" height="334" src="http://editthis.info/images/corposcindosis/2/2d/GreysAnatomyETS2.jpg" width="608" /></a></div>
</div>
DR. GREY<br />
<br />
(to Dr. KAREV) I guess it was worth the risk.<br />
<br />
<br /></blockquote>
</blockquote>
</blockquote>
</blockquote>
Drs. Grey and KAREV exit to the hallway.
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
DR. KAREV<br />
I still think it’s a (inaudible) major surgery just so people can’t tell how you’re feelin’.<br />
<br />
DR. GREY<br />
Really, you do?<br />
<br />
DR. KAREV<br />
Nah, I guess not. You can talk, you know, I mean, if you need to.<br />
<br />
DR. GREY<br />
I’m fine.<br />
<br />
DR. KAREV<br />
You’ve said that word so many times today it doesn’t even sound like a
word anymore. I’m just saying you can talk to me ‘cuz, ya know, even if I
repeat every word you say, no one around here likes me, they’ll just
call me a liar and move on.<br />
<br />
DR. GREY<br />
Izzy likes you.<br />
<br /></blockquote>
</blockquote>
</blockquote>
</blockquote>
Dr. Karev turns away and smiles
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
DR. GREY<br />
You’re blushing!</blockquote>
</blockquote>
</blockquote>
</blockquote>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-10956822526645994022013-06-01T19:04:00.001-07:002017-09-24T14:15:40.297-07:00Introduction<table class="toc" id="toc" summary="Contents">
<tbody>
<tr>
<td><br /></td></tr>
</tbody></table>
<h2>
</h2>
<table class="toc" id="toc" summary="Contents"><tbody></tbody></table>
<h2>
<span class="mw-headline" id="Medicine_is_an_Experiment" style="font-size: large;">Medicine is an Experiment</span></h2>
<br />
All of medicine is an experiment. R.Buckminster Fuller famously said of our planet, "Now there is one outstanding important fact regarding spaceship earth, and that is that no instruction book came with it.". The same can be said of the human body. We didn't get an instruction book. Our current considerable knowledge has been gained through centuries of trial and error. The human condition is fraught with, almost defined by, suffering of all sorts. We desire to ease our suffering, to cure our ills, but we don't know how. Thus is born medicine.<br />
<br />
Suffering can be physical, or it can be emotional. For example, some people sweat excessively, or at inappropriate times. Others blush. These are physically harmless conditions, but can cause great embarrassment. We know that sweating and blushing are regulated by the autonomic nervous system, so it is logical to look there for some understanding of what causes these problems, and for how to treat them.<br />
<br />
<h2>
<span class="mw-headline" id="A_Brief_History_of_Sympathectomy" style="font-size: large;">A Brief History of Sympathectomy</span></h2>
<h2>
<span class="mw-headline" id="A_Brief_History_of_Sympathectomy" style="font-size: large;"> </span></h2>
Scientists became fascinated with the idea of sympathectomy in the mid-19th century when it was learned that the autonomic nervous system runs to almost every organ, gland and muscle system in the body, and it was surmised that somehow these nerves must play a role in how the body is able to automatically adjust levels on many different body functions in response to changes in the environment, exercise and emotion. They wondered how exactly it was that the autonomic nervous system was able to do all that, and they wondered what might change if various parts of it were cut out.<br />
<br />
The first sympathectomy was performed by Dr. Alexander in 1889. Since the sympathetic nervous system was well known to affect many body systems, the surgery was performed in attempts to treat many conditions, including idiocy, goiter, epilepsy, glaucoma, and angina pectoris. Thoracic sympathectomy has been indicated for hyperhidrosis (excessive sweating) since 1920, when Dr. A. Kotzareff showed it would cause anhidrosis (total inability to sweat) from the nipple line upwards.<br />
A lumbar sympathectomy was also developed and used to treat excessive sweating of the feet and other ailments, and typically resulted in impotence in men.<br />
<br />
Sympathectomy itself is relatively easy to perform; however, accessing the nerve tissue in the chest cavity by conventional surgical methods was difficult, painful, and spawned several different approaches. The posterior approach was developed by Dr. A.W. Adson in 1908, and required resection (sawing off) of ribs. Sales of the procedure were slow. Dr. E.D. Telford came up with a supraclavical (above the collar-bone) approach in 1935, which was less painful than the posterior, but was more prone to damaging important nerves and blood vessels, also not a good selling point.<br />
<br />
Because of these difficulties, and because of disabling sequelae associated with sympathetic denervation, conventional or "open" sympathectomy was never a very popular procedure, although it continued to be practiced for hyperhidrosis, Raynaud's disease, and various psychiatric disorders. With the popularization of lobotomy in the 1940s, sympathectomy fell out of favor as psychosurgery.<br />
<br />
<a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a>The endoscopic version of thoracic sympathectomy was pioneered by Drs. Goren Claes and Christer Drott at the Boras hospital in Sweden in the late 1980s. The development of endoscopic "minimally invasive" surgical techniques have made possible the mass-marketing of sympathectomy, and today ETS surgery is practiced in many countries throughout the industrial world.<br />
<br />
<h2>
<span class="mw-headline" id="ETS_Surgery_is_Mass-Marketed" style="font-size: large;">ETS Surgery is Mass-Marketed</span></h2>
<h2>
<span class="mw-headline" id="ETS_Surgery_is_Mass-Marketed" style="font-size: large;"> </span></h2>
<h4>
<span class="mw-headline" id="YouTube">YouTube</span></h4>
<h4>
<span class="mw-headline" id="YouTube"> </span></h4>
YouTube offers this promotional video on Dr. David Neilson's "Micro ETS" for sweaty palms:<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/0UIrKVcS8fU?feature=player_embedded' frameborder='0'></iframe></div>
<br />
<h4>
<span class="mw-headline" id="Websites">Websites</span></h4>
<h4>
<span class="mw-headline" id="Websites"> </span></h4>
Websites advertising ETS surgery abound. These sites typically feature patient testimonials deploring the embarrassment over sweating and blushing, and extolling the virtues of the surgery. The long and checkered history of sympathectomy is not usually revealed. Following is a sampling of ETS surgeon advertising websites.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/BUb6LWE.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="84" src="https://i.imgur.com/BUb6LWE.jpg" width="640" /></a></div>
<br />
<div style="width: 220px;">
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Banner from Rafael Reidfeld's "Sweaty-Palms.com" </b>
</span></center>
</blockquote>
</blockquote>
</blockquote>
<h5>
<span class="mw-headline" id="Columibia_University">Columibia University</span></h5>
"Surgery only eliminates the pathway to the sweat glands of the hand."<br />
"Based on the clinical data that has been published to date, there is no evidence that ETS surgery has any negative impact on cardiac function, or the ability to reach preoperative peak work loads."<br />
<br />
<a class="externallink" href="http://web.archive.org/web/20090226030727/http://hyperhidrosiscumc.com/effects.html" rel="nofollow" title="http://www.hyperhidrosiscumc.com/effects.html">Columbia University Medical Center</a><br />
<h5>
<span class="mw-headline" id="Mayo_Clinic">Mayo Clinic</span></h5>
"Mayo Clinic's surgeons frequently perform these procedures for severe over-sweating of the hands when other treatments have failed," says Dr. (John) Eisenach. "From an integrative standpoint, we are interested in studying the long-term effects of this surgery on the skin and blood vessels of the arm. So far, we have found essentially no adverse consequence in the patients' warm and dry hands."<br />
<br />
<a class="externallink" href="http://www.doctorslounge.com/dermatology/articles/hyperhidrosis_therapy/index.htm" rel="nofollow" title="http://www.doctorslounge.com/dermatology/articles/hyperhidrosis_therapy/index.htm">Mayo Clinic press release</a><br />
<br />
"This procedure involves cutting the nerves that carry messages from the sympathetic nervous system to the sweat glands and completely removing part of the nerve chain. This surgery permanently interrupts the nerve signal that causes the body to sweat excessively."<br />
<br />
<a class="externallink" href="http://www.mayoclinic.org/hyperhidrosis/treatment.html" rel="nofollow" title="http://www.mayoclinic.org/hyperhidrosis/treatment.html">Mayo Clinic Webpage</a><br />
<h5>
<span class="mw-headline" id="Hyperhidrosis.LA">Hyperhidrosis.LA</span></h5>
Dr. Fischel has a 100% success rate in curing palmar hyperhidrosis. Dr. Fischel has a 100% success rate in curing underarm sweating by adding resection of the T4 ganlia[sic]. Dr. Fischel has a 100% success rate in curing facial sweating. Dr. Fischel has a 95% success rate in curing facial blushing.<br />
<br />
<a class="externallink" href="http://web.archive.org/web/20020811054112/www.hyperhidrosis.la/faq.htm" rel="nofollow" title="http://web.archive.org/web/20020811054112/www.hyperhidrosis.la/faq.htm">Hyperhidrosis.LA page</a><br />
<h5>
<span class="mw-headline" id="Southwest_Centre_for_Hyperhidrosis">Southwest Centre for Hyperhidrosis</span></h5>
Before long [after ETS], patients are back to their normal daily activities, minus the excessive sweat.<br />
<br />
Of course, the surgery actually has quite minimal side effects and a 95 percent or better chance for a permanent cure.<br />
<br />
<a class="externallink" href="http://web.archive.org/web/20120112120230/http://www.stopsweating.com/stories.html" rel="nofollow" title="http://www.stopsweating.com/stories.html">SCH stories</a><br />
<br />
Are there any side effects?
Very few.<br />
<br />
<a class="externallink" href="http://web.archive.org/web/20090206135734/http://stopsweating.com/faq.html" rel="nofollow" title="http://www.stopsweating.com/faq.html">SCH FAQ</a><br />
<br />
Hyperhidrosis presents a variety of problems <b><i>physical and emotional </i></b> for those afflicted with it:<br />
<ul>
<li>The danger of hands slipping from a child</li>
<li>The embarrassment of shaking hands or holding hands</li>
<li>The inconvenience of leaving everything you touch "wet" or "stained"</li>
<li>The professional disappointment of not being able to touch a computer keyboard</li>
<li>The drawbacks of not being able to wear make-up, or colors other than black and white</li>
<li>The frustration of smudging ink and saturating writing paper with perspiration</li>
</ul>
<br />
<a class="externallink" href="http://web.archive.org/web/20090225042128/http://stopsweating.com/whatis.html" rel="nofollow" title="http://www.stopsweating.com/whatis.html">SCH What is hyoerhidrosis?</a><br />
<h5>
<span class="mw-headline" id="Cedars-Sinai_Hyperhidrosis_Center">Cedars-Sinai Hyperhidrosis Center</span></h5>
What happens to the other nerves in the chest [after ETS surgery]?<br />
The sympathetic nerve chain has a built in "backup" system. Other nerves compensate for the function of the removed nerve region, and there are little or no long-term side effects.<br />
<br />
<a class="externallink" href="http://www.csmc.edu/2618.html" rel="nofollow" title="http://www.csmc.edu/2618.html">Cedars page</a><br />
<h4>
<span class="mw-headline" id="News_Media">News Media</span></h4>
<h4>
<span class="mw-headline" id="News_Media"> </span></h4>
<h5>
<span class="mw-headline" id="Television_News">Television News</span></h5>
Several ETS surgeons have appeared on national television promoting the procedure. Michael Mack appeared on the CBS morning show with Ann Curry, and Rafael Reisfeld was on Discovery Channel's "Medical Incredible".<br />
<br />
<div style="width: 220px;">
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/qVN7hDk.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="246" src="https://i.imgur.com/qVN7hDk.gif" width="320" /></a></div>
<blockquote>
<blockquote>
<blockquote>
<br />
<center>
<span style="color: blue; font-size: small;">
<b>CBS Morning Show</b>
</span></center>
<br />
<i>Surgeon Micahel Mack (center) promotes ETS surgery on national television. The patient (left) shakes hands with host Ann Curry. Curry comments, 'You're not sweaty palmed at all!' </i></blockquote>
</blockquote>
</blockquote>
<h5>
<span class="mw-headline" id="BBC_News">BBC News</span></h5>
"Surgeons have developed an operation to cure blushing."<br />
<br />
<a class="externallink" href="http://news.bbc.co.uk/2/hi/health/750813.stm" rel="nofollow" title="http://news.bbc.co.uk/2/hi/health/750813.stm">BBC article</a><br />
<h5>
<span class="mw-headline" id="WebMD">WebMD</span></h5>
If you've been suffering with hyperhidrosis, see your doctor. There is help available. One treatment, pioneered by (UCLA surgeon Samuel) Ahn, involves minimally invasive surgery to snip the sympathetic nerve connection to the hand. So far, says Ahn, the operation has been 100% successful, with no negative side effects.<br />
<br />
<a class="externallink" href="http://web.archive.org/web/20080112062805/http://www.webmd.com/content/article/18/1685_52932.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}" rel="nofollow" title="http://web.archive.org/web/20080112062805/http://www.webmd.com/content/article/18/1685_52932.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}">WebMD article</a><br />
<h5>
<span class="mw-headline" id="New_York_Times">New York Times</span></h5>
"ETS surgery turns off the nerve the signals the body to sweat too much."<br />
<br />
<a class="externallink" href="http://health.nytimes.com/health/guides/surgery/endoscopic-thoracic-sympathectomy/overview.html" rel="nofollow" title="http://health.nytimes.com/health/guides/surgery/endoscopic-thoracic-sympathectomy/overview.html">New York Times Health Guide</a><br />
<h4>
<span class="mw-headline" id="Billboards"> </span></h4>
<h4>
<span class="mw-headline" id="Billboards">Billboards</span></h4>
<h4>
<span class="mw-headline" id="Billboards"> </span></h4>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/ep5o11N.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300" src="https://i.imgur.com/ep5o11N.jpg" width="400" /></a></div>
<br />
<div style="width: 220px;">
</div>
<blockquote>
<blockquote>
<blockquote>
<br />
<center>
<span style="color: blue; font-size: small;">
<b>Jim Garza Billboard</b>
</span></center>
<br />
<i>Surgeon Jim Garza promises a cure with his attractive sign by a Houston Texas freeway. Garza and his practice was the subject of a 2005 investigative journalism piece by CBS2 news Houston, as part of their 'TroubleShooters' series.</i></blockquote>
</blockquote>
</blockquote>
<h4>
<span class="mw-headline" id="Product_Placement_in_Fictional_Drama">Product Placement in Fictional Drama</span></h4>
<h5>
<span class="mw-headline" id="Grey.27s_Anatomy">Grey's Anatomy</span></h5>
ETS surgery has been featured as "product placement" on the hit television series "Grey's Anatomy". Grey's Anatomy is fictional, but prides itself on medical accuracy, employing the consultation services of <a class="externallink" href="http://www.cep.com/profileInfo/ProviderProfile.asp?id=80" rel="nofollow" title="http://www.cep.com/profileInfo/ProviderProfile.asp?id=80">Karen Pike M.D.</a> On the show written by Shonda Rhymes, character Kelly Roche (played by Angela Gothels) has an embarrassing problem with facial blushing. <br />
<br />
<div style="width: 220px;">
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/aVwnq5L.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/aVwnq5L.jpg" /></a></div>
<blockquote>
<blockquote>
<blockquote>
<br />
<center>
<span style="color: blue; font-size: small;">
<b>Grey's Anatomy ETS Episode - Before Surgery</b>
</span></center>
<br />
<i>Patient Kelly Roche is extremely upset because her cheeks blush bright red every time she sees Dr. Sheppard.</i></blockquote>
</blockquote>
</blockquote>
Though other characters do not appreciate her situation, Merideth Grey (Ellen Pompeo) offers warm empathy. The show makes a point of having Kelly Roche recite an apparently exhaustive list of potential side effects: <br />
<blockquote>
DR. SHEPPARD: "Did you read the literature I gave you? Do you understand the possible side effects?"
