• Title/Summary/Keyword: 교감신경

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The Tendency of Compensatory Hyperhidrosis after Sympathicotomy in Essential Hyperhidrosis (다한증의 교감신경 차단술후 보상성 다한증의 경향)

  • 이재훈;박기성;박창권;유영선;이광숙;최세영
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.223-226
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    • 2002
  • Background: Thoracoscopic sympathicotomy is an effective treatment in essential hyperhidrosis. However, many patients suffer from compensatory hyperhidrosis. Compensatory hyperhidrosis is a very uncomfortable problem, but the mechanisms underlying compensatory hyperhidrosis are not completely understood. Material and Method: From May 1999 to June 2001, 25 cases of thoracoscopic sympathicotomy at the 2nd rib for facial hyperhidrosis and 116 cases of thoracoscopic sympathicotomy at the 3rd rib for palmar hyperhidrosis were performed in 141 patients. All of the patients were divided into noncompensatory sweating(NCS) and compensatory sweating(CS) group. Each group was investigated according to age, sex, body surface area(BSA), level of sympathicotomy and occupation. Result: The global rate of compensatory hyperhidorsis were 64.5%(91/141). There was no difference between the two groups for BSA, level of sympathicotomy and occupation. Mean age showed 23.2 years old in NCS group and 26.4 years old in CS group(p=0.09). In CS group, 46 cases were male(50.5%) and 45 cases were female(49.5%) and in NCS group, 19 cases were male(38.0%) and 31 cases were female(62.0%) (p=0.16). Conclusion: There were no available statistical data, but there was the fact that old age and male patients had the tendency for compensatory hyperhidrosis. If we have more patient group and consider the patient's family history or psychiatric problems, we will have more valuable data for compensatory hyperhidrosis.

The Effect of Manual Lymph Drainage on the Changes of Autonomic Nervous System and Pain in Stressed Hospital Office Employees

  • Ko, Min-Gyun
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.11
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    • pp.263-268
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    • 2020
  • This study is to investigate the effects of manual lymphatic drainage of stressed hospital office employees on the autonomic nervous. A total of 30 stressed hospital office women voluntarily participated in the study. The participants were randomized to the manual lymphatic drainage groups and rest groups. The intervention was conducted for 20 minutes in each group. There were significant differences in sympathetic nerve, parasympathetic nerve, and pain within manual lymphatic drainage groups(p<.05). There were significant differences between groups for the sympathetic nerve, parasympathetic nerve, and pain(p<.05). Therefore, manual lymphatic drainage is an effective intervention for reducing the stress and pain of stressed hospital office employees.

The Effect of Sympathectomy on Bone: -Evaluation with Quantitative Bone Scintigraphy- (흰쥐에서 교감신경절제술이 골에 미치는 영향 : -정량적 골스캔을 이용한 평가-)

