• The Journal of Internal Korean Medicine
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• v.33 no.3
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• pp.327-337
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• 2012

Objectives : The purpose of this study was to report the clinical effect of short- term admission program on primary palmar/plantar hyperhidrosis in children and adolescents. Methods : Between January 2011 and January 2012, a total of 11 patients with clinical diagnosis of primary palmar/plantar hyperhidrosis were treated with hospitalization which consisted of iontophoresis, electro-acupuncture, herbal medicine, topical therapy and physical therapy. The effects were evaluated as quality of life with dermatology life quality index (DLQI), severity of discomfort using visual analogue scale (VAS), and the patients' subjective satisfaction. We analyzed the patients' improvement before and after admission treatment, as well as six month later. Results : After treatment, the 11 patients' quality of life and severity of discomfort improved significantly. They also were satisfied with oriental treatments for hyper hidrosis. Six months later, 6 of 11 patients had visited the hyperhidrosis clinic. Their symptoms had improved and remained stable. Conclusions : The short-term admission program is effective on primary palmar/plantar hyperhidrosis. Further studies with a larger number of cases will be needed in the future.

• Korean Journal of Veterinary Research
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• v.53 no.4
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• pp.257-261
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• 2013

This study evaluated two different surgical techniques for the treatment of palmar annular ligament desmitis (PAL) in horses. The group 1 (G1) consisted of 11 Thoroughbred submitted to desmotomy, and G2 of 22 horses that underwent PAL desmectomy. There was no statistically significant difference between mean palmar annular ligament thickness in both groups evaluated (p = 0.800). In this study, the horses of G1 had 12 times more chance to return to physical activity, when compared to animals of G2 (p = 0.033; O.R. = 12.0; C.I.95% = 1,142 - 126,122). Desmectomy was more efficient in promoting the resolution of the injury and the return to sports activity.

• Archives of Reconstructive Microsurgery
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• v.23 no.2
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• pp.45-50
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• 2014

Palmar soft tissue defects are best reconstructed using a replacement flap of proper size with adequate soft tissue stability for mechanical resistance as well as with protective sensation. Reconstructive approaches are dictated by injury mechanism, defect size and location, and the status of the wound bed and tendino-skeletal structure. While uninjured portions of the hand can be used as a source for local flaps, the use of free flaps allows for maximal access for selection of the most ideal replacement tissue for the defect to be restored as close to the initial state as possible. Here, we review the garden variety of free flaps used in reconstruction of palmar soft tissue defects.

• Journal of Veterinary Science
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• v.24 no.6
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• pp.76.1-76.6
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• 2023

An 11-year-old neutered male Miniature Poodle with a stage 3 apocrine gland adenocarcinoma was started on chemotherapy with toceranib phosphate after surgery. Beginning on day 10 of toceranib, the dog's foot pads became erythematous and hyperkeratinized. The dog complained of pain, inability to walk, depression, and loss of appetite. The symptoms resolved when toceranib was discontinued and reappeared when toceranib was resumed. Grade 3 palmar-plantar erythrodysesthesia was identified as an adverse event of toceranib based on the VCOG-CTCAE and Naranjo scale. Although very rare in veterinary medicine, clinicians should consider that palmar-plantar erythrodysesthesia can occur after toceranib administration.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.999-1003
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• 1998

Background: Thoracoscopic sympathetic block in palmar hyperhidrosis has merits in its immediate responsiveness and recovery. In palmar hyperhidrosis, the level of sympathetic chain to be blocked has been somewhat obscure. Materials and methods: To compare the results of T2 with T2,3 sympathetic block, we retrospectively studied 192 patients (T2 group: 84, T23 group: 108) operated on at SNUH with palmar hyperhidrosis between April 1994 and July 1997. We reviewed medical records and recently interviewed the patients by telephone call. Sex and age distribution between two groups showed no significant differences. We performed sympathectomy at the early phase of the syudy until April 1997, and after then, we adopted sympathicotomy rather than sympathectomy. Results: All patients showed symptomatic improvement after the operation. Mean operation times of T2, T23 groups were 61.3$\pm$22.5min, 82.7$\pm$24.8min, respectively(p<0.01). Early postoperative complications, such as Horner's syndrome or chest tube insertion, were not different in two groups. There were no statistical differences of late complications such as compensatory truncal hyperhidrosis, gustatory sweating, and phantom sweating. No patient experienced recurrence of palmar hyperhidrosis during the study period. The only difference was the extent of compensatory truncal hyperhidrosis. The compensatory sweating occurred from axilla to suprapatella in T2 group whereas its extent was from nipple to suprapatella in T23 group. Conclusions: We concluded that T2 thoracic sympathetic block is mandatory for the treatment of primary palmar hyperhidrosis.