<br />
<br />
KELLY: "Compensatory sweating of the back, abdomen, thighs and legs; possible gustatory sweating; Horner’s syndrome occurs in less than one percent of patients; brachial plexus injury, pneumothorax and hemothorax are highly unlikely but possible side effects of the surgery."
<br />
<br />
DR. SHEPPARD: "You did your homework! Take her to pre op. I’ll alert the O.R."</blockquote>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/AgcjS75.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/AgcjS75.jpg" /></a></div>
<div style="width: 220px;">
</div>
<blockquote>
<blockquote>
<blockquote>
<br />
<center>
<span style="color: blue; font-size: small;">
<b>Grey's Anatomy ETS Episode - After Surgery</b>
</span></center>
<br />
<i>In the recovery room, Kelly Roche is deliriously happy now. She is able to say Dr. Sheppard's name without blushing. </i></blockquote>
</blockquote>
</blockquote>
Surgeon Derek Sheppard (Patrick Dempsey) performs the ETS, and by episode's end, Dr. Grey declares the operation "successful", "worth the risk", as a happy Kelly Roche relaxes in her recovery room. <br />
<br />
<a class="externallink" href="http://editthis.info/corposcindosis/Grey%27s_Anatomy" rel="nofollow" title="http://editthis.info/corposcindosis/Grey's_Anatomy">Grey's Anatomy ETS episode transcript</a><br />
<br />
<br />
<br />
<h2>
<span class="mw-headline" id="Patient_Websites_Paint_a_Much_Different_Picture" style="font-size: large;">Patient Websites Paint a Much Different Picture</span></h2>
Is the mainstream positive characterization of ETS surgery correct? A survey of ETS patient oral history, as documented in several websites and discussion forums, would seem to indicate something far different. By the mid 1990's, a site called <a class="externallink" href="http://home.swipnet.se/sympatiska/index3.htm" rel="nofollow" title="http://home.swipnet.se/sympatiska/index3.htm">FFSO - people disabled by sympathectomy</a> had been launched in Sweden, birthplace of ETS.ETS came to the U.S. in the late 1990's and had become widespread by 2002. ETS discussion forums like <a class="externallink" href="http://p069.ezboard.com/betsandreversals" rel="nofollow" title="http://p069.ezboard.com/betsandreversals">ETS & Reversals</a>, <a class="externallink" href="http://www.esfbchannel.com/forum/" rel="nofollow" title="http://www.esfbchannel.com/forum/">ESFB</a>, and <a class="externallink" href="http://no-ets.com/forums/viewforum.php?f=20" rel="nofollow" title="http://no-ets.com/forums/viewforum.php?f=20">No-ETS</a> began to appear.<br />
<br />
Comments on these ETS discussion boards tend to run at least 75% anti-ETS. On them, ETS patients complain of a myriad of symptoms. Often they describe being completely unable to sweat from the entire top 1/3 of the body, yet having the slightest physical exertion trigger profuse sweating in areas like the belly, lower back, and crotch.<br />
<br />
They also complain of a weak heart beat, shortness of breath, painfully dry hands, a hot temperature on the top part of the body, loss of goose bumps and the pleasurable ‘chills’ sensation that goes with them, chronic fatigue, loss of alertness, loss of strong emotions, sexual dysfunction, and more. Like the earlier FFSO, another common theme on these ETS discussion forums is that surgeons are unresponsive to patient complaints.<br />
<br />
2004 saw U.S. based "Truth About ETS" and the British "Raddison Group".<br />
<br />
<h4>
<span class="mw-headline" id="Sympathectomy_Blog">Sympathectomy Blog</span></h4>
<h4>
<span class="mw-headline" id="Sympathectomy_Blog"> </span></h4>
In January 2008, "Mia" began the Sympathectomy Blog, which presents a vast archive of empirical data on sympathectomy.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/58mbRjX.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="212" src="https://i.imgur.com/58mbRjX.jpg" width="400" /></a></div>
<blockquote>
<div style="width: 220px;">
</div>
<br />
"What you see here is not a result of the surgery gone wrong, this is the result of a ...successful operation; it is the inevitable consequence of cutting/clamping the sympathetic chain, independently of skill of the surgeon, experience of the surgeon, T2, or T3, T4, or method used. Once the communication is disrupted, (and it happens with the clamping as well), it will disable the body's thermoregulation and will cause malfunctioning of the sympathetic nervous system. This damage is permanent and irreversible."
</blockquote>
<br />
<a class="externallink" href="http://sympathectomy.blogspot.com/" rel="nofollow" title="http://sympathectomy.blogspot.com/">Sympathectomy Blog</a><br />
<br />
<h4>
<span class="mw-headline" id="ETS_.26_Reversals_Discussion_Forum">ETS & Reversals Discussion Forum</span></h4>
The most prominent discussion board on the subject is ETS & Reversals. Its members overwhelmingly offer anti-ETS viewpoints, detail their experiences, seek remedies, and offer advice for those who have had ETS, and for those considering it.<br />
<br />
<br />
<a class="externallink" href="http://etsandreversals.yuku.com/" rel="nofollow" title="http://etsandreversals.yuku.com/">ETS & Reversals home page</a><br />
<br />
<h4>
<span class="mw-headline" id="FFSO">FFSO</span></h4>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/zqH0Bv7.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/zqH0Bv7.jpg" /></a></div>
<br />
<div style="width: 220px;">
</div>
FFSO lists the following as side effects of ETS surgery:<br />
<ul>
<li>Severe compensatory sweating</li>
<li>Decreased physical capacity</li>
<li>Reduced blood circulation</li>
<li>Stomach problems (constipation or diarrhea)</li>
<li>Impotence</li>
<li>Oversensitivity to stress</li>
<li>Oversensitivity to sounds</li>
<li>Oversensitivity to light</li>
<li>Muscle weakness ("lactic acid in the arms")</li>
<li>Cold hands and feet</li>
<li>Horners syndrome</li>
<li>Reduced pulse reaction</li>
<li>Shortness of breath</li>
<li>Pain in arms and back</li>
<li>Chronic fatigue, lack of energy</li>
<li>Raynauds disease </li>
</ul>
<br />
The FFSO site states: <br />
<blockquote>
"Many of the symptoms are similar to those that come with Chronic Fatigue Syndrome or Fibromyalgia.Most of us have in some way been forced to change our way of living. Physical exercise is almost impossible for us. Some have found it impossible to continue with their profession and felt that they had to find another job. Some have even lost the ability to work and have gone in early retirement."</blockquote>
FFSO also documented another troubling aspect of ETS, having to do with the attitude of the operating surgeons:<br />
<blockquote>
"Several members in our association have, when the symptoms occured, contacted the operating surgeon to ask if this is a consequence of the operation. The answer has always been that they never have heard of these kind of side effects, YOU must be an exceptional case!"</blockquote>
<h4>
<span class="mw-headline" id="TruthAboutETS">TruthAboutETS</span></h4>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/owx7GE6.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="120" src="https://i.imgur.com/owx7GE6.jpg" width="640" /></a></div>
<div style="width: 220px;">
<a class="internal" href="image:TruthAboutETSbanner.jpg">
</a></div>
<br />
TruthAboutETS was created by ETS patient "songboy1234". The site offers many articles based on songboy1234's personal experience, including his participation in a neurocardiology study at U.S. National Institute of Neurological Disorders and Stroke (NINDS). (see <a class="externallink" href="http://www.truthaboutets.com/Pages/NIH.html" rel="nofollow" title="http://www.truthaboutets.com/Pages/NIH.html">U.S. Government Studies the Neurocardiologic Dysfunction of Sympathectomy Patients</a>
<br />
<br />
<div style="width: 220px;">
<a class="internal" href="image:TruthAboutETSThyroidClip.jpg">
</a></div>
<br />
TruthAboutETS reports a long list a potential side effects:<br />
<ul>
<li>Compensatory Hyperhidrosis</li>
<li>Chronic Fatigue</li>
<li>Skin Function Paralysis </li>
<li>Extremely Dry Hands </li>
<li>Hair Loss</li>
<li>Anhidrosis </li>
<li>Lowered Mental Function </li>
<li>Feeling "Weird"</li>
<li>Loss of Vascular Control </li>
<li>Emotional Changes </li>
<li>Frey's Syndrome</li>
<li>Poor Thermoregulation </li>
<li>Anger and Depression </li>
<li>Horner's Syndrome</li>
<li>Bradycardia </li>
<li>Referred Pain </li>
<li>Sexual Dysfunction</li>
<li>Reduced Lung Capacity </li>
<li>Chronic Pain (Neuralgia) </li>
<li>Stress Intolerance</li>
<li>Reduced Exercise Capacity </li>
<li>Loss of Goosebumps </li>
<li>Low Blood Pressure</li>
<li>Slow Healing </li>
<li>Denervation Supersensitivity </li>
<li>Paresthesia</li>
<li>Severe Pompholyx (Eczema)</li>
</ul>
<br />
<a class="externallink" href="http://www.truthaboutets.com/Pages/FXBottom.html" rel="nofollow" title="http://www.truthaboutets.com/Pages/FXBottom.html">TruthAboutETS side effects page</a><br />
<br />
<a class="externallink" href="http://www.truthaboutets.com/" rel="nofollow" title="http://www.truthaboutets.com">TruthAboutETS homepage</a><br />
<br />
<h4>
<span class="mw-headline" id="Radisson_Group_.28United_Kingdom.29">Radisson Group (United Kingdom)</span></h4>
<h4>
<span class="mw-headline" id="Radisson_Group_.28United_Kingdom.29"> </span></h4>
<h4>
<span class="mw-headline" id="No_a_la_ETS_.28Spain.29">No a la ETS (Spain)</span></h4>
<br />
<a class="externallink" href="http://www.terra.es/personal8/hiperhidrosis/" rel="nofollow" title="http://www.terra.es/personal8/hiperhidrosis/">No a la ETS home page</a><br />
<h4>
<span class="mw-headline" id="Taiwan_Forum_.28Taiwan.29"> </span></h4>
<h4>
<span class="mw-headline" id="Taiwan_Forum_.28Taiwan.29">Taiwan Forum (Taiwan)</span></h4>
<h4>
<span class="mw-headline" id="Taiwan_Forum_.28Taiwan.29"> </span></h4>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://i.imgur.com/wpWfs0M.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="https://i.imgur.com/wpWfs0M.jpg" width="300" /></a></div>
<blockquote>
<blockquote>
<blockquote>
<br />
<center>
<span style="color: blue; font-size: small;">
<b>Taiwan Activist Poster</b>
</span></center>
<br />
<i>The Chinese symbol means "ETS is like cutting the body in two". The rest of the poster is a warning to patients, and a protest to Taiwaneese health authorities.</i></blockquote>
</blockquote>
</blockquote>
<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/sCpD7l8vy9Y?feature=player_embedded' frameborder='0'></iframe></div>
<blockquote>
<blockquote>
<blockquote>
<br />
<center>
<span style="color: blue; font-size: small;">
"The Truth of the Sympathectomy"
</span></center>
<i> "This video is a Taiwan TV talking show broadcasting on Oct 24th,2006 which inviting some famous medical reporters. The reporters disclose lots of scandal and illegal behavior about Taiwan DOCTORS who lack of conscience." </i> <a class="externallink" href="http://www.youtube.com/watch?v=4QB--GDJBvE" rel="nofollow" title="http://www.youtube.com/watch?v=4QB--GDJBvE">YouTube</a></blockquote>
</blockquote>
</blockquote>
<h4>
<span class="mw-headline" id="Patients_Against_Sympathetic_Surgery_.28Australia.29"> </span></h4>
<h4>
<span class="mw-headline" id="Patients_Against_Sympathetic_Surgery_.28Australia.29">Patients Against Sympathetic Surgery (Australia)</span></h4>
<br />
<a class="externallink" href="http://www.ets-sideeffects.netfirms.com/" rel="nofollow" title="http://www.ets-sideeffects.netfirms.com/">P.A.S.S. homepage</a><br />
<h4>
<span class="mw-headline" id="ETS_Side_Effects_.28Japan.29"> </span></h4>
<h4>
<span class="mw-headline" id="ETS_Side_Effects_.28Japan.29">ETS Side Effects (Japan)</span></h4>
<br />
<a class="externallink" href="http://www.geocities.jp/etscontroversialop/index.html" rel="nofollow" title="http://www.geocities.jp/etscontroversialop/index.html">ETS side effects homepage</a><br />
<h2>
<span class="mw-headline" id="Patient_Complaints_on_Mainstream_TV_News"> </span></h2>
<h2>
<span class="mw-headline" id="Patient_Complaints_on_Mainstream_TV_News" style="font-size: large;">Patient Complaints on Mainstream TV News</span></h2>
<h3>
<span class="mw-headline" id="CBS2_News_TroubleShooters"> </span></h3>
<h3>
<span class="mw-headline" id="CBS2_News_TroubleShooters">CBS2 News TroubleShooters</span></h3>
<h3>
<span class="mw-headline" id="CBS2_News_TroubleShooters"> </span></h3>
<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/qORa1T8IaTY?feature=player_embedded' frameborder='0'></iframe></div>
<blockquote>
<blockquote>
<blockquote>
<br />
<center>
<span style="color: blue; font-size: small;">
<b>TroubleShooters</b>
</span></center>
<br />
<i>CBS2 News, Houston, Texas hidden camera report on ETS surgeon Jim Garza. "There may be risks patients don't hear about" says news anchor Bill Balleza introducing the segment, which includes interviews with an ETS victim, attorney Spencer Markle, and dermatologist Dr. Adelaide Hebert. Dr. Hebert indicates that ETS is not reversable, despite Garza's claims to the contrary.</i></blockquote>
</blockquote>
</blockquote>
<br />
<h3>
<span class="mw-headline" id="FOX_News">FOX News</span></h3>
<h3>
<span class="mw-headline" id="FOX_News"> </span></h3>
FOX News also aired a segment featuring disabled patients.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.youtube.com/embed/9eSCX9MSkPM?feature=player_embedded' frameborder='0'></iframe></div>
<br />
<br />
<br />
In addition to the physical symptoms, Alexandra Parker complains of emotional changes. She says, "It's just a feeling of being dead.".<br />
<br />
<a class="externallink" href="http://www.livevideo.com/video/DA86D572A6634B558B52B5B5AF79DE42/ets-fox-news-sympathectomy-sid.aspx" rel="nofollow" title="http://www.livevideo.com/video/DA86D572A6634B558B52B5B5AF79DE42/ets-fox-news-sympathectomy-sid.aspx">link to FOX News video</a><br />
<h2>
<span class="mw-headline" id="Who.27s_Right.3F"> </span></h2>
<h2>
<span class="mw-headline" id="Who.27s_Right.3F" style="font-size: large;">Who's Right?</span></h2>
<h2>
<span class="mw-headline" id="Who.27s_Right.3F" style="font-size: large;"> </span></h2>
What is the truth? Does ETS surgery really cure excessive sweating and/or facial blushing? Could this mainstream, mass-marketed surgery really be responsible for all the problems detailed on the patient websites and discussion forums? Or are the patients simply trying to assign blame for things unrelated or imaginary? Is there theoretical or empirical justification for the litany of patient complaints? Or not?<br />
<br />
<a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a>If there is merit to the patient complaints, it would imply that there is routine deception taking place on the part of the surgeons. Is this possible? Sadly, tragically, the past case of lobotomy offers an historical example in which surgeons portrayed a disabling procedure as safe and effective. A nobel prize was even awarded to lobotomist Egas Moniz.<br />
<br />
Is ETS the new lobotomy, in the sense of a grand deception being foist on vulnerable, unsuspecting patients? Or is it a safe and effective treatment for excessive sweating and facial blushing? This treatise is an attempt to resolve the dispute scientifically.<br />
<br />
X <br />
<br />Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-41579276731719838822013-05-30T12:41:00.003-07:002017-09-24T14:35:59.866-07:00The Corposcindosis Model<title>The Corposcindosis Model - Corposcindosis</title>
<link href="/skins/common/shared.css?207" media="screen" rel="stylesheet" type="text/css"></link>
<link href="/skins/common/commonPrint.css?207" media="print" rel="stylesheet" type="text/css"></link>
<link href="/skins/monobook/main.css?207" media="screen" rel="stylesheet" type="text/css"></link><!--
<rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#"
xmlns:dc="http://purl.org/dc/elements/1.1/"
xmlns:trackback="http://madskills.com/public/xml/rss/module/trackback/">
<rdf:Description
rdf:about="http://editthis.info/corposcindosis/The_Corposcindosis_Model"
dc:identifier="http://editthis.info/corposcindosis/The_Corposcindosis_Model"
dc:title="The Corposcindosis Model"
trackback:ping="http://editthis.info/corposcindosis/trackback.php?article=The_Corposcindosis_Model" />
</rdf:RDF>
-->
<br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<h2>
<a href="http://www.blogger.com/null" id="top" name="top"></a><span class="mw-headline" style="font-size: large;">Homeostasis</span></h2>
<div id="bodyContent">
Life is a balancing act. Human survival requires a number of internal bodily systems to stay within certain limits. Core body temperature, for example, is held remarkably constant at around 98.6 degrees F, despite changing temperatures in the air, and changes in how much heat is produced within the body. 98.6 degrees is known as a “set point”, and the body strives to maintain this set point regardless of external conditions. 98.6 degrees is the baseline set point under normal circumstances.<br />
<br />
In response to, say, an infection, the body may raise core temperature up to a new, temporary set point, and maintain that for some period of time, eventually reverting back down to the baseline. Blood pressure is also held to a baseline set point. During exercise, more oxygen is demanded by muscles, so to meet this demand blood pressure is made to go up, but not up too high, only enough to meet the new demand. When exercise is over, blood pressure is lowered back to its original baseline set point.<br />
<br />
Blood pressure and temperature are only two out of dozens of body systems that are balanced and rebalanced automatically all the time. This balancing act is called “homeostasis” (literally “one state”). The changing conditions (both internal and external) which stress the body and require it to respond and compensate in some way are known as “stressors”. Besides temperature and exercise, other stressors include hunger, digestion, emotion, injury and disease. The body is constantly trying to maintain homeostasis while responding to whichever stressors are present. It does so automatically, without our conscious effort.<br />
<br />
How then does the body achieve this balance, this homeostasis? What is the control center and what does it control?<br />
<br />
The autonomic control center of the human body is the hypothalamus. Located at the top of the brainstem, below the thalamus, we can think of the hypothalamus as a super-sophisticated thermostat. It’s busy all the time receiving different types of input information from throughout the body, and making necessary adjustments in real time. We shall often refer to “the control center”, meaning the hypothalamus.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/26TdKb5.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/26TdKb5.jpg" /></a></div>
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Inputs to the Control Center</b>
</span></center>
</blockquote>
</blockquote>
</blockquote>
</div>
</div>
</div>
</div>
<i>The control center gets messages about emotional state from the higher brain, and messages about blood pressure from special cells called baroreceptors, located inside major arteries near the heart. It also is kept apprised of the core body temperature and the outside air temperature by cells called thermoreceptors. Osmoreceptors provide information about ion balance, and chemoreceptors report chemical changes from throughout the body. Part of the optic nerve branches away from the retina and informs the hypothalamus about light and dark. </i>
<br />
<br />
Once the control center detects stressors which require body systems to compensate, what can it do?
