• Title/Summary/Keyword: 액와부

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Effect of Fourth and Fifth Chain Sympathicotomy in Axillary Hyperhidrosis -Five case report- (액와부 다한증에 대한 R4,5 교감신경 절단술의 효과 - 5예 보고 -)

  • 전순호;이재훈
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.297-299
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    • 2003
  • Thoracoscopic syrnpathicotomy is effective in treating not only palmar hyperhidrosis, but, also in treating axillary hyperhidrosis. In previous studies in Korea, sympathicotomy was focused on combinations including the End to 4th sympathetic chains (R2, 3, 4). Using a minimally invasive technique, the results of sympathicotomy of the 4th and 5th chains (R4, 5) of five patients, from February to August, 2002, for axillary hyperhidrosis without osmidrosis, were reviewed. All patients had a successful operation, their profuse sweating ceased. Three patients suffered from some degree of compensatory sweating. Among the three patients, only one patient suffered from moderate compensatory sweating over his back and thighs. Thoracoscopic R4, 5 sympathicotomy offers a very appealing method in the treatment for axillary hyperhidrosis in patients who have profuse axillary sweating.

Thoracoscopic Sympathetic Surgery for Axillary Hyperhidrosis (액와부다한증에서의 흉부교감신경절제수술)

  • 홍윤주;이두연;백효제;신화균;황정주;정은규
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1106-1110
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    • 1999
  • 배경: 다한증의 치료에 있어서 흉강경을 이용한 교감신경절제술의 시술 빈도가 급증하고 있다. 그러나 액와부 다한증의 경우 수장부나 안면 두부다한증에 비하여 절제범위가 광범위하여 이에 따른 보상성 다한증 및 기타 합병증의 발생의 높고 액취증이 동반되어있는 경우 장기적인 만족도가 낮아서 크게 각광 받지 못해왔다. 대상 및 방법: 본 교실에서는 1997년 3월부터 1999년 4월까지 45례의 액와부 다한증 환자에서 2 mm 흉강내시경을 이용하여 흉부교감신경절제술 또는 잘단술을 시행하였다. 남자 28례 여자 17례로 평균연령은 28(13-46세) 였고 평균추적기간은 10개월(1-24)이었다. 24례가 액와부에만 국한된 과도발한을 호소 하였고 2례에서 수술 전 심한 액취증이 동반되어있었다. 21례의 T3,4 교감신경절제술, 20례의 T2,4 교감신경단술 그리고 4례의 T4 교감신경절제수을 시행하여 즉각적인 증상치유효과 보상성 다한증 및 장기적 만족도를 비교 분석하였다. 중등도 이상의 흉막유착으로 5mm 내시경이 필요했던 2례을 제외한 전 환자에서 2mm 트로카 2개를 사용하여 수술을 하였다 결과: 평균수술시간은 T3,4 교감신경절제술이 46.2$\pm$11분 T2, 4 교감신경절단술이 32.5$\pm$23분 T4 교감신경절제술이 53.8$\pm$18분이 소요되었고 수술직후의 효과는 T3,4 교감신경절제술과 T2,4 교감신경절단술에서 '전혀땀이 나지 않는다'가 17례(81%) 와 12례(60%) '수술전보다 감소했으나 약간땀이 난다'가 4례(19%) 와 8례(40%) 로 모든 환자에서 효과가 있었으나 T4 교감신경절제술은 4례중3례(75%)에서 전혀 효과가 없었다. 보상성 다한증은 T3,4교감신경절제술과 T2,4 교감신경절단술에서 각각 67%, 60%로 나타났고 생활에 불편을 줄 정도의 심한경우는 10% 5%에 불과했으며 장기적인 만족도는 T3,4 교감신경절제술이 86% T2,4 교감신경절단술이 89%로 나타나 높은 성공률을 보았다 결론 : 액와부다한증의 치료에 있어서 T3,4 교감신경절제술과 T2,4교감신경절단술은 증상치유효과가 높고 절제범위의 제한에 따른 보상성 다한증의 감소로 장기적 만족도가 우수한 효과적인 방법이다. 액취증이 동반된 경우 이에대한 충분한사전 설명과 원인 감별후 적절한 보조요법을 병행함으로써 환자의 만족도를 높힐수 있다고 본다.

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A study on the usefulness of a fusion model designed cloak shield to reduce the radiation exposure of the assistant during CT of severely injured patient (중증외상환자 CT 검사 시 검사보조자의 방사선피폭 경감을 위한 융합적 망토 차폐체의 유용성 연구)

  • Seo, Sun-Youl;Han, Man-Seok;Kim, Chang-Gyu;Jeon, Min-Cheol;Kim, Yong-Kyun;Kim, Gab-Jung
    • Journal of the Korea Convergence Society
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    • v.8 no.9
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    • pp.211-216
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    • 2017
  • The purpose of this study is to evaluate the usefulness of a newly fusion model designed cloak shield to reduce the radiation exposure of the assistant during CT(computed tomography) of severely injured patient. Radiation dose was measured in the heart, both axillary and thyroid areas using newly designed cloak shield and existing shield with head phantom and human phantom under the same conditions as brain vascular CT scan. The newly designed cloak shield was measured higher for radiation shielding rate than the existing shields, 61.9 % for heart, 46.2 % for left axillary, 69.8 % for right axillary and 71.1 % for thyroid gland, respectively. a newly developed fusion model of cloak shields are useful for reducing radiation exposure. It is expected to make a significant contribution to reduction of radiation exposure.

