Background: Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any parts of the body. Thoracic sympathectomy has been a surgical procedure for the management of hyperhidrosis. Methods: We studied 30 ASA I and II patients suffering from severe hyperhidrosis. Bilateral upper thoracoscopic sympathectomy of $T_{2-4}$ was performed in 30 patients under general anesthesia. Anesthesia was induced with 2.5% thiopental sodium 5 mg/kg and succinylcholine chloride 1 mg/kg and was maintained with enflurane 1~2 Vol% and $N_2O-O_2$ mixture adjusted to maintain $SpO_2$ greater than 96%. During anesthesia, invasive arterial pressure, heart rate, EKG, $SpO_2$ and capnography were monitored. Skin temperature was measured with thermister probes attached to the index finger of each hand. An increase in temperature after cautery confirmed success of the sympathectomy. Results: There were 14 men and 16 women whose ages ranged from 16 to 46 years old (mean age 22.2). Of these patients, 13 patients had complained of palm-sole hyperhidrosis, 9 of palm-sole-axilla hyperhidrosis, 4 of palm-sole-face hyperhidrosis and 4 of palm-sole-axilla-face hyperhidrosis. The provocative factors of excessive sweating were tension and stress from interpersonal relationships. There was positive familial history in 37%. The most common complication was compensatory hyperhidrosis in 23 patients comprising 76%. Other complication included peumothorax (4 patients), hemothorax (1 patient), ipsilateral Horner's syndrome (1 patient) and paresthesia of right arm (1 patient). The degree of satisfaction was graded as good, fair and poor with 15, 12 and 3 patients, respectively. Conclusions: Thoracoscopic sympathectomy with VATS is an efficient, safe and minimally invasive surgical procedure for essential hyperhidrosis.
Choi, Jangyoun;Park, Song I;Rha, Eun Young;Seo, Bommie Florence;Kwon, Ho;Jung, Sung-No
Archives of Craniofacial Surgery
/
v.20
no.3
/
pp.176-180
/
2019
Background: Parotidectomy is the treatment of choice in many parotid tumors. Due to the extensive nature of the procedure, unfavorable complications such as gustatory sweating, surgical site depression are common. Various techniques using fascia, muscle or AlloDerm have been developed but debate still remains regarding its availability and affordability. We applied a newly developed acellular dermal matrix (Insuregraf) to the parotidectomy field to act as a physical barrier and to provide adequate filling effect for prevention of functional and aesthetic complications. Methods: From March 2010 to March 2017, 30 patients with parotid tumors underwent superficial parotidectomy. Twenty patients underwent only superficial parotidectomy. Ten patients had Insuregraf applied to the surgical site after superficial parotidectomy. We evaluated the incidence of Frey's syndrome, surgical site depression, and patient satisfaction rate in both groups. Results: The incidence of Frey's syndrome was lower in the Insuregraf group (0 vs. 2). Surgical site depression was also lower in the Insuregraf group (2 vs. 20). Satisfaction score for facial contour in Insuregraf group was 9.2 out of 10, which was comparable to 6.2 out of 10 in the control group. Conclusion: Application of Insuregraf after superficial parotidectomy is an effective surgical procedure to prevent complications such as Frey's syndrome and surgical site depression. This technique is affordable and safe with no immune reactions. Above all this surgical method should be considered as an option for patients who are concerned about the contour of the face after surgery.
Purpose: During postpartum period, many women complain multiple pain, sweating, cold hypersensitivity, abdominal pain, hot flush and so on. We called the postpartum disease as San Hu Pung. The San Hu Pung could related with dysautonomia. So we studied the character of the postpartum disease patients as heart rate variability(H.R.V) Methods: The subjects were 63 women who visited Kangnam Kyunghee hospital for postpartum management from February 2006 to June 2007. From history taking, 42 symptomatic women was divided at the postpartum disease group, 21 asymptomatic women was divided at the control group. All women was measured HRV, we studied the difference of HRV between two group. Results: Compared with the control group, SDNN of the disease group was significant low. TP, LF and HF of the disease group were significantly lower than the control group. Conclusion: The difference of HRV between the disease group and the control group was significant. The results of HRV on the disease group could mean that San hu pung is related dysautonomia. The more studies to diagnose San hu pung would be needed.