<br />
The hypothalamus has two types of output signals to regulate body function:
<br />
<ul>
<li> Endocrine (hormone) signals
</li>
<li> Neural signals </li>
</ul>
<div class="center">
<div class="floatnone">
</div>
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/3PuSoRX.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="256" src="https://i.imgur.com/3PuSoRX.jpg" width="640" /></a></div>
<br />
<blockquote>
<blockquote>
<blockquote>
<center>
<b>Outputs from the Control Center</b>
</center>
</blockquote>
</blockquote>
</blockquote>
<i>Neural signals go out to the Autonomic Nervous System (ANS). Endocrine signals go to the pituitary, thyroid and adrenal glands, which regulate chemical messengers in the blood.</i>
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Structure_of_the_Autonomic_Nervous_System" name="Structure_of_the_Autonomic_Nervous_System"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Structure of the Autonomic Nervous System</span></h2>
Autonomic means independent. The ANS is responsible for automatically regulating many bodily functions which are beyond the mind's conscious control (e.g. heart rate, contraction strength, blood vessel constriction, blood pressure, body temperature, digestion, sweating, pupil dilation, goose bumps, erection, ejaculation, salivation). It can also temporarily take over some functions that are otherwise within conscious control. (e.g. eyes blinking, breathing).<br />
<br />
There are two divisions of the ANS:
<br />
<ul>
<li> The sympathetic nervous system (SNS)
</li>
<li> The parasympathetic nervous system (PSNS)
</li>
</ul>
The SNS is generally associated with the “fight or flight” response – increasing heart rate, sweating, shunting blood flow into the deep muscles, halting digestion, and preparing the body to deal with situations of high stress. The PSNS is generally associated with the opposite, the “rest and digest” response - slowing down the heart, digesting food, and preparing the body to relax.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/ONV6Yig.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/ONV6Yig.jpg" /></a></div>
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Typical ANS Wall Chart</b>
</span></center>
</blockquote>
</blockquote>
</blockquote>
<i>SNS in yellow lines, PSNS in blue. This chart contains some innervated structures, but certainly not all.</i>
<br />
<pre><i> </i>
</pre>
<br />
Much has been discovered and studied since, as we shall see.
<br />
<a href="http://www.blogger.com/null" id="Structure_of_the_Sympathetic_Nervous_System" name="Structure_of_the_Sympathetic_Nervous_System"></a><br />
<h3>
<span class="mw-headline">Structure of the Sympathetic Nervous System</span></h3>
The SNS originates in the brainstem, and branches off left and right, forming two nerve trunks which descend down along either side of the spine, through the cervical (neck) region, the thoracic (chest) region and lumbar (lower back) region, finally into the pelvic region where the two trunks come back together and merge with the base of the spinal cord. Along the trunks, at the level of each vertebrae, is a cluster of neurons called a ganglion. Each trunk is a chain of these ganglia connected together by nerve tissue, and is known as the “sympathetic chain of ganglia”, or simply “sympathetic chain”. At the top between T1 and T2 the chain contains aprox. 4000 nerve fibres, lessening in number of fibres lower down the chain.<br />
<br />
Each sympathetic ganglion along the chain is given a name according to which vertebrae it is near, using a letter and a number. The letter represents the general region (C for cervical, T for thoracic, or L for lumbar), and the number represents the vertebrae, so T2 would be the ganglion at the level of the second thoracic vertebrae.<br />
<br />
Coming out of the spinal cord at the level of each vertebrae is a bundle of nerves which synapse with neurons inside the corresponding ganglion. These bundles are called “rami communicantes”, or pre-ganglionic fibers.<br />
<br />
Coming out of each ganglion is another bundle of post-ganglionic nerves which lead finally to various end targets - the organs, glands and muscles which are regulated by the control center. These end targets are known as “effectors”.<br />
<br />
The control center can send signals down the spinal cord, to the pre-ganglionic fibers, into the ganglia, and out to the effectors. However, each pre-ganglionic nerve signal does not necessarily correspond with (or only with) synapses and cells in the ganglion it enters, rather the signal can travel up or down the sympathetic chain to synapses and cells in other ganglia before it leaves for the target effoctors.<br />
<br />
The sympathetic nervous system runs to almost every gland, organ, blood vessel and bone in the entire human body. This is a statement worth repeating:
<br />
<blockquote>
<b> <i>The sympathetic nervous system runs to almost every gland, organ, blood vessel and bone in the human body.</i> </b>
</blockquote>
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"></a></div>
<br />
<div class="separator" style="clear: both; text-align: center;">
</div>
<h3>
<span class="mw-headline">Structure of the Parasympathetic Nervous System</span></h3>
The PSNS also originates in the brainstem, branches out and synapses in various ganglia before terminating at end target effectors. The main trunk of the PSNS is the vagus nerve. Parasympathetic nerves flow outward to many (but not all) of the same effectors as do the sympathetic nerves. The vagus nerve system is also flows back into the control center and is responsible for delivering many incoming messages coming from the various receptors.
<br />
<a href="http://www.blogger.com/null" id="Neurotransmitters" name="Neurotransmitters"></a><span style="font-size: large;"><br /></span>
<br />
<h2>
<span class="mw-headline" style="font-size: large;">Neurotransmitters</span></h2>
The post ganglionic nerves synapse in the effectors at cells called “receptors”. Receptor cells are activated by chemicals released by the SNS and PSNS, and these chemicals are called “neurotransmitters”. Usually, the SNS nerve endings release the neurotransmitter “norepinephrine” (NE), which has four main subtypes – alpha-1, alpha-2, beta-1 and beta-2. PSNS nerve endings release the neurotransmitter acetylcholine.<br />
<br />
Besides these neural signals to the ANS, the control center can also send out endocrine signals. This causes a gland called the “adrenal medulla” to release hormones such as adrenaline and noradrenaline into the bloodstream. These hormones collectively are known as “catecholamines” and are actually some the same types of chemicals as the neurotransmitters. “Epinephrine” is just another name for “adrenaline”. When catecholamines reach destination effectors through the blood stream, they can produce the same types of changes in function as do the neurotransmitters. Hormonal changes tend to take effect more slowly, and to be less drastic than changes brought on by the ANS. The control center often operates the sympathetic nervous system and the adrenal medulla in concert, so the two are sometimes viewed collectively as the “sympatho-adrenal axis”.
<br />
<br />
<br />
<a href="http://www.blogger.com/null" id="Sympathetic_and_Parasympathetic_Tone" name="Sympathetic_and_Parasympathetic_Tone"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Sympathetic and Parasympathetic Tone</span></h2>
Sympathetic and Parasympathetic nerves are always “on”. They supply a certain amount of “drive” or “tone” at all times to all of the effectors they reach. The control center can increase and decrease the sympathetic and parasympathetic tone to the effectors, thus regulating if, and how much, neurotransmitter is released into the receptor cells.<br />
<br />
Nerves are sometimes analogized to wires. This is a valid analogy but with some important considerations. The “wiring” of the sympathetic system is not one-to-one as with other types of nerves. Rather, the nerves which flow away from the ganglia form webs which then branch off to various different effectors in complex and overlapping ways. The ganglia in the upper thoracic region, T1-T5, supply nerves to the heart, for instance, but those are all bundled together with nerves leading to the lungs, the thyroid, sweat glands, blood vessels and bone. The control center can alter tone on specific ganglia, which then affects all innervated structures downstream. The bundled nature of the SNS is important to the corposcindosis model. ETS surgery will produce denervation in all structures downstream of the operated area, regardless of the intended target of treatment.<br />
<br />
Also, there can be significant anatomical differences in the “wiring” from one individual to the next.
<br />
<a href="http://www.blogger.com/null" id="Existing_Models_of_ANS_Function" name="Existing_Models_of_ANS_Function"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Existing Models of ANS Function</span></h2>
<a href="http://www.blogger.com/null" id="Doctrine_of_Reciprocity" name="Doctrine_of_Reciprocity"></a><br />
<h3>
<span class="mw-headline">Doctrine of Reciprocity</span></h3>
<div class="center">
<div class="floatnone">
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/6bu2q9N.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="198" src="https://i.imgur.com/6bu2q9N.jpg" width="640" /></a></div>
</div>
</div>
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Reciprocal Nature of ANS</b>
<br />
</span> </center>
<i>Often, the SNS and PSNS work reciprocally. As the sympathetic tone goes up, the parasympathetic tone goes down, and vice versa. This can be visualized as a balance that tips back and forth.</i></blockquote>
</blockquote>
</blockquote>
<br />
Alternatively, reciprocal behavior can be visualized as a spectrum across a two dimensional graph, with SNS activity on one axis, and PSNS activity on the other:<br />
<br />
<div class="center">
<div class="floatnone">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/zl0gHrl.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/zl0gHrl.jpg" /></a></div>
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>X-Y Graph of Reciprocal ANS Activity</b>
</span><br />
<br />
<br />
</center>
</blockquote>
</blockquote>
</blockquote>
<i>Sympathetic dominance is shown as yellow, parasympathetic dominance as blue. For many decades it was thought that this was the only way the two systems worked, and this became known as the doctrine of reciprocity.</i>
<br />
<a href="http://www.blogger.com/null" id="Doctrine_of_Autonomic_Space" name="Doctrine_of_Autonomic_Space"></a><br />
<h3>
<span class="mw-headline">Doctrine of Autonomic Space</span></h3>
While the SNS and PSNS often work in this reciprocal fashion, it is now known that this is not always the case. First, not every effector has both types of innervation. The sweat glands, kidneys, and most blood vessels are examples of effectors that have only sympathetic, and no parasympathetic nerve endings. Second, even those organs with dual innervation do not always respond in the classic reciprocal manner. Instead, sometimes both the sympathetic and parasympathetic tone increase at the same time (co-activation). Or, they may both decrease at the same time, (co-inhibition). Or, one may go up or down while the other does nothing (un-coupled activation or un-coupled inhibition).<br />
<br />
So, an increase in heart rate could be accomplished in classic reciprocal fashion, that is the SNS activity increases while the PSNS decreases. But, an increase in heart rate could be also be accomplished by an increase in SNS activity alone, or a withdrawal of PSNS activity alone, or an increase in both where the SNS increase was greater, or a withdrawal of both where the PSNS withdrawal was greater. (See <a class="external text" href="http://editthis.info/corposcindosis/References#Berntson1991" rel="nofollow" title="http://editthis.info/corposcindosis/References#Berntson1991">Berntson et al. 1991</a>)<br />
<br />
This more complex matrix of possible interactions between the two divisions of the ANS can be visualized on a three dimensional graph:<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/29opRD8.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/29opRD8.jpg" /></a></div>
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>Map of Autonomic Space</b>
</span><br />
</center>
</blockquote>
</blockquote>
</blockquote>
<i>This 3D graph, in addition to plotting relative amounts of sympathetic and parasympathetic activity on the x and y axes, also shows functional state on the z axis in arbitrary units centered around 0. Again, sympathetic dominance is yellow, parasympathetic is blue. The top surface represents all of the different functional states that can be produced by various combinations of reciprocal and co-active behavior. They show up as shades of green. This type of graph could be used to visualize the state of autonomic activity generally (as above), or the state of a particular effector.</i><br />
<i> </i>
<br />
Emotions have been shown to elicit co-activation in the heart. (See <a class="external text" href="http://editthis.info/corposcindosis/References#OBRIST1965" rel="nofollow" title="http://editthis.info/corposcindosis/References#OBRIST1965">Obrist et al.1965</a>). Human male sexual function was long ago recognized to involve co-activation. (See <a class="external text" href="http://editthis.info/corposcindosis/References#Root1947" rel="nofollow" title="http://editthis.info/corposcindosis/References#Root1947">Root & Bard, 1947</a>).<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/UhLae0F.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/UhLae0F.jpg" /></a></div>
<br />
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue;"><b>Other Landmarks in Autonomic Space</b>
</span><br />
</center>
</blockquote>
</blockquote>
</blockquote>
<i>Here we plot ANS co-activation to the sex organs. The entire sexual experience involves co-activation, with the arousal phase marked by parasympathetic dominance, and orgasm by sympathetic dominance.</i><br />
<i> </i>
<br />
In the above diagram, what effects are represented by the question marks? Does “melancholy” produce co-inhibition? What about “nostalgia”? Are the subtle differences we feel between these two emotions actually subtle differences in body states regulated by the ANS? Perhaps.