  • Kim, Hak-Hee;Yang, Woo-Jin;Lee, Seong-Yong;Chung, Soo-Kyo;Park, Jang-Sang;Yim, Jung-Ik;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.85-88
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    • 1994
  • 근래 골조직에 있어서 자율신경의 기능에 대하여 많은 연구가 이루어지고 있으며, 골내의 자율신경의 해부학적 분포는 많이 알려져 있다. 그러나 임상적으로 반사적 교감신경 이상이나 레이노드 현상등과 같은 교감신경의 기능이상증에서나, 버거씨병 등의 치료 목적으로 시행되고 있는 교감신경 절제술 후, 자율신경기능의 변화가 사지골의 혈류나 골대사에 미치는 영향에 대하여는 아직도 논란의 여지가 있다. 저자들은 교감신경절제술 후 시간 경과에 따른 골에 미치는 영향을 알아보기 위하여 흰쥐에서 골대사와 혈류상태를 비교적 충실히 반영하는 정량적 골스캔을 시행하였다. 체중 $300{\sim}400g$의 수컷 흰쥐 10마리에서 복강을 통한 편측 요추부 교감신경절제술을 시행하였고, 수술 전과 후 1일, 3일, 1주, 2주, 3주, 4주에 양측 하지에서 각각 골스캔을 시행하고 교감신경 절제측 하지와 정상 하지에 대칭적으로 관심구역을 정하여 양측의 골스캔상 섭취계수를 비교하였다. 측정부위는 각 하지의 대퇴골간, 경골간 및 중족골로 하였다. 교감신경 절제술을 시행한 하지에서는 골스캔 소견상 수술 후 1일 또는 3일부터 동위원소 집적이 유의하게 증가되었으며 원위부로 갈수록 더욱 증가되었다. 그러나 3주 이후에는 정상측 수준으로 환원되었다. 교감신경절제술 후 골스캔상 동위원소집적이 증가되는 것은 골자체의 혈류가 증가되기 때문이며 이차적으로 골의 흡수를 유발하여 골밀도가 감소하는 것으로 생각되는데 이러한 변화는 시술 후 1일 째부터 관찰되어 사지골이 교감신경 절제에 매우 민감하게 반응하는 것을 알 수 있었다.9m}Tc$-MAA를 이용한 간 동맥 혈류 검사는 간암에서 색전술의 효과를 정확히 평가할 수 있는 유용한 검사법으로 이용될 수 있으리라 생각한다. 활성화 과정을 알아볼 수 있었으며 위상영상히스토그램을 통하여 이를 정량화하여 심실내 전기적 활성의 비동시성 여부를 추적관찰 할 수 있는 비관혈적검사임을 확인하였다.며, 3. $^{99m}Tc$으로 표지된 avidin과 streptavidin은 먼저 간으로 흡수된 후 대사된 다음 신장으로 배설된다는 사실을 알았다.damole에 의한 부작용은 흉통, 두통, 복통 등의 순이었고 전예에서 호전되었으며 생명에 위험을 초래할 수 있는 정도의 심장마비나 심부정맥은 한 예에서도 없었다. 결론적으로 dipyridamole은 약물부하 심근 SPECT 검사에 안전하게 사용할 수 있는 약물로 사료된다. 미소핵 빈도수가 증가하는 경향을 보였으나, 각 군간에 통계학적으로 유의한 차이는 없었다(p>0.05). 결론 : 임상적으로 치료를 중단하게 되는 1000mCi/60 Kg(16.67 mCi/Kg)를 투여한 군에서도 생쥐 골수내 미소핵이 발현되지 않는 것으로 보아, 방사성옥소는 비교적 안심하고 치료에 사용할 수 있는 제제로 사료되었다.반드시 비례하지만은 않아서 시간경과에 따른 추후 검사가 필요하리라 생각된다. 또한 방광요관역류가 있는 환아에서 DMSA 섭취율로 신기능을 평가할 때, 특히 영유아에서 연령에 따른 고려가 있어야 할 것으로 보인다.었다. 4) $^{99m}Tc-DISIDA$ hepatobiliary scintigram 음성율을

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Thoracoscopic T-3 Sympathicotomy for Palmar Hyperhidrosis (수부 다한증에서 흉부 3번 교감신경 차단 수술의 효과)

