• Title/Summary/Keyword: 교감신경차단술

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Lumbar Sympathetic Ganglion Block with Alcohol for Plantar Hyperhidrosis (발 다한증 환자에서 알코올을 이용한 요부교감신경절 차단술 후의 결과)

  • Han, Seung Tak;Kim, Chan;Han, Kyung Ream;Cho, Hae Won;Noh, Hyun Ju
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.161-164
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    • 2005
  • Background: Chemical lumbar sympathetic ganglion block could potentially be used to treat plantar hyperhidrosis; therefore, we analyzed the outcome of lumbar sympathetic ganglion block using alcohol for the treatment of plantar hyperhidrosis. Methods: Between March 1992 and June 2003, 356 patients with plantar hyperhidrosis underwent lumbar sympathetic ganglion block using alcohol. All 356 patients were followed up for 2 years and the results evaluated. There were 185 and 171 male and female patients, respectively, with a mean age of 25.1 years, ranging from 15.3 to 56.5 years old. Lumbar sympathetic ganglion block using alcohol was performed with fluoroscopic guidance under local anesthesia. Results: The recurrence rate after 2 years was 34%. Compensatory hyperhidrosis, ejaculation failure, lower back pain and genitofemoral neuritis developed as complications in 132, 4, 12 and 2 patients, respectively. Of the 356 patients, 65% were satisfied. Conclusions: Lumbar sympathetic ganglion block using alcohol is an effective and safe method for the treatment of plantar hyperhidrosis, but more information about the complications and relatively high recurrence rates should be provided to the patient.

Limited Sympathicotomy Using 2mm Endoscope in Palmar Hyperhidrosis (2mm 내시경을 이용한 수장부 다한증의 제한적 교감신경절 차단술)

  • Jeong, Deuk-Chae;Cho, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1177-1181
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    • 2001
  • Objective : Thoracoscopic T2 sympathicotomy had been performed as a simple and effective method in treating palmar hyperhidrosis, but some patients are not satisfied with the result of sympathicotomy due to compensatory hyperhidrosis. Therefore, a more limited T2 sympathicotomy using 2mm endoscope was introduced. We made a comparison between conventional T2 sympathicotomy and limited T2 sympathicotomy on operative results and compensatory hyperhidrosis. Material and Method : From January 1998 to April 2000, 56 patients were treated by video assisted endoscopic thoracic sympathicotomy. Thirty patients of these underwent T2 sympathicotomy(Group A), and the remainders underwent limited T2 sympathicotomy(Group B). The limited T2 sympathicotomy is coagulation of the interganglionic fibers of T2 sympathetic ganglion on T2 rib head. The comparative analysis between two groups was based on the medical records and telephone interview results. Result : All patients were treated for excessive sweating on palms with 2mm endoscopic sympathicotmy. There were no mortalities, life-threatening complications except one recurrent patient who was treated successfully with reoperation( endoscopic sympathicotomy). Compensatory hyperhidrosis was common in group A. An individual satisfactory rate for the operations was higher in group B than in group A. Conclusion : The limited T2 sympathicotomy considered to be a more effective and less complicated method than the T2 sympathicotomy for the treatment of palmar hyperhidrosis.

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Effect of Sternal Closure Method on Sternal Dehiscence With or Without Infection (흉골 봉합 방법이 흉골 열개 및 감염에 미치는 영향)

  • 이삼윤;박권재;고광표;최종범
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.485-489
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    • 2001
  • Background: The most important factor in preventing sternal complications is stable sternal approximation. We have tried to find the most effective sternal closure method by examining the incidence of sternal dehiscence with or without infection in patients with cardiac surgery through median sternotomy. Material and Method: This study was performed in 489 patients over 45 years of age with median sternotomy for open cardiac surgery. Simple closure with interrupted 6 wires was performed in 159 patients, figure-of-8 closure technique in 119, overlapping interrupted closure using 10 wires in 150, and combined closure technique of interrupted simple closure and figure-of-8 suture closure in 61. Two hundred thirty-four patients underwent valve and aortic operations and 213 patients coronary artery bypass surgery. Result: Sternal dehiscence with or without infection occurred in 12 (2.5 %) patients. The complication developed in 5 of 159 patients (3.1%) with six interrupted simple closure, in 4 of 119 patients (3.4%) with figure-of-8 closure, and in 3 of 150 patients (2.0%) with overlapping interrupted closure using 10 wires, but there was no complication in 61 patients with combined closure technique (relative risk for other closure techniques, p<0.05). There was no significant difference in the incidence of the sternal complication between valve and aortic operation group and coronary artery bypass group (3.0% vs 2.3%, not significant), but diabetes mellitus was a significant independent risk factor (odds ratio and multivariate analysis, p<0.05). Conclusion: The sternal closure technique that combines simple interrupted suture closure and figure-of-8 suture closure may be a more useful technique to enhance sternal stabilization compared to other closure techniques, such as simple interrupted closure, 8-figure closure, and overlapping interrupted closure.