<br />
<blockquote>
“Body state changes, particularly those mediated by the autonomic nervous system, are crucial to the ongoing experience of emotion”. (<a class="external text" href="http://editthis.info/corposcindosis/References#Critchley2001" rel="nofollow" title="http://editthis.info/corposcindosis/References#Critchley2001">Critchley et al. 2001</a>).
</blockquote>
<br />
<br />
<a href="http://www.blogger.com/null" id="Complexity_in_Context" name="Complexity_in_Context"></a><br />
<h3>
<span class="mw-headline">Complexity in Context</span></h3>
The physiology of the ANS is complex, to say the least. It is far from being completely understood. With regard to some organs, such as the heart, our knowledge appears to be relatively complete. In other areas, such as its role in immune function and bone metabolism, we are really just beginning to unravel its mysteries. The sympathetic nervous system runs to almost every organ, gland, blood vessel and bone in the entire human body. And while it is useful to explore this complexity, as we shall throughout, it is also useful to consider simple general statements such as:
<br />
<blockquote>
“The sympathetic nervous system is critical for organ and tissue homeostasis” (<a class="external text" href="http://editthis.info/corposcindosis/References#Tourtellotte" rel="nofollow" title="http://editthis.info/corposcindosis/References#Tourtellotte">Tourtellotte</a>)
</blockquote>
<h2>
<a href="http://www.blogger.com/null" id="Mapping_Denervation" name="Mapping_Denervation"></a></h2>
<h2>
<span class="mw-headline" style="font-size: large;">Mapping Denervation</span></h2>
To complete the CS model, we seek to determine which, and to what extent, body structures are denerved by ETS surgery. Toward this end, it may be useful to consider just what conditions have been treated by sympathectomy over the decades.
<br />
<h2>
<a href="http://www.blogger.com/null" id="Many_Indications" name="Many_Indications"></a></h2>
<h2>
<span class="mw-headline" style="font-size: large;">Many Indications</span></h2>
Sympathectomy is, by definition, the intentional destruction of some part of the sympathetic chain. Sympathectomies are broadly divided into 2 categories – lumbar and thoracic. The first such operation took place in 1889. Because the sympathetic system runs to so many different organs, glands and muscles, surgeons have since 1920 regularly performed sympathectomy in experimental attempts to treat a great long list of physical and mental disorders:
<br />
<ul>
<li> angina pectoris
</li>
<li> anxiety
</li>
<li> epilepsy
</li>
<li> erythrophobia (fear of blushing)
</li>
<li> glaucoma
</li>
<li> goiter
</li>
<li> hyperhidrosis (excessive sweating)
</li>
<li> idiocy
</li>
<li> raynaud’s disease
</li>
<li> reflex sympathetic dystrophy
</li>
<li> pain
</li>
<li> social phobia
</li>
</ul>
<br />
(See <a class="external text" href="http://editthis.info/corposcindosis/References#Hashmonai2003" rel="nofollow" title="http://editthis.info/corposcindosis/References#Hashmonai2003">Hashmonai et al 2003</a>; also <a class="external text" href="http://en.wikipedia.org/wiki/Endoscopic_thoracic_sympathectomy" rel="nofollow" title="http://en.wikipedia.org/wiki/Endoscopic_thoracic_sympathectomy">Wikipedia</a>)
<br />
<br />
Several of these indications, such as idiocy and glaucoma, have been abandoned. Recently (2005) two new experimental indications have emerged - headaches and hyperactive bronchial tubes. There is also current interest in treating schizophrenia with ETS. <a class="external text" href="http://editthis.info/corposcindosis/References#Teleranta2003" rel="nofollow" title="http://editthis.info/corposcindosis/References#Teleranta2003">Teleranta 2003</a>. In any case, clearly the surgery affects a great many body parts, as evidenced by the wide variety of indications.
<br />
Historically sympathectomy was performed with an “open surgery” approach, and required large incisions and resecting (sawing off) of ribs. Since the late 1980’s, “minimally invasive” sympathectomies have been developed, which utilize vary narrow surgical instruments and tiny cameras inside the chest. This requires only very small incisions. The most popular instruments are:
<br />
<ul>
<li> Electrocautery, in which electricity is used to burn the tissue
</li>
<li> Harmonic scalpel, in which ultrasound is used to make very precise cuts in the tissue
</li>
<li> Clamping, in which a titanium clamp is used to crush the tissue
</li>
<li> Chemical sympathectomy, in which a long needle is used to inject phenol into the tissue
</li>
</ul>
In all cases the goal of thoracic sympathectomy is the same - to destroy some part of the sympathetic chain of ganglia in the thoracic region. However, the precise target varies depending on the symptom being treated, and the preferences and theories of the individual surgeon.
<br />
<h2>
<a href="http://www.blogger.com/null" id="Variations_of_ETS_surgery" name="Variations_of_ETS_surgery"></a></h2>
<h2>
<span class="mw-headline" style="font-size: large;">Variations of ETS surgery</span></h2>
In this video, Dr. Richard J. Fischel uses a Harmonic Scalpel to remove the T2, T3 sympathetic ganglia.<br />
<a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Reciprocity.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="X-Y Graph of Reciprocal ANS Activity"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><br /></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:ANSChart.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Typical ANS Wall Chart"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:ControlCenterOut.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Outputs from the control center"></a>
<br />
<div class="separator" style="clear: both; text-align: center;">
<object class="BLOGGER-youtube-video" classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0" data-thumbnail-src="http://img.youtube.com/vi/Qf_Pvh6yJsM/0.jpg" height="266" width="320"><param name="movie" value="https://youtube.googleapis.com/v/Qf_Pvh6yJsM&source=uds"><param name="bgcolor" value="#FFFFFF" /><param name="allowFullScreen" value="true" /><embed width="320" height="266" src="https://youtube.googleapis.com/v/Qf_Pvh6yJsM&source=uds" type="application/x-shockwave-flash" allowfullscreen="true"></embed></object></div>
<br />
<br />
<br />
<br />
<br />
<a class="image" href="http://www.blogger.com/corposcindosis/File:ASpace2.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;" title="Other Landmarks in Autonomic Space"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:ASpace1.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;" title="Map of Autonomic Space"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Reciprocity.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;" title="X-Y Graph of Reciprocal ANS Activity"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:Balance.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;" title="Reciprocal Nature of ANS"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><br /></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:ANSChart.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;" title="Typical ANS Wall Chart"></a><a class="image" href="http://www.blogger.com/corposcindosis/File:ControlCenterOut.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;" title="Outputs from the control center"></a>
Some surgeons prefer to sever the sympathetic trunk, while leaving the ganglia intact. Others prefer to cut out and remove ganglia, while still others prefer to crush the trunk with a titanium clamp, which is left inside the patient. Generally thoracic sympathectomy takes place around the T2-T5 level. T2 is sometimes targeted to treat excessive facial sweating or blushing, while T3-T4 is targeted to treat excessive hand sweating.<br />
<br />
Surgeons have made various claims about achieving high degrees of specificity with their own brands of ETS surgery. For example, Timo Telaranta and Chien Lin devised the Lin-Telaranta classification system:
<br />
<ul>
<li> Sweating of the hands - T4
</li>
<li> Sweating and Facial Blushing - T3
</li>
<li> Blushing of the face alone - T2
</li>
<li> Social anxiety with Facial Blushing - T2
</li>
<li> Social anxiety without Facial Blushing - T3 and T4 on the left side only
</li>
<li> Heart racing and rhythm disorders - T3, T4, and T5 on the left side only (<a class="external text" href="http://editthis.info/corposcindosis/References#Lin2001" rel="nofollow" title="http://editthis.info/corposcindosis/References#Lin2001">Lin et al. 2001</a>)
</li>
</ul>
Other surgeons have made different, yet no less specific, claims. Many examples have emerged of surgeon advertising websites which state or imply that ETS can target sweat glands exclusively, or can target the hands to the exclusion of other body regions.<br />
<br />
However, empirical support for any such degree of specificity is mostly absent, and contradictory data is present. For instance, a study in France showed a lowered cardiac response to exercise after ETS, even if they only operated on one side, and it didn’t matter which side it was. The authors said this was consistent with the “random distribution” of cardiac fibers noted in anatomical studies. (See <a class="external text" href="http://editthis.info/corposcindosis/References#Abraham2002" rel="nofollow" title="http://editthis.info/corposcindosis/References#Abraham2002">Abraham et al. 2002</a>). Yet Goldstein and colleagues at NIH produced a graph which appears to indicate that unilateral sympathectomy does not produce the same amount of denervation as does bilateral.<br />
<br />
An early study demonstrated a “bottleneck” effect at T2. The authors presented evidence that denervation of the top 1/3 of the body was complete, whether the surgeons took just T2, or T2-T3, or T2-T4. (see <a class="external text" href="http://editthis.info/corposcindosis/References#Hyndman1942" rel="nofollow" title="http://editthis.info/corposcindosis/References#Hyndman1942">Hyndman et al. 1942</a>)
<br />
<a href="http://www.blogger.com/null" id="Problems_in_Targeting" name="Problems_in_Targeting"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Problems in Targeting</span></h2>
From a physiological perspective, attempts to target specific local symptoms via sympathectomy will encounter three great problems, namley:
<br />
<ul>
<li> The “bundling” problem
</li>
<li> The “overlap” problem
</li>
<li> The “individuality” problem
</li>
</ul>
In reality, patients with excessive palm sweating do not wish to stop palm sweating altogether, rather they would like to reduce it to normal. But let’s assume we wanted to completely stop sympathetic nerve function to the sweat glands in the palms of the hands.
<br />
First, it is impossible to isolate the “sweat gland nerves” because such nerves do not exist. Nerves leading to the sweat glands are all bundled together with nerves leading to many other effectors, such as the heart, the lungs, blood vessels, thyroid, bone, bone marrow, arrector pili, adipose tissue, senory nerves, etc. (the “bundling” problem).<br />
<br />
Second, even if we wanted to stop nerve function to all sorts of effectors, it is impossible to treat “just the hands”. Each individual sympathetic ganglion serves a much larger region than that. It is generally true that ganglia higher up along the sympathetic chain innervate structures higher up in the body, but there is no possible way to isolate that portion that serves just “the hands” (the “overlap” problem).<br />
<br />
Third, there can be significant individual differences in innervation from patient to patient, which are not discernable to the surgeon (the “individuality” problem).
<br />
Hence the results of thoracic sympathectomy remain somewhat unpredictable, and denervation is always far more extensive than desired. So, again, the challenge is to figure out which, and to what extent, structures are denerved by thoracic sympathectomy.
<br />
<a href="http://www.blogger.com/null" id="Cutaneous_Denervation_Patterns" name="Cutaneous_Denervation_Patterns"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Cutaneous Denervation Patterns</span></h2>
<h2>
<span class="mw-headline" style="font-size: large;"> </span></h2>
<h3>
<span class="mw-headline">Songboy1234 Study</span></h3>
From 2004-2005 an informal study of anhidrosis patterns was conducted by ETS patient songboy1234, of the Truth About ETS website. Two patterns emerged.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/vZJkwtN.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="472" data-original-width="482" height="625" src="https://i.imgur.com/vZJkwtN.jpg" width="640" /></a></div>
<br />
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
<b>The Two Patterns of Skin Denervation from ETS</b>
</span><br />
</center>
</blockquote>
</blockquote>
</blockquote>
<i>Pattern I is the corposcindosis pattern, the split body. Pattern II will be shown in section on systemic function to have less severe consequences than Pattern I, and may be considered as a mild case of CS.</i>
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<b>Thermal Image After T2-T4 ETS</b>
<br />
</center>
</blockquote>
</blockquote>
</blockquote>
<i>Pattern I denervation is quite evident in this thermal image. The denerved upper body region is 10-12˚ F hotter on average the section below, with a clear dividing line. In the upper region, surface blood vessels are unable to constrict, and sweat glands are unable to provide the normal thin layer of moisture.</i>
<br />
<br />
<br />
ETS surgeons have thus far not seen fit to publish their results on denervation patterns, and they are called upon to begin doing so. Based on this independent research (37 patients), pattern I appears to be by far the most common. Pattern II has also occurred, and is associated with T3-T4 sympathectomy. T2 sympathectomy, whether involving other levels or not, appears to invariably result in pattern I. T3-T4 sympathectomy may also result in pattern I, or pattern II, it is unpredictable. No other patterns were observed in this study, data are presented <a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Denervation_Patterns" rel="nofollow" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Denervation_Patterns">here</a>. These patterns are “all or nothing”. The denerved areas are totally denerved, devoid of sympathetic activity.<br />
<br />
The above diagrams and thermal image represent the cutaneous (skin deep) effects. Patterns of denervation to deeper innervated structures are more difficult to ascertain, yet no less (perhaps more) important, and again much needed research is called for.<br />
<br />
Denervation of deep structures, such as heart, lungs, blood vessels, thyroid, bone, bone marrow, thymus, etc, can be either partial or total, and will be discussed on a case-by-case basis in section II.
<br />
<a href="http://www.blogger.com/null" id="Longmire_Classification_System_for_Regional_Sympathetic_Dysfunction" name="Longmire_Classification_System_for_Regional_Sympathetic_Dysfunction"></a><br />
<h3>
<span class="mw-headline">Longmire Classification System for Regional Sympathetic Dysfunction</span></h3>
In 2006 David Longmire proposed a classification system for regional sympathetic dysfunction. He documents various diseases and injuries that can cause regional sympathetic denervation, including “Thoracic sympathetic block”, but not including “Thoracic sympathectomy” or “ETS”.
<br />
He diagrams several cutaneous denervation patterns, none of which resemble the split-body corposcindosis pattern described here.<br />
<br />
In the Longmire classification, "Thoracic sympathetic block" appears under section III – “BILATERAL SUDOMOTOR DYSFUNCTION”, subsection A.2 - “Bilateral Hypohidrosis, Asymmetric”<br />
<br />
"Thoracic sympathetic block" ordinarily refers to a chemical blockade, not a sympathectomy. "Hypohidrosis" means lowered sweating, as opposed to "anhidrosis" which means no sweating. Longmire is certainly aware of these distinctions, considering the following passage from his paper:
<br />
<blockquote>
“Testing for focal hypohidrosis or anhidrosis has been one of the few ways in which anesthesiologists and surgeons have been able to quantitatively test for the success of a sympathetic block or surgical sympathectomy.”
</blockquote>
It is unclear why Longmire chooses to ignore "sympathectomy" and "anhidrosis" in favor of "sympathetic block" and "hypohidrosis" within his classification system. Longmire is urged to include thoracic sympathectomy as an etiology of sympathetic dysfunction, and to diagram the split-body pattern (see <a class="external text" href="http://editthis.info/corposcindosis/References#Longmire2006" rel="nofollow" title="http://editthis.info/corposcindosis/References#Longmire2006">Longmire, 2006</a>).