  • Kim, Kwang-Taek;Kim, Il-Hyun;Lee, Song-Am;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Seong
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.739-744
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    • 1999
  • Background: This study was designed to evaluate the effectiveness of T3 sympathicotomy in treatment of palmar hyperhidrosis. Material and Method: During the period of June to December 1998, 50 patients (24 females and 26 males) suffering from palmar hyperhidrosis either in isolation (n=37) or in combination with axillary hyperhidrosis (n=13) were operated. The mean age of the patients was 20 years. The bilateral sympathetic trunks were severed on the 3rd rib (2nd and 3rd ganglia) for the isolated palmar hyperhidrosis and on the 3rd and 4th ribs for the combined type using electrocoagulation scissors. A linear analogue scale was used to assess the degree of sweating on the palms, face, trunk, and feet (ranged 0 to 10:0 = anhidrosis: 10 = excessive sweating) as well as the patient's satisfaction with the surgery (ranged 0 to 10:0 = regret; 10 = completely satisfied). Result: All of the patients were relieved from palmar hyperhidrosis. A mean palmar sweat production score after T3 sympathicotomy was $1.5\pm$0.8. Some degree of compensatory sweating had occurred in 39 patients (78%) with a mean score of 3.4$\pm$1.6. Gustatory sweating occurred in 2 patients (4%). The mean score of the patient's satisfaction after the surgery was 8.5$\pm$1.2. Conclusion: Palmar hyperhidrosis can be successfully relieved by the T3 sympathicotomy. When considering the advantages of T3 sympathicotomy with respects to a better preservation of facial sympathetic function, less occurrence of severe compensatory sweating, and lower incidence of gustatory sweating. We recommend T3 sympathicotomy as a treatment of choice for palmar hyperhidrosis.

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Clinical Results According to the Level and Extent of Sympathicotomy in Essential Hyperhidrosis (본태성다한증에서 흥부교감신경의 차단 범위와 부위에 따른 임상결과)

  • 최순호;박권재;이삼윤
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.127-132
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    • 2002
  • Video-assisted thoracic sympathicotomy is a safe and effective therapy for the treatment of essential hyperhidrosis with immediate symptomatic improvement. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory hyperhidrosis. Therefore, by comparing and assessing the degree of symptomatic improvement or compensatory sweating following sympathicotomy at various levels and the extent of block, we are to determine the optimal level of sympathicotomy and which method will result in minimal side effects and maximal benefits. Material and Method: From January 1998 to June 2001, the thoracoscopic sympathicotomy was performed in 150 patients suffering from essential hyperhidrosis in the Dept. of Thoracic and Cardiovascular Surgery, Wonkwang University Hospital. The patients were divided into three groups. GroupI(n=50): patients having undergone 72,3,4 sympathicotomy, GroupII (n=50): patients having undergone 72 sympathicotomy which consist of blocking the interganglionic neural fiber on the second rib, and group 111(n=50): patients having undergone 73 sympathicotomy which consist of blocking the interganglionic neural fiber on the third rib. The parameters were composed of the satisfaction rate of treatment, the degree of compensatory sweating, postoperative complications, and changes of plantar sweating. Results: There was no difference in age and sex among the groups. All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis in immediate postoperative period. However the rate of long-term satisfaction were 80%, 92%, and 96% in groupsI,II, and III respectively(p<0.05). More than embarrassing compensatory hyperhidrosis was present in 50%, 28%, and 18% in groups I,II ,and III respectively(p<0.05). Slight but comfortable amounts of palmar humidness was expressed in decreasing order, group III(34%), groupII(6%), and group I(4%) respectively(p<0.05). In regard to plantar sweating, decrease in sweating was expressed in each of the three groups, but was not significant between the groups.

Development of Intergrated Ring-Type System for Measurement Signal of Electrodermal Activity Based on Dynamic State (동적 상태의 신경변화 자극에 따른 피부전도도 신호 검출을 위한 반지형 통합 측정 시스템 개발)

  • Lim, Min-Gyu;Lee, Young-Jae;Lee, Jae-Ho;Park, Hee-Jung;Kang, Seung-Jin;Kim, Kyung-Nam;Lee, Jeong-Whan
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2013.07a
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    • pp.359-360
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    • 2013
  • 본 연구에서는 외부 자극과 내적인 교감신경의 변화에 따라 나타나는 땀 반응으로 얻어진 생체신호를 다루었다. 즉, 땀 반응을 지칭하는 피부전도도를 측정할 수 있는 시스템과, 더불어 차량 운전시 혹은 운동 등의 동적 자극에 의한 영향을 최소화하여 교감신경에 의한 피부전도도의 신뢰도를 높일 수 있는 방안을 강구하였다. 기존의 두 개의 전극 간 리지스턴스(Resistance)를 측정하는 방식을 내부에서 분리된 한 개의 전극을 사용하여 신체적 움직임의 제한점을 해소하고 피부전도도로 나타난 생체신호가 외적인 움직임에 따른 영향인지 내적인 신경의 변화에 따른 영향인지를 추정할 수 있는 모듈을 개발하였다. 20명의 건강한 청년을 대상으로 피실험하여 기존의 생체신호 측정 장비인 MP-150의 EDA모듈과 동시 측정한 결과, 두 데이터가 약 88% 일치하는 것으로 확인하였다.