Journal of the Korean Society of Clothing and Textiles
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v.38
no.1
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pp.73-86
/
2014
Persimmon juice dye-printed fabrics with printing were used for a Galot one-piece dress. The Galot dress was assessed in comparison to a white undyed one-piece dress of the same design through a wearing test conducted in a climatic chamber with an air temperature of $30{\pm}1^{\circ}C$, $50{\pm}5%$ R.H, and 0.2m/sec air movement on 4 healthy female subjects in their 20s. The subjects went through a 30-min stable period, a 30-min exercise of walking on a $5^{\circ}$ slope treadmill at 70m/min period, and a 20-min recovery period. In addition, a physiological reaction and subjective sensation were estimated. The results showed that significant differences were mostly observed from a sweating period that occurred during the latter half of the exercise. More specific results are as follows. First, skin temperature on the chest and mean skin temperature were significantly higher (p<.01) in rayon dyed sample dresses. Second, micro-humidity on the back showed a significant difference (p<.01). Both cotton and rayon persimmon juice dyed sample dresses produced lower microhumidity than their counterparts and as for cotton the difference occurred over the entire experimental period; however, it occurred after the middle of the exercise period for rayon. Third, the sweating rate on the back decreased in both cotton and rayon with persimmon juice dye but no significant difference was observed. Fourth, subjective three sensations revealed significant differences between cotton and rayon (p<.01), indicating that the subjects felt more cool, dryer and more comfortable in a cotton Galot. As described above, the analysis of physiological responses and the subjective sensation of undyed and dyed clothing shows the effect of persimmon juice dyeing. Persimmon juice dyeing also seemly increased air permeability, moisture regain and permeability facilitating body heat ventilation, as micro-humidity and sweat rate were lowered. However, this was not shown consistently in subjective responses on comfort especially when wearing rayon dresses.
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.
Background: Since 1992, we developed the technique for video endoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Compensatory hyperhidrosis, however, is the main cause of patient dissatisfaction after video-assisted thoracoscopic sympathectomy. According to many authors, initial satisfaction rate was high(94-98%), but it was declined with time (66%) due to mainly to embarrassing side effects. Material and Method: From January 1992 to February 1998, the thoracoscopic T2 sympathicotomy, T2 sympathectomy and T2-4 sympathectomy were performed in 315 patients suffering from Essential hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Eighty-nine patients underwent T2 sympathicotomy, and Eighty-eight patients underwent division T2 sympathectomy. Result: All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis. The global rate of compensatory sweating were ; 64.0% in T2 sympathicotomy, 73.8% in T2 sympathectomy and 87.8% in T2-4 sympathectomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathicotomy 15.7%(14/89) and in T2 sympathectomy 32.8%(28/88) than in T2-4 sympathectomy 58.0%(80/138) with significancy in statistic analysis(p<0.05). Video- assisted thoracoscopic sympathectomy is an effective minimally invasive and effective procedure. Conclusion: We suggest that the incidence and degree of compensatory hyperhidrosis was closely related to the extent of thoracic sympathectomy.