<br />
<br />
<br />
<div class="center">
<div class="floatnone">
<br />
<br /></div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<br />
<b>Graphical Representation of Partial Sympathetic Denervation.</b>
<br />
</center>
</blockquote>
</blockquote>
</blockquote>
<i>The “high elevations” are no longer available. With ETS, this would pertain to partially denerved structures such as the heart. Totally denerved structures, such as sweat glands above the nipple line, would be represented by only the left-most row of squares on the functional surface. Since sweat glands only work above a zero threshold, this means that sweat glands in the denerved area are non-functional.</i>
<br />
<a href="http://www.blogger.com/null" id="Denervation_Supersensitivity" name="Denervation_Supersensitivity"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Denervation Supersensitivity</span></h2>
Since sympathectomy is denervation, a correct model must consider the principle of “denervation super-sensitivity”, otherwise known as “Cannon’s Law”. Receptor cells that are denerved, will, over time, remodel themselves and become super-sensitive to the neurotransmitters and catecholamines which activate them. (see <a class="external text" href="http://editthis.info/corposcindosis/References#Cannon1949" rel="nofollow" title="http://editthis.info/corposcindosis/References#Cannon1949">Cannon 1949</a>)
<br />
<a href="http://www.blogger.com/null" id="Summary_of_Corposcindosis_Model" name="Summary_of_Corposcindosis_Model"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Summary of Corposcindosis Model</span></h2>
<ol>
<li>Sympathetic function has been completely eliminated in some effectors, and partially eliminated in others. The normal effect of sympathetic increase is predicted to now be absent or diminished in denerved areas.
</li>
<li>At the systemic level, predictions become more complex, but the guiding principle is the same. Body-state changes ordinarily modulated by the SNS are now predicted to be absent or diminished, and systemic physiological abnormalities can be inferred.
</li>
<li>Because a significant portion of the SNS is now non-functional, the corposcindosis model predicts that the still-functioning portion may operate hyperactively, as the control center attempts to maintain homeostasis by over-compensating.
</li>
<li>Over time, denerved receptor cells are predicted to become super-sensitive to catecholamines, according to Cannon’s law.
</li>
</ol>
<!--
NewPP limit report
Preprocessor node count: 31/1000000
Post-expand include size: 0/2097152 bytes
Template argument size: 0/2097152 bytes
Expensive parser function count: 0/100
-->
<!-- Saved in parser cache with key corposcindosis:pcache:idhash:1288-0!1!0!!en!2!edit=0 and timestamp 20130421045907 -->
<br />
<script type="text/javascript">if (window.runOnloadHook) runOnloadHook();</script>
<script type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script>
<script type="text/javascript">
var pageTracker = _gat._getTracker("UA-600316-1");
pageTracker._initData();
pageTracker._trackPageview();
</script><!-- Served in 0.784 secs. --><!-- Cached 20130421045907 -->
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-32773264710403588632013-05-30T12:14:00.000-07:002017-09-23T11:45:05.915-07:00Thermoregulation<title>Changes to Systemic Function, part 1 - Corposcindosis</title>
<link href="Changes_to_Systemic_Function,_part_1_files/shared.css" media="screen" rel="stylesheet" type="text/css"></link>
<link href="Changes_to_Systemic_Function,_part_1_files/commonPrint.css" media="print" rel="stylesheet" type="text/css"></link>
<link href="Changes_to_Systemic_Function,_part_1_files/main.css" media="screen" rel="stylesheet" type="text/css"></link><br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<a href="http://www.blogger.com/null" id="top" name="top"></a>We spend our entire lives inside a narrow range of internal body
temperatures. Humans cannot tolerate internal temperatures below 95˚ F
or above 105˚F for very long at all. Maintaining core body temperature
homeostasis is a key responsibility of the control center. How does it
manage this?<br />
<br />
As described in <a href="http://corposcindosis.blogspot.com/2013/05/the-corposcindosis-model.html">the Corposcindosis Model</a>,
the control center is analogized to a very sophisticated thermostat,
taking in information about core body temperature and skin temperature
at all times. It is thought that the control center is able to
continually target core body temperature to a “set point”. The normal
set point for most people is 98.6˚F.</div>
<div id="content">
<div id="bodyContent">
<br />
Penn State University physiology professor W. Larry Kenney has
given a magnificent treatise on Human Thermoregulation. Kenney
describes the mechanisms by which the human body gains and loses heat:
<br />
<blockquote>
“By far, the largest source of heat imparted to the body
results from metabolic heat production (M). Even at peak mechanical
efficiency, 75 to 80% of the energy involved in muscular work is
liberated as heat. At rest, a metabolic rate of 300 ml per minute
creates a heat load of approximately 100 Watts. During steady-state
work at an oxygen consumption of 1 l/min, approximately 350 W of heat
are generated-less any energy associated with external work (W). Even
at such a mild to moderate work intensity, body core temperature would
rise approximately one degree centigrade every 15 min were it not for
an efficient means of heat dissipation. In fact, very fit individuals
can produce heat in excess of 1,200 W for 1 to 3 hours without heat
injury (see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Gisolfi1984" title="references.html#Gisolfi1984">Gisolfi et al. 1984</a>).
<br />
<br />
Heat can also be gained from the environment via radiation (R) and
convection (C) if the globe temperature (a measure of radiant heat) and
air (dry-bulb) temperature, respectively, exceed skin temperature.
These avenues of heat gain are typically small relative to M, and
actually become avenues of heat loss when the skin-to-air thermal
gradient is reversed. <b>The
final avenue for heat loss-evaporation (E)-is also typically the most
important, since the latent heat of vaporization of sweat is
high-approximately 680 W-h/l of sweat evaporated.” </b>(<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kenney" title="references.html#Kenney">Kenney</a>, emphasis added)
</blockquote>
<a href="http://www.blogger.com/null" id="Maintaining_Core_Temperature_Against_Cold" name="Maintaining_Core_Temperature_Against_Cold"></a><br />
<h2>
<span class="mw-headline"> Maintaining Core Temperature Against Cold </span></h2>
When the environment temperature goes below a certain threshold, the
body must take measures to maintain core temperature. It essentially
has two strategies for this:
<br />
<ul>
<li> Generating additional heat from metabolic processes (thermogenesis)
</li>
<li> Conserving the body heat which is already present
</li>
</ul>
Generating additional body heat beyond that which the muscles
release can be accomplished by burning fat tissue, especially brown
adipose tissue. How does the control center deliver the message to the
brown adipose tissue (BAT) to begin lipolysis?
<br />
<blockquote>
“The initial event in the stimulation of thermogenesis is
the release of noradrenaline from the sympathetic nerves which
extensively innervate Brown Adipose Tissue.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#TRAYHURN1993" title="references.html#TRAYHURN1993">Trayhurn 1993</a>)
</blockquote>
So sympathetic innervation is required to trigger thermogenesis, but is it important in the overall process?
<br />
<blockquote>
“The SNS plays<b> a pivotal role</b> in the regulation of
the increased energy expenditure associated with the adaptive response
to cold, particularly in relation to the stimulation of thermogenesis
in brown adipose tissue” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Trayhurn1998" title="references.html#Trayhurn1998">Trayhurn et al. 1998</a> emphasis added; see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Landsberg1984" title="references.html#Landsberg1984">Landsberg et al. 1984</a>).
</blockquote>
Besides thermogenesis, the other response to cold is to conserve
body heat. The control center does this by constricting surface blood
vessels, reducing the surface area exposed to the environment, thus
reducing the amount of heat lost due to convection. Under even more
extreme exposure to cold, extremity blood vessels may be further
constricted, shunting blood and life-preserving warmth into the core.<br />
<br />
Considering the loss of sympathetic innervation to brown
adipose tissue, and especially considering the loss of vasoconstriction
to the denerved areas, there is strong reason to suspect that ETS will
diminish the ability to stay warm in cold temperatures.
<br />
<a href="http://www.blogger.com/null" id="Maintaining_Core_Temperature_Against_Hot" name="Maintaining_Core_Temperature_Against_Hot"></a><br />
<h2>
<span class="mw-headline"> Maintaining Core Temperature Against Hot </span></h2>
There are three methods by which body heat can escape into the
environment – radiation, convection, and evaporation. Radiation is
electromagnetic waves which are given off by all things. If the
environment is cooler than the skin, some heat will radiate away, but
the body has no control over this.
<br />
Convection refers to the heat exchange that takes place between
any two things of differing temperature. As with radiation, if the air
temperature is below that of the skin, body heat will be lost through
convection. The body does have some control over convection, which is
the first line of defense against hyperthermia (overheating).
Increasing heat loss via convection is accomplished by dilating surface
blood vessels. This moves warm blood from the body core out to the skin
where a greater surface area is exposed to the air.<br />
<br />
However, if the air temperature is too hot, convection (and
radiation) will work in the opposite direction, causing the body to
gain instead of lose heat. Or, even if the environment temperature is
below the skin temperature, the heat generated by metabolic work may
overwhelm the ability of convection to sufficiently cool the body down.<br />
<br />
In these situations, when convection is not enough, the body
must employ what Kenney calls “typically the most important” means of
heat loss – evaporative cooling, that is sweating. The control center
increases sympathetic tone to the sweat glands, which secrete sweat
onto the surface of the skin. As water evaporates into the air, heat is
taken along with it. Simple, effective and refreshing.
<br />
Consider the following diagram from the Kenney treatise, with added ETS comments in red:<br />
<br />
<div class="center">
<div class="floatnone">
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/O3IS8KR.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/O3IS8KR.jpg" /></a></div>
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b>Schematic of Control Center Response to Increased/Decreased Core Temperature </b>
</span><br />
<span style="color: blue; font-size: small;"><br />
</span><br />
<span style="color: blue; font-size: small;"></span>
</center>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
<a href="http://www.blogger.com/null" id="Thermal_Images_of_Corposcindosis" name="Thermal_Images_of_Corposcindosis"></a><br />
<h2>
<span class="mw-headline"> Thermal Images of Corposcindosis </span></h2>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/jnC4zgi.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/jnC4zgi.jpg" /></a></div>
<br />
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b>Thermal Image After ETS, Patient 1 </b>
</span><br />
<span style="color: blue; font-size: small;"></span>
</center>
<br />
<i>Pattern I Corposcindosis. The denerved body section above the nipple
line is obvious, and shows an abnormal 10-12˚ F difference in skin
temperature. Denerved cutaneous blood vessels are unable to constrict,
and the upper body acts as a giant heat leak in cold temperatures. The
same region is unable to sweat, so any evaporative cooling must come
from the other part of the body. </i>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
Owing to the simple fact that heat rises, approximately 40% of
body heat lost through convection is lost through the head. We can
easily surmise that evaporative cooling from the lower body is
significantly less efficient than on the head, compounded by the fact
that this part of the body is usually covered by clothing.<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/x9L8xDO.gif?1" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/x9L8xDO.gif?1" /></a></div>
<br />
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b>Thermal Images After T2-T4 ETS, Patient 1, 360˙ rotation</b>
</span><br />
<span style="color: blue; font-size: small;"></span>
</center>
</blockquote>
</blockquote>
</blockquote>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/s8NS7ew.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="254" src="https://i.imgur.com/s8NS7ew.jpg" width="320" /></a></div>
<br />
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b> Thermal Image After ETS, Patient 2 </b>
</span><br />
<span style="color: blue; font-size: small;"></span>
</center>
</blockquote>
</blockquote>
</blockquote>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/6r1hgb5.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/6r1hgb5.jpg" /></a></div>
<br />
<div class="center">
<div class="floatnone">
<br /></div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b> Thermal Image After ETS, Patient 3 </b>
</span><br />
<span style="color: blue; font-size: small;"></span>
</center>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<a href="http://www.blogger.com/null" id="Normal_Thermal_Images" name="Normal_Thermal_Images"></a><br />
<h2>
<span class="mw-headline">Normal Thermal Images</span></h2>
<div class="center">
<div class="floatnone">
<div class="separator" style="clear: both; text-align: center;">
<a class="image" href="file:///NormalFrontal.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="NormalFrontal.jpg"></a><a class="image" href="file:///SleepyFrontal.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="SleepyFrontal.jpg"></a><a class="image" href="file:///Mark_front.thermal.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Mark front.thermal.jpg"></a><a class="image" href="file:///SBThermalRotate.gif" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="SBThermalRotate.gif"></a><a href="https://i.imgur.com/KVNmm35.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/KVNmm35.jpg" /></a></div>
<br /></div>
</div>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b>Normal Thermal Image </b>
</span><br />
<span style="color: blue; font-size: small;"></span>
</center>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<a href="http://www.blogger.com/null" id="NIH_Core_Temperature_Study_After_ETS" name="NIH_Core_Temperature_Study_After_ETS"></a><br />
<h2>
<span class="mw-headline"> NIH Core Temperature Study After ETS </span></h2>
We have already shown that ETS will destroy vasoconstriction in the
denerved area. Combined with the disruption of SNS signaling to brown
adipose tissue, it is reasonable to think that ETS surgery will
diminish the ability to fight cold temperatures.<br />
<br />
Given the loss of sweating on the top 1/3 of the body,
including the loss of head sweating, it seems clear that ETS surgery
will result in a diminished tolerance for heat. As expected, empirical
findings indicate that patients do not maintain core body temperatures
as well as normal control subjects, and this is true for both hot and
cold.
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="-moz-background-clip: -moz-initial; -moz-background-inline-policy: -moz-initial; -moz-background-origin: -moz-initial; background: rgb(255, 255, 153) none repeat scroll 0% 0%; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will reduce the ability to thermoregulate in cold temperatures.</b>
<br />
<br />
<b>Empirical status: Confirmed.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="-moz-background-clip: -moz-initial; -moz-background-inline-policy: -moz-initial; -moz-background-origin: -moz-initial; background: rgb(255, 255, 153) none repeat scroll 0% 0%; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will reduce the ability to thermoregulate in hot temperatures.</b>
<br />
<br />
<b>Empirical status: Confirmed.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
The empirical confirmation for the thermoregulatory problems
comes from an as yet unpublished study by David Goldstein at National
Institutes of Health. In addition to his published neurocardiology
findings about ETS patients, Goldstein has begun thermoregulatory
investigations.<br />
<br />
The patients are fitted with what Goldstein jokingly calls a
“superhero vest”. Water is pumped into the vest, and the temperature of
the water can be controlled very accurately. A thermometer probe is
placed in the ear to monitor how well the patient is maintaining core
body temperature against both the cold and hot water in the vest.<br />
<br />
Goldstein has written as his interpretation of one test:
<br />
<blockquote>
"The change in core temperature of about 0.4ºC during
manipulation of skin temperature would be consistent with decreased
ability to maintain core temperature in response to changes in
environmental temperature."
<br />
<br />
"There was evidence for a decreased ability to maintain core
temperature in response to changes in environmental temperature. Taken
together, there was evidence for multiple direct and indirect effects
of bilateral thoracic sympathectomy that would be expected to interfere
with the ability to maintain homeostasis in response to a variety of
stressors."
<br />
<br />
<b>"The patient should avoid extremes of environmental temperature."</b>
</blockquote>
<a href="http://www.blogger.com/null" id="Annals_of_Thoracic_Surgery_Case_Study" name="Annals_of_Thoracic_Surgery_Case_Study"></a><br />
<h2>
<span class="mw-headline">Annals of Thoracic Surgery Case Study</span></h2>
A published case study from the Annals of Thoracic Surgery
characterizes cold sensitivity as a "new side effect" of sympathectomy.
The authors describe a patient who, when "exposed to cold, the right
hand and forearm become numb and the skin temperature drops to
uncomfortable levels, while the left extremity remains comfortably
warm." They also comment on the state of the mainstream literature,
noting that sensitivity to cold was "previously unreported". <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Lowe2005" title="references.html#Lowe2005">Lowe et al. 2005</a>.