• Journal of Chest Surgery
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• v.44 no.2
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• pp.154-158
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• 2011

Background: Video-assisted thoracic sympathicotomy plays an important for the treatment of essential hyperhidrosis. Patients are usually satisfied with the surgical outcome at the early post-operative period, but suffer recurrence and compensatory sweating in the late post-operative period. There are many sympathicotomy methods to minimize recurrence and compensatory sweating. We compared the outcome of sympathicotomy methods above the third rib (R3) and the fourth rib (R4) with regards to symptoms, satisfaction, recurrence, and compensatory palmar and axillary hyperhydrosis. Materials and Methods: From January 1999 to April 2009, 39 cases of thoracoscopic sympathicotomy at the third rib (R3), and 94 cases of thoracoscopic sympathicotomy at the fourth rib (R4) for palmar and axillary hyperhidrosis were compared for early and late post-operative satisfaction, compensatory sweating and recurrence. Results: There was no sex or age difference between groups. Early satisfaction was 94.9% and 98.9% in the R3 group and R4 group, respectively. There was no difference in early satisfaction (94.9% in R3 and 98.9% in R4), late satisfaction (84.6% in R3 and 89.4% in R4), or recurrence (17.9% in R3 and 17.0% in R4) between groups. There was significant difference in compensatory sweating (71.8% in R3 and 33% in R4, p=0.002). Conclusion: R4 sympathicotomy demonstrated superior efficacy in the treatment of compensatory sweating compared to R3 in palmar and/or axillary hyperhidrosis.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.818-822
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• 1999

Background: Thoracoscopic T2 sympathicotomy had been performed as a simple and effective method in treating palmar hyperhidrosis, however, this method had the complications of compensatory hyperhidrosis and facial anhidrosis. Therefore, a more limited and modified methods for T2 sympathicotomies were introduced and comparative analysis of the modified upper and lower T2 sympathicotomy were made in the treatment of palmar hyperhidrosis. Material and Method: From January 1997 to December 1998, 41 patients with palmar hyperhidrosis had been treated by modified T2 sympathicotomy at the Kon-Kuk University Seoul Hospital. Twenty-four patients underwent a modified upper T2 sympathicotomy(Group A), and seventeen patients underwent a modified lower sympathicotomy(Group B). A comparison between groups A and B were made according to the medical records and interview results. Result: All patients showed symptomatic improvements after the operation. The anisocoria, facial anhidrosis and dissatisfaction for compensatory hyperhidrosis were more common in Group A and the individual satisfaction for the operations were higher in Group B. Conclusion: The modified lower T2 sympathicotomy might be a more effective and less complicated method than the modified upper T2 sympathicotomy.

• 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.

• 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.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.724-729
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• 2002

Although variable surgical methods of sympathetic nerve for palmar hyperhidrosis are curative and safe therapeutic options, they have some limitations such as compensatory sweating and anhidrosis of hand in long term satisfaction rate. Material and Method: Therefore, we tried to decrease severity of compensatory sweating and prevent excessive dryness of hand through selective division of rami communicantes of thoracic sympathetic ganglia distributed to the hands(ramicotomy). Result: In postoperative results, about half of the patients maintained humidity of hands and most of them showed no more than mild degree of compensatory sweating. Conclusion: Therefore, ramicotomy of thoracic sympathetic ganglia can be recommended as selective and physiologic surgical method for palmar hyperhidrosis.