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Objective To determine the incidence, etiology, prognosis, and treatment of vocal cord paralysis (VCP) after surgery for thoracic aortic aneurysm (TAA). Study design Retrospective study performed between 1989 and 1995. Setting Academic, tertiary care, referral medical center. Patients Seventy-one TAA patients underwent surgery at the Kameda Medical Center between 1989 and 1995. Results Sixty-two of 71 patients were examined postoperatively for voice quality. Twenty patients (32%) had hoarseness develop caused by VCP, as confirmed by laryngoscopy. The left recurrent laryngeal nerve had been sacrificed in 1 patient during surgery, but it was preserved in the remaining 19 patients. Unilateral left VCP was noted in 19 patients, and bilateral VCP occurred in 1 patient. The incidence of VCP was higher in those patients who underwent surgery for type I aneurysms (9 of 14 patients, 64%). In 16 of the 19 patients (84%) who received follow-up for > 6 months, vocal cord movement did not return to normal. Surgery to improve voice quality, arytenoid adduction in five patients and intracordal injection in two patients, was performed with success. Conclusions Our results indicate that surgery for TAA is associated with a relatively high incidence of VCP. VCP occurred despite preservation of the recurrent laryngeal nerve, and the paralysis did not show a spontaneous recovery even 6 months after surgery.

Summary The developmental changes of substance P (SP), somatostatin and vasoactive intestinal polypeptide (VIP) were studied in chick embryonic brain tissue by radioimmunoassays. In the cerebellum, SP and somatostatin were present initially (day 10) at high levels, and then rapidly declined to a minimum at hatching. In the cerebrum, VIP was first detectable on day 16, and the level increased through to hatching. The content of somatostatin gradually increased from day 10, while the SP content was constant until day 16 and then increased up to hatching. The SP immunoreactivity of the cerebellum from 10-day-old chicks chromatographed as two peaks on a Sephadex G-50 Superfine column. Most of the activity (75%) eluted at the zone indicating a 13 Kdalton protein; the other peak co-eluted with synthetic SP. The SP immunoreactive materials in the cerebrum chromatographed as a single peak which co-migrated with synthetic SP. In contrast, somatostatin immunoreactive materials in both the cerebrum and cerebellum from 10-day-old chick embryos eluted as three peaks. The major immunoreactivity (over 80%) eluted with synthetic somatostatin and two larger molecules showed molecular weights of 13 and 3 Kdaltons.

The concentrations of vasoactive intestinal polypeptide, somatostatin and substance P were determined in various cerebral subdivisions of adult and foetal Japanese monkeys (Macaca fuscata fuscata) by specific radioimmunoassays. In adult tissues, the highest level of vasoactive intestinal polypeptide was found in the somatosensory cortex and the lowest level in the occipital cortex. A high level of somatostatin was found in the association cortex (prefrontal, parietal and temporal cortex); the lowest level was noted in the occipital cortex. Substance P was found to be high in prefrontal and temporal cortex. The highest levels of substance P and somatostatin were obtained in the amygdala. Between embryonic 4 and 5.5 months, concentrations of peptides increased dramatically, and in the adult, all neuropeptides in cortical subdivisions significantly decreased. By the gel filtration method, only one immunoreactivity which coeluted with substance P and vasoactive intestinal polypeptide was demonstrated in extracts of 4-, 5.5-month-old and adult monkey cerebral cortex. In contrast, somatostatin immunoreactivity eluted as 3 peaks. Almost 80% of the immunoreactivity co-eluted with synthetic somatostatin, regardless of the age of the tissue. The molecular weights of two larger molecules were determined to be 13 and 3 kdaltons.

The smooth muscle stimulating activity of a new PGE1 analog, 16, 16-dimethyl- trans delta2 -PGE1 methyl ester (ONO-802) was evaluated by simultaneously recording the EMG of the uterus and intestines, along with urinary bladder pressure, and blood pressure in pregnant and non-pregnant Japanese monkeys (Macaca fuscata fuscata). Single intravenous injections of ONO-802 in increasing dosages (0.2-5 microgram/kg) were found to be 50-100 times or more effective in inducing uterine contraction than PGF2alpha and PGE1. A mild, transient gastrointestinal muscle stimulating activity was observed, but change in urinary bladder pressure and blood pressure was not evident. ONO-802 induced uterine contractions in the pregnant animals were 10 times greater than in the non-pregnant animals. These results suggest that ONO-802 may be a suitable clinical prostaglandin for use in therapeutic abortion.

A total of sixty 2.5-year-old rainbow trout ( Salmo gairdnerii ) were used. About half of them had been radiothyroidectomized by I 131 injections that began when the animals weighed 2–3 g, and continued for 6 months. Accordingly, they were without thyroids for more than two years, and fed a low iodine diet. Heart rate was 26% lower in thyroidectomized than in control trout. It was increased in both groups by low dosages of thyroxine, but decreased by a higher dose. Thyroidectomized trout had a differentiated (from normal) pattern of spontaneous EEG from the olfactory bulb, they had a higher stimulus threshold for evoking an electrical response in the olfactory bulb, and the magnitude of the response at any particular stimulus strength was inferior to the control. Thyroxine lowered the threshold in thyroidectomized trout and increased the size of the electrical response. Most of the these measured parameters of nervous function varied biphasically with thyroxine dose. That is, they were stimulated at lower doses, but beyond a certain dose most often they were progressively inhibited. Measuring the evoked olfactory response in these animals after section of the olfactory tract or of the midbrain-diencephalon connection showed that a complex series of inhibitory or stimulatory (depending on thyroid state) regulatory influences move centrifugally from the hindbrain and from the forebrain to modify the olfactory response.

Evoked olfactory electrical responses in the olfactory bulbs of young adult goldfish were studied after administration of different dosages of estradiol. The magnitudes of the olfactory responses were augmented in estrogenized goldfish up to a dose of 8.0 μg of estradiol. Beyond this dose less augmentation occurred, and higher doses (32.0 μg, 64.0 μg) of estradiol actually inhibited the responses to values below the control. Olfactory responses in estrogenized goldfish after olfactory tract section (freeing the bulbs from centrifugal control) also were biphasic with respect to dose, but mirror image to the dose-response relation in intact goldfish. These data are interpreted to mean that estrogens influence olfactory-evoked nervous responses in the bulb and elsewhere in the nervous system in a complex manner related to dose. Different parts of the central nervous system, at particular doses of estradiol, may respond simultaneously quite differently in terms of inhibition or facilitation.

In the olfactory buld and telencephalon of normal goldfish typical electrical responses may be observed after infusion into the olfactory sac of weak salt solutions. These patterns are altered after section of the olfactory tract in such a way as to indicate facilitation of the bulbar olfactory response by centrifugal influences from the more posterior parts of the brain. Thyroxine tends to inhibit telencephalic centrifugal action upon the NaCl-evoked bulbar response, but it appears to have a local facilitatory action in the olfactory bulb itself.