<br />
<a href="http://www.blogger.com/null" id="Nielson_Website" name="Nielson_Website"></a><br />
<h2>
<span class="mw-headline">Nielson Website</span></h2>
Additional confirmation of thermoregulatory difficulties comes from
ETS surgeon David Nielson, whose advertising website has, since 2003,
listed “heat intolerance” among the “side effects” produced by the
surgery. <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#NielsonSite" title="references.html#NielsonSite">Nielson website</a>
<br />
<a href="http://www.blogger.com/null" id="Selective_Brain_Cooling" name="Selective_Brain_Cooling"></a><br />
<h2>
<span class="mw-headline"> Selective Brain Cooling </span></h2>
Besides the general “heat intolerance”, ETS patients have
anecdotally reported what they consider to be a “hot brain” syndrome.
In particular, Taiwanese ETS patient and robotics engineer “Hpymaker”
has made frequent references in the oral history to this hot brain
phenomenon. Songboy1234 has also reported a very disturbing sensation
like a fever that occurs when exercise is attempted.<br />
<br />
Is there any scientific reason to suppose that ETS surgery
could interfere with brain cooling, separate from the general
thermoregulatory difficulties already shown? This would depend upon
whether the normal human has any mechanism to selectively cool the
brain; and if so, whether that mechanism is damaged by sympathectomy.
The answers are yes we do; and yes it is.
<br />
Studies from decades ago began to confirm Selective Brain
Cooling. “Cooling of the head skin . . .produces a significant
improvement in the performance of heat-stressed humans.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Kenney" title="references.html#Kenney">Kenney</a>, see Williams & Shitzer, 1974).<br />
<br />
The ability to selectively cool the brain during hyperthermia
(overheating) has long been an accepted fact in many mammals, such as
dogs. Dogs have a network of blood vessels in the head called the
“carotid rete” which allows heat exchange between warm blood in
arteries and cooler blood in veins. The excess heat escapes through the
mouth during panting. Humans do not have a carotid rete, so for some
time the notion of selective brain cooling in humans was controversial.<br />
<br />
However, it has been shown that at 65.8˚ F (18.8˚ C) ambient
temperature the deep trunk temperature of a marathon runner may rise to
107.4˚ F (41.9˚ C) with no clinical sign of heat illness (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#CABANAC1979" title="references.html#CABANAC1979">Cabanac et al. 1979</a>;
see Maron, Wagner & Horvath, 1977). Michel Cabanac at the
Department of Physiology, Laval University, Quebec has been studying
Selective Brain Cooling in Humans since the 1970’s, and has evidently
discovered the mechanism by which humans accomplish this.<br />
<br />
It turns out that certain veins in the face, such as the ophthalmic veins, will actually <i>reverse</i>
the direction of blood flow when the body begins to overheat. The blood
in these veins is cooled by evaporation of facial sweat, then flows
backwards into the sinus and intercranuim area, cooling the carotid
artery and the brain.
<br />
<blockquote>
“The selective influence of facial fanning on human brain
temperature can be attributed, therefore, to cool venous blood
perfusing the cavernous sinus and possibly cooling the blood of the
internal carotid artery.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#CABANAC1979" title="references.html#CABANAC1979">Cabanac et al. 1979</a>)
</blockquote>
A group of Japanese physiologists at Kanazawa University have been
confirming and expanding upon Cabanac’s findings. Their studies subject
people to heat stress and exercise, and measure variables such as skin
temperature, core temperature, forehead sweating, and blood flow in the
ophthalmic vein. They found “that there are elements within the brain
that control the mechanisms for switching the direction of venous flow
through the emissary veins to keep the brain cool during hyperthermia.”
(<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Hirashita1992" title="references.html#Hirashita1992">Hirashita et al. 1992</a>)<br />
<br />
Given that this direction-reversing mechanism requires vascular
control in the face, we already have strong reason to suspect that ETS
would disturb if not destroy selective brain cooling. Is head sweating
also important to this process?
<br />
<blockquote>
“The efficiency of SBC (Selective Brain Cooling) is
increased by evaporation of sweat on the head and by ventilation
through the nose.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Nagasaka1998" title="references.html#Nagasaka1998">Nagasaka et al. 1998</a>)
<br />
<br />
“A necessary condition for SBC is a high heat loss capacity from the
head itself, without such a heat loss SBC is not possible.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Cabanac1993" title="references.html#Cabanac1993">Cabanac 1993</a>)
<br />
<br />
“Because the human head sweats more than the rest of the body, heat
loss from the head skin could amount to 125-175 Watts under conditions
of moderate hyperthermia.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Cabanac1993" title="references.html#Cabanac1993">Cabanac 1993</a>)
<br />
<br /></blockquote>
Therefore, given the loss of vascular control after ETS surgery, it
is likely that that the control center is unable to reverse the
direction of venous blood flow in the face. Given the loss of head
sweating, such a reversal of blood flow would likely be very
ineffective at selective brain cooling anyway.
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="-moz-background-clip: -moz-initial; -moz-background-inline-policy: -moz-initial; -moz-background-origin: -moz-initial; background: rgb(255, 255, 153) none repeat scroll 0% 0%; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will significantly compromise selective brain cooling.</b>
<br />
<br />
<b>Empirical status: Unstudied.</b>
</blockquote>
</td><td></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
</div>
</div>
</div>
</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-22352896653012121912013-05-29T22:44:00.002-07:002013-05-29T22:46:11.331-07:00Table 2<br />
<br />
<table border="3" cellpadding="4" cellspacing="2" style="width: 725px;">
<tbody>
<tr>
<td align="left" height="1374" valign="top" width="641"><br /></td><td align="left" height="1374" valign="top" width="641"><br /></td></tr>
<tr>
<td align="left" height="1120" valign="top" width="641"><table border="3" cellpadding="4" cellspacing="2" style="width: 625px;">
<tbody>
<tr>
<td bgcolor="#003333" colspan="3"><center>
<span style="color: white; font-size: large;">Changes to Systemic Function</span></center>
</td></tr>
<tr>
<td bgcolor="#003333"><span style="color: white;">Body System</span>
</td><td bgcolor="#003333"><span style="color: white;">Predicted Change from Sympathectomy</span>
</td><td bgcolor="#003333"><span style="color: white;">Empirical Status</span>
</td></tr>
<tr>
<td bgcolor="#99cc99"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_1#Thermoregulation" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_1#Thermoregulation">thermoregulation</a>
</td><td bgcolor="#cccc99"><br />
loss of upper body sweating + loss of selective brain cooling = trouble staying cool<br />
<br />
loss of surface vasoconstriction + loss of deep tissue vasodilation + decreased fat burning = trouble staying warm<br />
<br />
increased upper body skin temperature = false messages from thermo-receptors</td><td bgcolor="#cccc99"><br />
<br />
thermal Images.<br />
<br />
Goldstein’s (NINDS) core-body temperature study (not yet published)
shows significant problems maintaining core body temperature against
both hot and cold .<br />
<br />
Nielson website listing “Heat Intolerance” among side effects.<br />
<br />
anecdotal complaints of heat and cold intolerance abound.</td></tr>
<tr>
<td bgcolor="#99cc99"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Exercise_Function" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Exercise_Function">exercise capacity</a>
</td><td bgcolor="#cccc99">reduced cardiac output + reduced baroreflex
+ diminished lung volume + reduced evaporative cooling + inability to
redistribute blow flow into deep muscle = reduced exercise capacity
</td><td bgcolor="#cccc99">reductions in every measure: cardiac index, heart rate, mean
arterial pressure, rate–pressure product, stroke index,
Changes_to_Systemic_Function%2C_part_ vascular resistance. “significant
reduction in baroreflex response to exercise”.<br />
more studies needed
</td></tr>
<tr>
<td bgcolor="#99cc99"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Endocrine_Function" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Endocrine_Function">endocrine function</a>
</td><td bgcolor="#cccc99">lowered blood catecholamines
</td><td bgcolor="#cccc99">confirmed
</td></tr>
<tr>
<td bgcolor="#99cc99" rowspan="2"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Mental_and_Emotional_Function" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Mental_and_Emotional_Function">mental and emotional</a>
</td><td bgcolor="#cccc99">Loss of body-state changes in response to
strong emotion + Loss of feedback signal to brain = Reduced subjective
experience of emotion<br />
<br />
Loss of sympathetic tone to cerebral artery + lowered blood catechols + loss of selective brain cooling = lowered alertness
</td><td bgcolor="#cccc99">Critchley, et. al. report “Changes in bodily states, particularly
those mediated by the autonomic nervous system, are crucial to ongoing
emotional experience”. <br />
Telaranta reports significant reduction in “fear” and “alertness” in studies of ETS on mental patients.<br />
<br /></td></tr>
<tr>
<td bgcolor="#cccc99">lack of informed consent + disturbing physical condition = profound anger + depression = suicide, suicidal ideation
</td><td bgcolor="#cccc99">one confirmed U.S. ETS suicide, anecdotal reports abound</td></tr>
<tr>
<td bgcolor="#99cc99" rowspan="2"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Immune_Function" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Immune_Function">immune function</a>
</td><td bgcolor="#cccc99">decreased tumor necrosis factor = increased tumors
</td><td bgcolor="#cccc99">unstudied
</td></tr>
<tr>
<td bgcolor="#cccc99">decreased immune response + decreased blood cathechols = slow healing
</td><td bgcolor="#cccc99">confirmed in rat skin, no human studies
</td></tr>
<tr>
<td bgcolor="#99cc99"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Adipose_Tissue" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Adipose_Tissue">body fat</a>
</td><td bgcolor="#cccc99">reduction in exercise capacity + reduced fat burning = increase in fat cell number + increase in fat cell size
</td><td bgcolor="#cccc99">confirmed in rats, no human studies
</td></tr>
</tbody></table>
</td></tr>
</tbody></table>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-91547422201165102172013-05-29T22:27:00.002-07:002013-05-29T22:42:00.008-07:00Table 1<br />
<br />
<table border="3" cellpadding="4" cellspacing="2" style="width: 725px;">
<tbody>
<tr bgcolor="#cc6633">
<td bgcolor="#000066" colspan="5"><center>
<blockquote>
<blockquote>
<span style="color: white; font-size: large;">Changes to Individual Effectors in the Denerverd Area</span></blockquote>
</blockquote>
</center>
</td></tr>
<tr bgcolor="#cc6633">
<td bgcolor="#000066"><span style="color: white;">Effector</span>
</td><td bgcolor="#000066"><span style="color: white;">Sympathetic Effect</span>
</td><td bgcolor="#000066"><span style="color: white;">Parasympathetic<br /> Effect (if any)</span>
</td><td bgcolor="#000066"><span style="color: white;">Predicted Change From Sympathectomy</span>
</td><td bgcolor="#000066"><span style="color: white;">Empirical Status</span>
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#9999ff" rowspan="3">heart
</td><td bgcolor="#ccccff">increase heart rate
</td><td bgcolor="#ccccff">decrease heart rate
</td><td bgcolor="#ccccff">reduced heart rate
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#ccccff">increase heart contraction strength
</td><td bgcolor="#ccccff">decrease heart contraction strength
</td><td bgcolor="#ccccff">reduced heart contraction strength
</td><td bgcolor="#ccccff">not studied
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#ccccff">increase cardiac response to exercise
</td><td bgcolor="#ccccff">decrease cardiac response to exercise
</td><td bgcolor="#ccccff">reduced cardiac response to exercise
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#9999ff">baroreflex
</td><td bgcolor="#ccccff">increase heart rate
</td><td bgcolor="#ccccff">decrease heart rate
</td><td bgcolor="#ccccff">decreased baroreflex control of heart rate
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#9999ff" rowspan="2">blood vessels
</td><td bgcolor="#ccccff">Constrict surface blood vessels
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">loss of vasoconstriction
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#ccccff">Dilate deep blood vessels via NO release
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">Loss of NO modulated vasodilation
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#9999ff" rowspan="2">lungs
</td><td bgcolor="#ccccff">dilate bronchial tubes
</td><td bgcolor="#ccccff">constrict bronchial tubes
</td><td bgcolor="#ccccff">Diminished lung volume
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#ccccff">facilitate CO<span style="font-size: xx-small;">2</span> transfer
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">reduced CO<span style="font-size: xx-small;">2</span> transfer
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#9999ff">sweat glands
</td><td bgcolor="#ccccff">Secrete sweat
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">anhidrosis
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#9999ff">arrector pili muscles
</td><td bgcolor="#ccccff">goose bumps/physical pleasure
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">loss of goosebumps/physical pleasure
</td><td bgcolor="#ccccff">not studied
</td></tr>
<tr>
<td bgcolor="#9999ff">muscles
</td><td bgcolor="#ccccff">release nitric oxide (NO), dilate muscular blood vessels
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">loss of NO release, atrophy, fiber splitting, necrosis, phagocytosis, fibrosis
</td><td bgcolor="#ccccff">confirmed in rabbits, no human studies
</td></tr>
<tr>
<td bgcolor="#9999ff">sensory nerves
</td><td bgcolor="#ccccff">modulate sensitivity, physical pleasure
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">reduced tactile sensitivity
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#9999ff" rowspan="2">adipose tissue
</td><td bgcolor="#ccccff">inhibit fat cell creation
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">increased fat cell number
</td><td bgcolor="#ccccff">confirmed in hamsters, no human study
</td></tr>
<tr>
<td bgcolor="#ccccff">stimulate lipolysis (fat burning)
</td><td bgcolor="#ccccff">stimulate lipogenisis (fat storage)
</td><td bgcolor="#ccccff">decreased fat burning, increased fat cell size
</td><td bgcolor="#ccccff">confirmed in hamsters, no human study
</td></tr>
<tr>
<td bgcolor="#9999ff" rowspan="3">bone
</td><td bgcolor="#ccccff">inhibit bone resorption
</td><td bgcolor="#ccccff">stimulate bone resorption
</td><td bgcolor="#ccccff">increased bone resorption
</td><td bgcolor="#ccccff">confirmed in rats, no human study
</td></tr>
<tr>
<td bgcolor="#ccccff">inhibit interluken 1 alpha production
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">increased interluken 1 alpha production
</td><td bgcolor="#ccccff">confirmed in rats, no human study
</td></tr>
<tr>
<td bgcolor="#ccccff">stimulate tumor necrosis factor (TNF) production
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">decreased TNF production
</td><td bgcolor="#ccccff">confirmed in rats, no human study
</td></tr>
<tr>
<td bgcolor="#9999ff" rowspan="3">thyroid
</td><td bgcolor="#ccccff">facilitate iodide uptake
</td><td bgcolor="#ccccff"><center>
?</center>
</td><td bgcolor="#ccccff">reduced iodide uptake
</td><td bgcolor="#ccccff">confirmed in rats, no human studies