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Clincal Results according to the Level and Extent of Sympathicotomy in Axillary Hyperhidrosis (액와부 발한을 동반한 일차성다한증 환자에 있어서 수술방법에 따른 결과 비교)

  • Kim, Byung-Ho;Huh, Dong-Myung
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.570-575
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    • 2005
  • Background: Video-assisted thoracic sympathicotomy plays an important role as an effective method for the treatment of axillary hyperhidrosis. People with axillary hyperhidrosis were not satisfied by the occurrence of the high rate of disabling compensatory hyperhidrosis and axillary resweating. Therefore, by comparing and assessing the clincal results according to the level and extent of sympathicotomy in axillary hyperhidrosis, we aim to determine which method will result in maximal benefits. Material and Method: Among 70 patients suffering from axillary hyperhidrosis having undergone thoracoscopic sympathicotomy from January 2001 through December 2003, 57 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into two groups, Group 1 (n=25): patients having undergone R3, 4, 5 sympathicotomy which consist of blocking the interganglionic neural fiber on the third, fourth, and fifth rib, Group 11 (n=32): patients having undergone R3,4 sympathicotomy which consist of blocking the interganglionic neural fiber on the third and fourth rib. The study parameters were satisfaction rate and degree of compensatory sweating. Result: There was no difference on age and sex, family history, combined hyperhidrosis, and mean follow up month between the two groups. Patients expressing satisfaction were $88.0\%$ in group and $56.3\%$ in groups 11 with statistically significant difference (p=0.02). Moderate to severe compensatory sweating were $52.0\%$ (embrassing 6 patients, disabling 7 patients) in group 1 and $62.5\%$ (embrassing 5 patients, disabling 15 patients) in groups 11 with no significance in the statistical analysis. Conclusion: R3, 4, 5 sympathicotomy was an effective means of treating axillary hyperhidrosis because of higher long term satisfaction rate.

Thoracic Sympathetic Ganglionectomy for Primary Hyperhidrosis (본태성 다한증의 흉부 교감신경절 절제술)

  • 김일현;김광택;이인성;김형묵;김학제
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.519-524
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    • 1998
  • From January 1996 to December 1996, we performed 137 thoracic sympathetic ganglionectomies with VATs for primary hyperhidrosis in the department of thoracic and cardiovascular surgery at Anam hospital, Korea university medical center. There were 83 men and 54 women whose ages ranged from 13 to 63 years old(mean age: 25years). Of these patients, 128 patients had complained of palmar hyperhidrosis and 26 of facial hyperhidrosis. Thoracoscopic sympathetic ganglionectomies procedures included lower 1/3 Stellate ganglionectomies in 4 patients; lower 1/3 Stellate ganglionectomies and T2-sympathetic ganglionectomies in 18 patients; T2-sympathetic ganglionectomies in 86 patients; T2 and T3 sympathetic ganglionectomies in 10 patients; and T2, T3 and T4 sympathetic ganglionectomies in 19 patients. The mean operating time was 59 minutes(range: 25 to 162 minutes), and the mean hospital stay was 3.8 days(range: 2 to 8 days). Common complications were compensatory hyperhidrosis(109 patients) and causalgia(18 patients). At the end of the follow-up period(mean: 8 months) ninety-seven percent of the patients reported satisfactory results. Thoracic sympathetic ganglionectomy with VATs is an efficient, safe, and minimally invasive surgical procedure for primary hyperhidrosis.