A Case Report of Axillary Hibernoma: US, CT, MR, and Histopathologic Findings (액와부 갈색지방종의 증례 보고: 초음파, 컴퓨터단층촬영, 자기공명영상, 병리 소견)

  • Ji Yeon Park;Seong Yoon Yi;Ji Young Lee;Tae Jung Kwon
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.439-443
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    • 2022
  • Hibernoma is a rare benign tumor of brown adipose tissue. Herein, we report a case of axillary hibernoma in a 53-year-old female and discuss the various radiologic findings. The US revealed a 4.5-cm well-defined oval heterogenous hyperechoic mass in the right axilla with anterior displacement of the axillary vessels. Non-enhanced chest CT showed a 5.0-cm well defined, oval, and low-attenuated mass. MRI demonstrated a 5.5-cm mass with heterogeneous intermediate-to-high signal intensity on T1-and T2-weighted images and irregular enhancement at the peripheral portion. The patient underwent an US-guided core needle biopsy and the final diagnosis was hibernoma.

Granular Cell Tumor of the Axillary Accessory Breast: A Case Report (액와부 부유방에 발생한 과립 세포 종양: 증례 보고)

  • Youn Joo Jung;Kyung Jin Nam;Ki Seok Choo;Kyeyoung Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.275-279
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    • 2023
  • Granular cell tumors (GCTs) are rare benign soft tissue tumors that can occur throughout the body, particularly the head and neck; only 5%-8% of GCTs occur in the breast. We report a case of a GCT of the axillary accessory breast, which is a rare location of this tumor. A 50-year-old woman had a 2-month history of a palpable mass in the left axilla. Physical examination, as well as mammographic and ultrasonographic findings suggested a breast malignancy. Histopathological examination showed a benign GCT, and wide local excision was performed. The patient has remained disease-free over 2 years postoperatively. Although most GCTs are benign, wide complete resection of the tumor and follow-up are required considering the possibility of recurrence. The radiologist should know the characteristics of GCTs as a differential diagnosis of breast and axillary lesions to prevent unnecessary treatment.

In vivo and in vitro Confirmation of Dose Homogeneity in Total Body Irradiation with Thermoluminescent Dosimeter (인체 및 인형 팬톰에서 전신방사선조사시 열형광선량계(TLD)를 이용한 선량분포 균일성 확인)

  • Chie Eui Kyu;Park Suk Won;Kang Wee-Saing;Kim Il Han
    • Radiation Oncology Journal
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    • v.17 no.4
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    • pp.321-328
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    • 1999
  • Purpose : Total body irradiation (TBI) or whole body irradiation is used to acquire immune suppression, to treat malignant lymphoma and leukemia, and as an conditioning regimen for bone marrow transplantation. For these purposes, many methods were developed to obtain homogenous dose distribution. The objective of this study was to analyze and confirm the accuracy and the homogeneity of the treatment setup, the parallel opposed lateral technique, currently used in Seoul National University Hospital. Materials and Metheods : Surface dose data, measured with a thermoluminescent dosimeter, of 8 patients among 10 patients, who were given total body irradiation with the parallel opposed lateral technique between September 1996 to August 1998, at Seoul National University Hospital were analyzed. Surface doses were measured at the head, neck, axilla, thigh, and ankle level. Surface and midline doses were measured with similar set-up and technique in the Humanoid phantom. Results : Measured surface doses relative to prescribed dose for the head, neck, axilla, thight, and ankle leve were $91.3{\pm}7.8,{\;}98.3{\pm}7.5,{\;}95.1{\pm}6.3,{\;}98.3{\pm}5.5$, and $95.3{\pm} 6.3\%$, respectively. The midline doses of the head, neck, axilla, thigh, and ankle level estimated from the surface-to-midline ratios in the Humanoid Phantom were $103.4{\pm}9.0,{\;}107.8{\pm}10.5,{\;}91.1{\pm}6.1,{\pm} 93.8{\pm}4.5,{\;}and{\;}104.5{\pm}9.3\%$, respectively. Measured surface doses and estimated midline doses ranged from $-8.9\%$ to $+7.8\%$. Midline doses at the neck and the axilia level deviated more than $5\%$ from the prescribed doses. The difference of the estimated midline doses at the neck and the axilla level and the actual doses were attributed to the thickness differences between the Humanoid phantom and the patients. Conclusion Distribution of the midline doses as well as the suface doses were measured to be within $-8.7\~{\pm}7.8\%$ range. Actual dose distribution in the patient is expected to be better than the measured dose range mainly attributed to thickness difference between the patient and the Humanoid phantom.

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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.

Imaging Findings of Axillary Granular Cell Tumor in a Patient with Breast Cancer History: A Case Report (유방암 과거력을 가진 환자에서 액와부 과립세포종의 영상 소견: 증례 보고)

  • Jeongeum Oh;Ji Yeon Park;Mee Joo
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1176-1180
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    • 2023
  • Granular cell tumors (GCTs) are rare soft tissue tumor, originating from neural or perineural cells. We present a case of axillary GCT in a 69-year-old woman with breast cancer history and discuss the various radiologic findings. US revealed a circumscribed oval heterogeneous iso- and hyperechoic mass in the left axilla. Chest CT showed a well-defined, oval, and mildly enhancing mass in the left axilla on the lateral aspect of the pectoralis muscle. A final diagnosis of GCT was made through US-guided core needle biopsy. Follow-up US showed no significant changes in the axillary GCT. Familiarity with GCT may facilitate early diagnosis and subsequent management.