</td></tr>
<tr>
<td bgcolor="#ccccff">increase thyroid weight
</td><td bgcolor="#ccccff"><center>
?</center>
</td><td bgcolor="#ccccff">loss of thyroid weight
</td><td bgcolor="#ccccff">confirmed in rats, no human studies
</td></tr>
<tr>
<td bgcolor="#ccccff">increase thyroid metabolism generally
</td><td bgcolor="#ccccff"><center>
?</center>
</td><td bgcolor="#ccccff">hypothyroidism
</td><td bgcolor="#ccccff">unstudied
</td></tr>
</tbody></table>
<br />Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-82356886335564864182013-05-29T17:10:00.001-07:002013-05-29T17:17:45.862-07:00Tables<title>Tables - Corposcindosis</title>
<link href="Tables_files/shared.css" media="screen" rel="stylesheet" type="text/css"></link>
<link href="Tables_files/commonPrint.css" media="print" rel="stylesheet" type="text/css"></link>
<link href="Tables_files/main.css" media="screen" rel="stylesheet" type="text/css"></link><br />
<div id="globalWrapper">
<div id="column-content">
<div id="content">
<div id="bodyContent">
<div align="right">
<table align="left" style="width: 658px;">
<tbody>
<tr>
<td align="left" height="1374" valign="top" width="641"><table border="3" cellpadding="4" cellspacing="2" style="width: 625px;">
<tbody>
<tr bgcolor="#cc6633">
<td bgcolor="#000066" colspan="5"><center>
<blockquote>
<blockquote>
<span style="color: white; font-size: large;">Changes to Individual Effectors in the Denerverd Area</span></blockquote>
</blockquote>
</center>
</td></tr>
<tr bgcolor="#cc6633">
<td bgcolor="#000066"><span style="color: white;">Effector</span>
</td><td bgcolor="#000066"><span style="color: white;">Sympathetic Effect</span>
</td><td bgcolor="#000066"><span style="color: white;">Parasympathetic<br /> Effect (if any)</span>
</td><td bgcolor="#000066"><span style="color: white;">Predicted Change From Sympathectomy</span>
</td><td bgcolor="#000066"><span style="color: white;">Empirical Status</span>
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#9999ff" rowspan="3"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_1#Heart" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_1#Heart">heart</a>
</td><td bgcolor="#ccccff">increase heart rate
</td><td bgcolor="#ccccff">decrease heart rate
</td><td bgcolor="#ccccff">reduced heart rate
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#ccccff">increase heart contraction strength
</td><td bgcolor="#ccccff">decrease heart contraction strength
</td><td bgcolor="#ccccff">reduced heart contraction strength
</td><td bgcolor="#ccccff">not studied
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#ccccff">increase cardiac response to exercise
</td><td bgcolor="#ccccff">decrease cardiac response to exercise
</td><td bgcolor="#ccccff">reduced cardiac response to exercise
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#9999ff"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_1#Baroreflex" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_1#Baroreflex">baroreflex</a>
</td><td bgcolor="#ccccff">increase heart rate
</td><td bgcolor="#ccccff">decrease heart rate
</td><td bgcolor="#ccccff">decreased baroreflex control of heart rate
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#9999ff" rowspan="2"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_1#Blood_Vessels" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_1#Blood_Vessels">blood vessels</a>
</td><td bgcolor="#ccccff">Constrict surface blood vessels
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">loss of vasoconstriction
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr bgcolor="#ccccff">
<td bgcolor="#ccccff">Dilate deep blood vessels via NO release
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">Loss of NO modulated vasodilation
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#9999ff" rowspan="2"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_1#Lungs" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_1#Lungs">lungs</a>
</td><td bgcolor="#ccccff">dilate bronchial tubes
</td><td bgcolor="#ccccff">constrict bronchial tubes
</td><td bgcolor="#ccccff">Diminished lung volume
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#ccccff">facilitate CO<span style="font-size: xx-small;">2</span> transfer
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">reduced CO<span style="font-size: xx-small;">2</span> transfer
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#9999ff"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Sweat_Glands" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Sweat_Glands">sweat glands</a>
</td><td bgcolor="#ccccff">Secrete sweat
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">anhidrosis
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#9999ff"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#3%29_Arrector_Pili" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#3)_Arrector_Pili">arrector pili muscles</a>
</td><td bgcolor="#ccccff">goose bumps/physical pleasure
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">loss of goosebumps/physical pleasure
</td><td bgcolor="#ccccff">not studied
</td></tr>
<tr>
<td bgcolor="#9999ff"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Muscles" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Muscles">muscles</a>
</td><td bgcolor="#ccccff">release nitric oxide (NO), dilate muscular blood vessels
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">loss of NO release, atrophy, fiber splitting, necrosis, phagocytosis, fibrosis
</td><td bgcolor="#ccccff">confirmed in rabbits, no human studies
</td></tr>
<tr>
<td bgcolor="#9999ff"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Sensory_Nerves" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Sensory_Nerves">sensory nerves</a>
</td><td bgcolor="#ccccff">modulate sensitivity, physical pleasure
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">reduced tactile sensitivity
</td><td bgcolor="#ccccff">confirmed
</td></tr>
<tr>
<td bgcolor="#9999ff" rowspan="2"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Adipose_%28Fat%29_Tissue" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Adipose_(Fat)_Tissue">adipose tissue</a>
</td><td bgcolor="#ccccff">inhibit fat cell creation
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">increased fat cell number
</td><td bgcolor="#ccccff">confirmed in hamsters, no human study
</td></tr>
<tr>
<td bgcolor="#ccccff">stimulate lipolysis (fat burning)
</td><td bgcolor="#ccccff">stimulate lipogenisis (fat storage)
</td><td bgcolor="#ccccff">decreased fat burning, increased fat cell size
</td><td bgcolor="#ccccff">confirmed in hamsters, no human study
</td></tr>
<tr>
<td bgcolor="#9999ff" rowspan="3"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_3#Bone" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_3#Bone">bone</a>
</td><td bgcolor="#ccccff">inhibit bone resorption
</td><td bgcolor="#ccccff">stimulate bone resorption
</td><td bgcolor="#ccccff">increased bone resorption
</td><td bgcolor="#ccccff">confirmed in rats, no human study
</td></tr>
<tr>
<td bgcolor="#ccccff">inhibit interluken 1 alpha production
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">increased interluken 1 alpha production
</td><td bgcolor="#ccccff">confirmed in rats, no human study
</td></tr>
<tr>
<td bgcolor="#ccccff">stimulate tumor necrosis factor (TNF) production
</td><td bgcolor="#ccccff"><center>
-</center>
</td><td bgcolor="#ccccff">decreased TNF production
</td><td bgcolor="#ccccff">confirmed in rats, no human study
</td></tr>
<tr>
<td bgcolor="#9999ff" rowspan="3"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_3#Thyroid_Gland" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_3#Thyroid_Gland">thyroid</a>
</td><td bgcolor="#ccccff">facilitate iodide uptake
</td><td bgcolor="#ccccff"><center>
?</center>
</td><td bgcolor="#ccccff">reduced iodide uptake
</td><td bgcolor="#ccccff">confirmed in rats, no human studies
</td></tr>
<tr>
<td bgcolor="#ccccff">increase thyroid weight
</td><td bgcolor="#ccccff"><center>
?</center>
</td><td bgcolor="#ccccff">loss of thyroid weight
</td><td bgcolor="#ccccff">confirmed in rats, no human studies
</td></tr>
<tr>
<td bgcolor="#ccccff">increase thyroid metabolism generally
</td><td bgcolor="#ccccff"><center>
?</center>
</td><td bgcolor="#ccccff">hypothyroidism
</td><td bgcolor="#ccccff">unstudied
</td></tr>
</tbody></table>
</td><td align="left" height="1374" valign="top" width="641"><br /></td></tr>
<tr>
<td align="left" height="1120" valign="top" width="641"><table border="3" cellpadding="4" cellspacing="2" style="width: 625px;">
<tbody>
<tr>
<td bgcolor="#003333" colspan="3"><center>
<span style="color: white; font-size: large;">Changes to Systemic Function</span></center>
</td></tr>
<tr>
<td bgcolor="#003333"><span style="color: white;">Body System</span>
</td><td bgcolor="#003333"><span style="color: white;">Predicted Change from Sympathectomy</span>
</td><td bgcolor="#003333"><span style="color: white;">Empirical Status</span>
</td></tr>
<tr>
<td bgcolor="#99cc99"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_1#Thermoregulation" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_1#Thermoregulation">thermoregulation</a>
</td><td bgcolor="#cccc99"><br />
loss of upper body sweating + loss of selective brain cooling = trouble staying cool<br />
<br />
loss of surface vasoconstriction + loss of deep tissue vasodilation + decreased fat burning = trouble staying warm<br />
<br />
increased upper body skin temperature = false messages from thermo-receptors</td><td bgcolor="#cccc99"><br />
<br />
thermal Images.<br />
<br />
Goldstein’s (NINDS) core-body temperature study (not yet published)
shows significant problems maintaining core body temperature against
both hot and cold .<br />
<br />
Nielson website listing “Heat Intolerance” among side effects.<br />
<br />
anecdotal complaints of heat and cold intolerance abound.</td></tr>
<tr>
<td bgcolor="#99cc99"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Exercise_Function" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Exercise_Function">exercise capacity</a>
</td><td bgcolor="#cccc99">reduced cardiac output + reduced baroreflex
+ diminished lung volume + reduced evaporative cooling + inability to
redistribute blow flow into deep muscle = reduced exercise capacity
</td><td bgcolor="#cccc99">reductions in every measure: cardiac index, heart rate, mean
arterial pressure, rate–pressure product, stroke index,
Changes_to_Systemic_Function%2C_part_ vascular resistance. “significant
reduction in baroreflex response to exercise”.<br />
more studies needed
</td></tr>
<tr>
<td bgcolor="#99cc99"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Endocrine_Function" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Endocrine_Function">endocrine function</a>
</td><td bgcolor="#cccc99">lowered blood catecholamines
</td><td bgcolor="#cccc99">confirmed
</td></tr>
<tr>
<td bgcolor="#99cc99" rowspan="2"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Mental_and_Emotional_Function" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Mental_and_Emotional_Function">mental and emotional</a>
</td><td bgcolor="#cccc99">Loss of body-state changes in response to
strong emotion + Loss of feedback signal to brain = Reduced subjective
experience of emotion<br />
<br />
Loss of sympathetic tone to cerebral artery + lowered blood catechols + loss of selective brain cooling = lowered alertness
</td><td bgcolor="#cccc99">Critchley, et. al. report “Changes in bodily states, particularly
those mediated by the autonomic nervous system, are crucial to ongoing
emotional experience”. <br />
Telaranta reports significant reduction in “fear” and “alertness” in studies of ETS on mental patients.<br />
<br /></td></tr>
<tr>
<td bgcolor="#cccc99">lack of informed consent + disturbing physical condition = profound anger + depression = suicide, suicidal ideation
</td><td bgcolor="#cccc99">one confirmed U.S. ETS suicide, anecdotal reports abound</td></tr>
<tr>
<td bgcolor="#99cc99" rowspan="2"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Immune_Function" title="http://editthis.info/corposcindosis/Changes_to_Systemic_Function%2C_part_2#Immune_Function">immune function</a>
</td><td bgcolor="#cccc99">decreased tumor necrosis factor = increased tumors
</td><td bgcolor="#cccc99">unstudied
</td></tr>
<tr>
<td bgcolor="#cccc99">decreased immune response + decreased blood cathechols = slow healing
</td><td bgcolor="#cccc99">confirmed in rat skin, no human studies
</td></tr>
<tr>
<td bgcolor="#99cc99"><a class="external text" href="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Adipose_Tissue" title="http://editthis.info/corposcindosis/Changes_to_Individual_Effectors%2C_part_2#Adipose_Tissue">body fat</a>
</td><td bgcolor="#cccc99">reduction in exercise capacity + reduced fat burning = increase in fat cell number + increase in fat cell size
</td><td bgcolor="#cccc99">confirmed in rats, no human studies
</td></tr>
</tbody></table>
</td></tr>
<tr>
<td align="left" height="556" valign="top" width="641"><table border="1" cellpadding="9" style="width: 626px;">
<tbody>
<tr>
<td bgcolor="#330066" colspan="3"><center>
<span style="color: white; font-size: large;">Compensatory Changes in Fucntional Areas</span></center>
</td></tr>
<tr>
<td bgcolor="#330066"><div align="left">
<span style="color: white; font-family: Helvetica, Geneva, Arial, SunSans-Regular, sans-serif;">Effector</span></div>
</td><td bgcolor="#330066"><div align="left">
<span style="color: white; font-family: Helvetica, Geneva, Arial, SunSans-Regular, sans-serif;">Predicted Change from Sympthectomy</span></div>
</td><td bgcolor="#330066"><div align="left">
<span style="color: white; font-family: Helvetica, Geneva, Arial, SunSans-Regular, sans-serif;">Empirical Confirmation?</span></div>
</td></tr>
<tr>
<td bgcolor="#cc99ff"><div align="left">
<b>sweat glands</b></div>
</td><td><div align="left">
hyperactive sweating</div>
</td><td><div align="left">
yes - "compensatory hyperhidrosis"</div>
</td></tr>
<tr>
<td bgcolor="#cc99ff"><div align="left">
<b>surface blood vessels</b></div>
</td><td><div align="left">
overly constricted</div>
</td><td><div align="left">
studies needed</div>
</td></tr>
<tr>
<td bgcolor="#cc99ff"><div align="left">
<b>deep blood vessels</b></div>
</td><td><div align="left">
overly dilated</div>
</td><td><div align="left">
studies needed</div>
</td></tr>
<tr>
<td bgcolor="#cc99ff"><div align="left">
<b>immune Function</b></div>
</td><td><div align="left">
increased inflammatory response</div>
</td><td><div align="left">
studies needed</div>
</td></tr>
<tr>
<td bgcolor="#cc99ff"><div align="left">
<b>adipose (fat) tissue</b></div>
</td><td><div align="left">
increased fat burning</div>
</td><td><div align="left">
studies needed</div>
</td></tr>
<tr>
<td bgcolor="#cc99ff"><b>arrector pili muscles</b>
</td><td>hyperactive goosebumps
</td><td>studies needed
</td></tr>
<tr>
<td bgcolor="#cc99ff"><b>sex organs (male)</b>
</td><td>difficulty achieving erection, more intense orgasm if achieved
</td><td>anecdotal reports of loss of libido, studies needed
</td></tr>
<tr>
<td bgcolor="#cc99ff"><b>sex organs (female)</b>
</td><td>difficulty achieving clitoral erection, reduced lubrication, more intense orgasm if achieved
</td><td>anecdotal reports of loss of libido, studies needed
</td></tr>
</tbody></table>
</td></tr>
<tr>
<td align="left" height="401" valign="top" width="641"><table border="3" cellpadding="4" cellspacing="2" style="width: 628px;">
<tbody>
<tr>
<td bgcolor="black" colspan="5"><center>
<span style="color: white; font-size: x-large;">Possible Collateral Damage</span></center>
</td></tr>
<tr>
<td bgcolor="black"><span style="color: white;">Body System</span>
</td><td bgcolor="black"><span style="color: white;">Proximity to Target Area</span>
</td><td bgcolor="black"><span style="color: white;">Function</span>
</td><td bgcolor="black"><span style="color: white;">Predicted Change If Accidentally Damaged</span>
</td><td bgcolor="black"><span style="color: white;">Empirical Status</span>
</td></tr>
<tr>
<td bgcolor="#999999">T1 sympathetic ganglion
</td><td bgcolor="#cccccc">immediately above T2 on sympathetic chain
</td><td bgcolor="#cccccc">innervates eyes, eyelids, heart, lungs, sweat glands, etc.