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Effect of speech on GSR for electromagnetic hypersensitivity and control groups (전자기장에 민감한 사람과 일반인의 언어자극이 피부저항에 미치는 영향)

  • Ji, Hyo-Chul;Shim, Young-Woo;Noh, Hyung-Wook;Kim, Deok-Won
    • Proceedings of the KIEE Conference
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    • 2008.10b
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    • pp.129-130
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    • 2008
  • 교감 신경계의 활성정도를 판별할 수 있는 지표로 피부저항(Galvanic skin resistance: GSR)이 있다. 교감신경이 흥분하면 땀이 분비되어 손가락의 피부저항이 감소하게 된다[1]. 전자기장에 민감한 사람(electromagnetic hypersensitivity: EHS)에게 전자기장을 노출시키면 전자기장을 잘 느끼지 못하는 일반인에 비해 교감신경이 많이 흥분하여 땀을 더 많이 분비할 것이라 생각하여 손가락 피부저항의 변화를 측정하여 전자기장에 민감한 사람과 일반인의 교감신경 활성정도의 차이를 알아보고자 하였다. 그러나 전자기장에 민감한지 민감하지 않은지를 판별하기 위한 인지 및 증상에 관한 설문에 의해서도 피부저항의 변화가 생길 수 있다. 따라서 본 연구에서 전자파에 민감한 사람과 일반인간의 언어자극에 의한 피부저항의 변화를 알아보고 전자기장 노출 실험에서 인지 설문이 전자기장 노출여부에 의한 피부저항의 변화에 영향을 주는지 주지 않는지를 알아보고자 한다. 피부저항 측정 결과 EHS와 일반인군 모두에게서 언어자극(인지 및 자각증상에 관한 설문)에 의해 피부저항이 감소되는 경향을 보였다.

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Change of both Palmar Temperature During Thoracoscopic Sympathicotomy for Palmar Hyperhidrosis (다한증환자의 흉부교감신경절단술시 양측 손바닥의 온도변화)

  • Lee, Hyeon-Jae;Kim, Dae-Sik;Moon, Seung-Cheol;Koo, Won-Mo;Yang, Jin-Young;Lee, Gun;Lim, Chang-Young;Park, Chung-Hyun
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.461-464
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    • 1999
  • Background: Thoracoscopic T2 sympathicotomy is an effective method for the treatment of palmar hyperhidrosis. Not only are the symptoms of hyperhidrosis abolished but also the temperature of the ipsilateral palm is elevated due to the sympatholytic vasodilation after the completion of the sympathicotomy on the first side. However little is known about the temperature changes in the contralateral palm. This study was performed to evaluate the changes in both palmar temperatures during the thoracoscopic T2 sympathicotomy for palmar hyperhidrosis. Material and Method: Thoracoscopic T2 sympathicotomy was performed in 15 patients with primary palmar hyperhidrosis. Surface temperatures of both palms were monitored continuously and were recorded simultaneously during the 7 different stages of the operation. Result: When T2 sympathicotomy was performed on the first(left) side, an ipsilateral increase with a contralateral decrease of temperature was observed. The difference in the temperature of both palms was greatest just before the sympathicotomy on the contralateral(right) side(Lt. 34.6$\pm$0.9$^{\circ}C$ vs. Rt. 31.6$\pm$1.3$^{\circ}C$, P<0.0001). After the sympathicotomy on the second(right) side, temperature of the right palm was elevated. The difference in the temperature of both palms was abolished at the end of the operation(Lt.34.7$\pm$0.9$^{\circ}C$ vs. Rt.34.4$\pm$1.$0^{\circ}C$, P=0.415). Conclusion: When T2 sympathicotomy was performed on the first side, an ipsilateral palmar temperature increased due to the sympatholytic vasodilation. However contralateral palmar temperature decreased due to a vasoconstriction. Although the mechanism of vasoconstriction is still unknown, it is postulated that there may be a cross- inhibitory effect by the post-ganglionic neurons innervating blood vessels of the palm.

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