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A Study on the Nutrition Contents and Blood Glucose Response Effect of Diabetic-Oriented Convenience Food prepared Medicinal Plants and Chicken (생약재와 닭고기를 이용하여 개발된 편의 당뇨식사의 영양성분 및 혈당반응)

  • 한종현;박성혜
    • Journal of the East Asian Society of Dietary Life
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    • v.12 no.2
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    • pp.91-99
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    • 2002
  • This study was carried out to develop a diabetic-oriented convenience flood using 7 medicinal plants (Schisandra chinensis, Coix lachryma-jobi, Dioscorea batatas, Ophipogon japonicus, Lyicium chinense, Houttuynia cordata, Polygonatum sibiricum) and chicken. Portion size was 310g, total calorie was 551.6 kcal and carbohydrate, lipid and protein were consisted of 53.0%, 20.9% and 26.1%, respectively. Calcium, zinc and iron content were 268.9mg, 5.4mg and 6.1mg, respectively. Crude fiber content was 22.9g. In sensory evaluation, the scores of taste, color, texture and overall acceptability were higher than normal diabetic meal. Hypoglycemic effect of the device meal for diabetic persons was excellent compared to that of normal diabetic meal. The above results indicate that the 7 medicinal plants can be used as functional ingredients fur diabetic-oriented convenience flood industry. Also, device meal can be used as ready-prepared food for weight control.

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The Selective T3 Sympathicotomy in Patients with Essential Palmar Hyperhidrosis (본태성 수장부 다한증 환자에서 선택적인 T3 교감신경 차단술)

  • Youn, Seung-Hwan;Cho, Joon;Moon, Chang-Taek;Chang, Sang-Keun;Bae, Ki-Man
    • Journal of Korean Neurosurgical Society
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    • v.29 no.11
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    • pp.1499-1504
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    • 2000
  • Objectives : In general, conventional T2, T3 thoracoscopic sympathicotomy must be one of the most effective treatments for the essential palmar hyperhidrosis. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory sweating and Hornor's syndrome. The authors have performed a selective T3 thoracoscopic sympathicotomy to our patients to see whether it provides successful results with less side effects. Its preliminary results were compared with those of conventional T2, T3 thoracoscopic sympathicotomy. Methods : The thoracoscopic sympathicotomy was performed in 54 patients suffering from essential palmar hyperhidrosis. Twenty-four patients underwent a conventional sympathicotmy(group A) from Jan 1997 to Dec 1997 and 30 patients a selective T3 sympathicotmy(group B) from Jan 1998 to Dec 1999. For assessment of postoperative success and of complications all patients charts were reviewed. Patients further received a postal questionnaire regarding long-term effect, satisfaction, and side-effects. Results : No recurrence was observed in both groups. The global rate of compensatory sweating was significantly(p =0.020) different in both groups : 11 patients(45.8%) in group A and 5 patients(16.73%) in group B. The Hornor's syndrome was observed only in 4 patients in group A. The preliminary results of the procedure in group A were considered fully-satisfying by 16 patients(66.6%), 6 patients(25%) were satisfied partially, and only 2 patients(8.3%) were dissatisfied, and those of the procedure in group B satisfying by 26 patients(86.6%), 4 patients(13.3.% ) were satisfied partially, and none dissatisfied. Conclusion : The selective T3 sympathicotomy results in a significant decrease in the rate of disturbing side effects comparing to conventional T2, T3 sympathicotomy and it dose not lead to recurrence. Our results contribute to recommendations of a selective T3 thoracoscopic sympathicotomy as treatment of choice in essential palmar hyperhidrosis.

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The Effects of Lumbar Sympathetic Ganglion Block in the Patients with Spinal Stenosis and the Skin Temperature Changes according to the Contrast Spread Patterns (요척주관 협착증 환자의 요부 교감신경 차단술의 효과 및 조영 양상에 따른 피부 체온의 변화)

  • Hong, Ji Hee;Kim, Jin Mo;Kim, Ae Ra;Lee, Yong Chul;Kim, Sae Young;Kwon, Seung Ho;Oh, Min Ju
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.151-157
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    • 2009
  • Background: We hypothesized that if a fluoroscopic image of the lumbar sympathetic ganglion block (LSGB) showed the spread patterns of contrast at both the L2/3 and L4/5 disc areas, then this would demonstrate a more profound blockade effect because the spread patterns are close to sympathetic ganglia. In addition, we compared the effects of LSGB and transforaminal epidural steroid injection (TFESI) for the patients suffering with spinal stenosis. Methods: Eighty patients were divided into two groups (Group S: the patients treated with TFESI, Group L: the patients treated with LSGB). The patients of group L were classified into three groups (groups A, B and, C) according to their contrast spread pattern. The preblock and postblock temperature difference between the ipsilateral and contralateral great toe ($DT^{pre}$, $DT^{post}$, $^{\circ}C$), and the DTnet were calculated as follows. $DT^{net}$ = $DT^{post}$ - $DT^{pre}$. Results: Both group showed a significant reduction of the visual analogue score (VAS) and the Oswestry disability index (ODI) score. Only the patients of group L showed a significant increase of their walking distance (WD). Group A showed the most significant changes in the $DT^{post}$ ($6.1{\pm}1.2^{\circ}C$, P = 0.021), and the DTnet ($6.0{\pm}1.0^{\circ}C$, p = 0.023), as compared to group C. Conclusions: LSGB showed a similar effect on the VAS, and ODI, and a significant effect, on WD, compared with TFESI. Group A showed a significant sympatholytic effect, as compared to group C.