</td><td bgcolor="#cccccc">horner's syndrome
</td><td bgcolor="#cccccc">confirmed
</td></tr>
<tr>
<td bgcolor="#999999">intercostal nerves
</td><td bgcolor="#cccccc">immediately behind sympathetic trunk and running along each rib
</td><td bgcolor="#cccccc">provides sensory innervation to ribs and connecting tissue
</td><td bgcolor="#cccccc">intercostal neuralgia, nerve pain
</td><td bgcolor="#cccccc">confirmed
</td></tr>
<tr>
<td bgcolor="#999999">brachial plexus
</td><td bgcolor="#cccccc">emerges from spine, C5-T1, into axillae
</td><td bgcolor="#cccccc">provides motor function to arms
</td><td bgcolor="#cccccc">paralysis of arms
</td><td bgcolor="#cccccc">confirmed
</td></tr>
<tr>
<td bgcolor="#999999">lung
</td><td bgcolor="#cccccc">must be deflated for thoracic surgery
</td><td bgcolor="#cccccc">O<span style="font-size: xx-small;">2</span> in, CO<span style="font-size: xx-small;">2</span> out
</td><td bgcolor="#cccccc">pleural adhesion, collapsed lung
</td><td bgcolor="#cccccc">confirmed
</td></tr>
</tbody></table>
</td></tr>
</tbody></table>
</div>
<!--
NewPP limit report
Preprocessor node count: 68/1000000
Post-expand include size: 0/2097152 bytes
Template argument size: 0/2097152 bytes
Expensive parser function count: 0/100
-->
<!-- Saved in parser cache with key corposcindosis:pcache:idhash:1296-0!1!0!!en!2!edit=0 and timestamp 20091128170624 -->
</div>
</div>
</div>
</div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-75249453676123657292013-05-29T16:40:00.002-07:002017-09-22T22:26:06.022-07:00Adipose Tissue<span style="font-size: large;"><br /></span>
<br />
<h2>
<span class="mw-headline" style="font-size: large;"> Lipogenesis and Lipolysis </span></h2>
Weight gain and loss of energy are common anecdotal complaints found
in the oral history, so we turn now to the study of fat tissue. Mammals
have two types of fat tissue, White Adipose Tissue (WAT) and Brown
Adipose Tissue (BAT). WAT is located primarily under the skin surface
and serves to store energy, and as a layer of insulation against the
cold. BAT is found in deeper nooks and crannies, and is a prime source
of generating heat energy (thermogenesis). BAT will be discussed in the
section on thermoregulation.<br />
<br />
The control center maintains homeostasis in adipose by altering
energy intake and energy expenditure. WAT is able to store excess
energy when food is abundant, and make that energy available when food
is scarce. WAT stores energy in the form of molecules called lipids.
Each individual white adipose cell can shrink or grow, depending on
whether lipids are being burned or deposited. The size of the fat cell
is known simply as “Fat Cell Size” or FCS. The body can also create new
fat cells, and we can count them and call that “Fat Cell Number” or
FCN.<br />
<br />
Lipogensis is the deposition of fat. It is accomplished by
depositing more lipid in each cell, increasing the FCS; and by creating
brand new adipose cells, increasing the FCN. Lipolysis is the chemical
decomposition and release of fat from adipose tissue, otherwise known
as “burning fat”.<br />
<br />
<div class="center">
<div class="floatnone">
</div>
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/MTFSId7.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/MTFSId7.jpg" /></a></div>
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b>Cross Section of White Adipose Tissue</b>
</span><br />
</center>
</blockquote>
</blockquote>
</blockquote>
<br />
Robert Bowers, head of the Molecular and Cellular Biology and
Pathobiology Program, at the Medical University of South Carolina,
heads up a world-wide research team studying the metabolism of adipose
tissue. Bowers and colleagues warn that “Prolonged positive energy
balance promotes obesity that in humans is associated with a number of
health risks. The deposition of lipid initially results in increases in
fat cell size (FCS), but soon triggers increases in fat cell number
(FCN)” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bowers2004" title="References.html#Bowers2004">Bowers et al. 2004</a>, see also <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Satcher2001" title="References.html#Satcher2001">Satcher 2001</a>)
<br />
<blockquote>
“The accretion of lipid in and of itself is not necessarily associated
with these health risks (see Simms 2001); rather it is the distribution
of body fat that is critical (see Gasteyger et al. 2002). That is,
visceral obesity is closely associated with development of the
“metabolic syndrome” and type II diabetes (see Vague 1980). Thus
understanding how body fat is preferentially deposited and mobilized is
necessary for the prevention and treatment of obesity, respectively.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bowers2004" title="References.html#Bowers2004">Bowers et al. 2004</a>)
</blockquote>
Could ETS surgery affect adipose metabolism? If so, how? To begin
answering, we first ask, “Does the SNS run to adipose tissue?” Yes, it
does. “White adipose tissue (WAT) is innervated by the sympathetic
nervous system (SNS)”. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bowers2004" title="References.html#Bowers2004">Bowers et al. 2004</a>). Brown adipose is also sympathetically innervated, and will be discussed under thermoregulation. .<br />
<br />
The sympathetic nervous system evidently plays a dominant role
in the regulation of fat burning, and adipose function in general. In
their 1994 study of lypolysis [fat burning] in humans, researchers at
University College London stated: “Catecholamines are powerful
regulators of lypolysis. In both in vivo and in vitro studies,
stimulation of adrenoreceptors in adipose tissue (from at least some
sites) dominates over alpha 2-adrenoreceptor inhibition of lipolysis.
Catecholamines may reach adipose tissue via the general circulation or
via the rich sympathetic innervation”. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Coppack1994" title="References.html#Coppack1994">Coppack et al. 1994</a>)<br />
<br />
Back in the 1990’s, the London researchers observed, “It is
apparent that lipolysis is controlled largely by sympathetic activity
and insulin concentrations.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Coppack1994" title="References.html#Coppack1994">Coppack et al. 1994</a>). By 2004, consensus had become even clearer, allowing Bowers to
state unequivocally in his introduction, “Although the more established
role of this sympathetic innervation of WAT is as a major stimulator of
lipid mobilization, this innervation also inhibits WAT fat cell number
(FCN); thus, local [sympathetic] denervation of WAT leads to marked
increases in WAT mass and FCN.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bowers2004" title="References.html#Bowers2004">Bowers et al. 2004</a>)<br />
<br />
The purpose of Bowers’ study then is just to further quantify
what is already known. Bowers shares our suspicions about this dominant
role of the SNS: “One mechanism that may underlie the differential
accumulation of lipid by WAT depots, as well as the differential
mobilization of lipid, is through its innervation by the sympathetic
nervous system (SNS) and the effects of its primary postganglionic
neurotransmitter, norepinephrine (NE)”. (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bowers2004" title="References.html#Bowers2004">Bowers et al. 2004</a>).<br />
<br />
All of this allows the CS model to generate two more predictions about thoracic sympathectomy in humans:
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="-moz-background-clip: -moz-initial; -moz-background-inline-policy: -moz-initial; -moz-background-origin: -moz-initial; background: rgb(255, 255, 153) none repeat scroll 0% 0%; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will increase Fat Cell Size (FCS).</b>
<br />
<br />
<b>Empirical status: Confirmed in hamsters, unstudied in humans.</b>
</blockquote>
</td><td><br /></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="-moz-background-clip: -moz-initial; -moz-background-inline-policy: -moz-initial; -moz-background-origin: -moz-initial; background: rgb(255, 255, 153) none repeat scroll 0% 0%; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will increase Fat Cell Number (FCN)</b>
<br />
<br />
<b>Empirical status: Confirmed in hamsters, unstudied in humans.</b>
</blockquote>
</td><td><br /></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
<a href="http://www.blogger.com/null" id="Sympathectomy_and_Adipose_Tissue" name="Sympathectomy_and_Adipose_Tissue"></a><span style="font-size: large;"><br /></span>
<br />
<h2>
<span class="mw-headline" style="font-size: large;"> Sympathectomy and Adipose Tissue </span></h2>
To satisfy his curiosity, Bowers and colleagues set about doing
sympathectomies on hamsters. The results? “[Sympathetic] denervation
produced significant increases in WAT mass and FCN” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Bowers2004" title="References.html#Bowers2004">Bowers et al. 2004</a>).
Below are graphs summarizing their findings. “R” WAT and “I” WAT refer
to adipose tissue in two different body locations. “R” stands for
“retroperitoneal”, which means in the abdominal cavity, “I” stands for
“inguinal” which means in the groin area.<br />
<br />
<div class="center">
<div class="floatnone">
<div class="separator" style="clear: both; text-align: center;">
<a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a class="image" href="file:///Adipos-iWatCellNumber.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Adipos-iWatCellNumber.jpg"></a><a class="image" href="file:///Adiposemass.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Adiposemass.jpg"></a><a class="image" href="file:///Adipose.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Adipose.jpg"></a><a href="https://i.imgur.com/ncF9bQ7.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/ncF9bQ7.jpg" /></a></div>
</div>
</div>
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b>Mass of White Adipose Tissue in Innverated vs. Sympathetically Denervated Hamsters</b>
</span><br />
</center>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
<div class="center">
<div class="floatnone">
</div>
</div>
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.imgur.com/MP8LfpN.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/MP8LfpN.jpg" /></a></div>
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b>Number of White Adipose Cells in Innervated vs. Sympathetically Denervated Hamsters (iWAT)</b>
</span><br />
</center>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
<div class="center">
<div class="floatnone">
</div>
</div>
<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a class="image" href="file:///Adipos-rWatCellnumber.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Adipos-rWatCellnumber.jpg"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://www.blogger.com/blogger.g?blogID=57275967465495542" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a class="image" href="file:///Adipos-iWatCellNumber.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Adipos-iWatCellNumber.jpg"></a><a class="image" href="file:///Adiposemass.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Adiposemass.jpg"></a><a class="image" href="file:///Adipose.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;" title="Adipose.jpg"></a><a href="https://i.imgur.com/2ToB6h4.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://i.imgur.com/2ToB6h4.jpg" /></a></div>
<br />
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<blockquote>
<center>
<span style="color: blue; font-size: small;">
</span>
<span style="color: blue; font-size: small;"><b>Number of White Adipose Cells in Innervated vs. Sympathetically Denervated Hamsters (rWAT)</b>
</span><br />
</center>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
</blockquote>
<br />
Clearly, sympathectomy caused a great increase in the mass, the size and the number of fat cells in these mice.<br />
<br />
The denervation of white adipose tissue produced by ETS surgery
will likely follow the same patterns as the skin, since a good deal of
it is located directly under the skin. Pattern I corposcindosis then
would entail sympathetic denervation all the WAT from the chest
upwards. It would also lower the catecholamine levels in the blood, as
shown earlier. Thus <i>both</i> sources of lypolysis stimulation,
neural and hormonal, will be affected by ETS surgery. However, most of
the body’s adipose lies below the chest, and would remain innervated,
and potentially hyperactive.<br />
<br />
We call for study of the effects of ETS surgery on lipolysis
and lipogenesis in humans. Based on animal studies and the anecdotal
oral history, there is compelling reason to do so. Until then, ETS
remains experimental with regard to adipose. Patients should be warned
as such and informed of the likely effects, based on theory and animal
data.<br />
<br />
In the early 1990’s some very important discoveries were made
about fat metabolism – the discovery of the ob (obesity) gene, and of
“leptin”. Leptin is a peptide released by adipose tissue into the blood
stream. Leptin will travel to the hypothalamus and bind with receptors
there. Thus, leptin acts as another input to the control center.
Sufficient leptin in the blood tells the control center “enough storing
of fat”. There is a great deal of interest in leptin studies currently,
because mice given extra leptin lose a lot of body fat. However, great
caution is in order, because not only does leptin have a key role in
the regulation of fat metabolism, it turns out to be essential to bone
metabolism as well.
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-57275967465495542.post-56510211840803920852013-05-29T16:33:00.003-07:002013-06-27T13:59:52.194-07:00Sensory Nerves<h2>
<span class="mw-headline" style="font-size: large;">Loss of Tactile Sensitivity</span></h2>
The anecdotal oral histories consistently report loss of tactile
sensitivity in the denerved areas. Is this possible, given that sensory
nerves are something separate from sympathetic nerves? Yes, because
“sympathetic nerves are known to modulate sensory nerve function” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Merhi1997" title="References.html#Merhi1997">Merhi et al. 1998</a>; see <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Khalil1997" title="References.html#Khalil1997">Khalil 1997</a>).
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="-moz-background-clip: -moz-initial; -moz-background-inline-policy: -moz-initial; -moz-background-origin: -moz-initial; background: rgb(255, 255, 153) none repeat scroll 0% 0%; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will reduce tactile sensitivity in the denerved area.</b>
<br />
<br />
<b>Empirical status: Confirmed.</b>
</blockquote>
</td><td><br /></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
Back in the 1940’s, surgeons were using sympathectomy to treat a
number of war-related problems, including causalgia. Causalgia is a
burning pain sensation resulting from injury to sensory nerves, usually
in the arms or legs. To begin figuring out if sympathectomy would be
effective, the surgeons first injected anesthetic into the sympathetic
ganglion. “The prompt relief of pain after the injection [into the
sympathetic ganglion] was usually striking and conclusive” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Freeman1955" title="References.html#Freeman1955">Freeman 1955</a>). This led the surgeons to use sympathectomy, both thoracic and lumbar, to alleviate pain.<br />
<br />
The war surgeons had provided empirical confirmation for the
physiological discoveries later made by Merhi, Khalil and colleagues:
that the SNS has a strong role in the modulation of sensory nerves.
<br />
Mailies and Furlan conducted a 2002 review of sympathectomy in
the treatment of pain syndromes. As Mailis explains, today “many
neuropathic pain syndromes, particularly reflex sympathetic dystrophy
and causalgia (currently called Complex Regional Pain Syndromes (CRPS),
types I and II, respectively), are thought to be ’Sympathetically
Maintained Pain’.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Mailis2002" title="References.html#Mailis2002">Mailis et al. 2002</a>)
<br />
<a href="http://www.blogger.com/null" id="Pain" name="Pain"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Pain</span></h2>
Now let’s apply the principle of denervation super-sensitivity to
the receptor cells in the sensory nerves. After they are denerved, it
is expected that they will become super-sensitive to catecholamines. We
can surmise that super-sensitivity induced on a sensory nerve would
manifest as “pain”.
<br />
<br />
<br />
<blockquote>
<blockquote>
<blockquote>
<table style="width: 540px;">
<tbody>
<tr>
<td style="-moz-background-clip: -moz-initial; -moz-background-inline-policy: -moz-initial; -moz-background-origin: -moz-initial; background: rgb(255, 255, 153) none repeat scroll 0% 0%; color: black;"><blockquote>
<b>Prediction: Thoracic sympathectomy will induce chronic pain.</b>
<br />
<br />
<b>Empirical status: Confirmed.</b>
</blockquote>
</td><td><br /></td></tr>
</tbody></table>
</blockquote>
</blockquote>
</blockquote>
<br />
<br />
Mailis again: “Furthermore, complications of [ETS surgery] may be significant, in terms of both worsening the pain or producing <b>a new pain syndrome</b>. . .” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Mailis2002" title="References.html#Mailis2002">Mailis et al. 2002</a>, emphasis added). Mailis concludes “more clinical trials of sympathectomy are
required to establish the overall effectiveness and potential risks of
this procedure.” (<a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Mailis2002" title="References.html#Mailis2002">Mailis et al. 2002</a>).
I too call for research into the role of the SNS in modulating sensory
nerves, and the effect of ETS on sensitivity. Patients should be warned
about potential loss of tactile sensitivity in the denerved area, and
possible chronic nerve pain.
<br />
<a href="http://www.blogger.com/null" id="Paresthesia" name="Paresthesia"></a><br />
<h2>
<span class="mw-headline" style="font-size: large;">Paresthesia</span></h2>
Loss of sympathetic drive to sensory nerves may also manifest as
parestheia, which is experienced as a tingling or burning sensation.
17.6% of patients reported permanent paresthesia in a 2005 Chinese
study.
<br />
<blockquote>
Paresthetic discomfort distinguishable from wound pain was
described by 17 patients (50.0%). The most common descriptions were of
'bloating' (41.2%), 'pins and needles' (35.3%), or 'numbness' (23.5%)
in the chest wall. The paresthesia resolved in less than two months in
12 patients (70.6%), but was still felt for over 12 months in three
patients (17.6%). <a class="external text" href="http://www.corposcindosis.blogspot.com/2013/05//references.html#Sihoe2005" title="References.html#Sihoe2005">Sihoe et al. 2005</a>
</blockquote>
<a href="http://www.blogger.com/null" id="Adipose_Tissue" name="Adipose_Tissue"></a>
Unknownnoreply@blogger.com