Background : Ephedra (Ephedra sinica) has been widely used to treat respiratory disease in traditional medicine of East Asia for over a hundred years. Despite safety concerns raised by some, the use of ephedra in traditional medicine is documented over more than 1,800 years. It is well established that ephedra is one of the central medicines in Korean 'Seseng constitution' medicine. In Sasang constitution medicine, all humans can be divided into one of four types: Soeumin, Soyangin, Taeumin or Taeyangin, and each constitution type has their own typical characteristics. Accordingly, it is hypothesized that the adverse effects of ephedra differ depending on the Sasang constitution classification. Objectives : The aim of this study was to determine adverse effects of ephedra which is classified as a Taeumin herb, and to observe whether the response differs or not. according to Sasang constitution classification. Methods : The study design was a double-blind randomized controlled trial. The subjects were healthy adults 20 - 50 years old who agreed to participate in this study. They were allocated through randomization to either ephedra group (N=55) or placebo group (N=24). where ephedra extract (6 g of dried ephedra) and placebo with similar opaque capsules were given twice for one day. To compare the adverse events of ephedra according to Sasang constitution classification, we analyzed blood pressure (systolic and diastolic), pulse rate, the morning questionnaire, and patient's global assessment scale score for well known adverse events: palpitation, headache, sweating, tiredness, dyspepsia, and dry mouth. Results : After ingestion of ephedra, the pulse rate had a significant increase in all constitution types. The changes of diastolic pressure in Soeumin and the changes of pulse rate in Soeumin, Soyangin and Taeumin had a significant increase in the ephedra over the control group. In the ephedra group, the palpitation and dyspepsia score of the patients' global assessment scale had a significant increase in Soeumin, with palpitation and sweating score increasing in Soyangin. Others observations were insignificant results. Conclusion : The results of this study may confirm that the physical responses or adverse effects of herbs differ for each type of Sasang constitution. Future studies using other herbs will be required to ascertain the herbal drug reaction of Sasang constitutions.
Journal of the Korean Society of Clothing and Textiles
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v.24
no.7
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pp.1073-1080
/
2000
Moisture transfer property of fabrics has known as one of the most important factors deciding wearer's subjective comfort not only thermally but also of sensorial. As a decisive property of fabric materials in determining human sensorial comfort, moisture vapor management property of heat resistant workwear material was examined in terms of increasing and decreasing rate and maximum value of relative humidity in the microclimate under the sweat pulse situation. An unique moisture regulation index, B$_{d}$, was calculated from the measurements using a novel dynamic sweating hot plate apparatus and was used to assess the buffering capacity of fabrics against a moisture vapor sweat pulse.e.
Jun-seok Kim;Ji-hyeon Kang;Seo-hyun Kim;Chae-eun Kim;Na-yeon Kim;Woo-seok Jang
The Journal of Internal Korean Medicine
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v.44
no.1
/
pp.66-76
/
2023
Background: The aim of this study is to investigate the use of heart rate variability on a stroke patient with autonomic dysfunction and the effectiveness of Bunshimgi-eum. Case report: The patient showed autonomic dysfunction, including chest discomfort, 煩燥 (sweating, anxiety, insomnia, nausea, lightheadedness), and abdomen discomfort (dyspepsia, heartburn) after ischemic stroke. She was treated with a herbal medicine (Bunshimgi-eum) through complex Korean medicine treatment. The effect was evaluated using heart rate variability (HRV), Mini-Mental State Examination-DS (MMSE-DS), mean pulse rate, and subjective percentage of symptoms. After treatment, the HRV score, MMSE-DS score, and subjective percentage of symptoms improved, and the pulse rate decreased from the upper boundary value. Discussion: The results suggest that HRV may be useful in evaluating stroke patients with autonomic dysfunction and that Bunshimgi-eum is suitable for treatment.
Journal of Physiology & Pathology in Korean Medicine
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v.27
no.5
/
pp.509-519
/
2013
Through the study on judgment of Body form and settle Energy flow(立形定氣) before diagnose the patients, the results are as follows. The observation of the body form is to determine prosperity and deficiency of each internal organ. It is necessary to distinguish Body form loss(形脫) and Body form fullness(形充). Fat man(肥人), Thin man(瘦人), Creamy man(膏人), Muscular man(肉人), Small Fat man(脂人) are discriminated by fat distribution, fat content, and muscle mass. The observation of the body form means the observation of structure disorder, color change, develop part at body, head and face. The observation of the body form that is to determine prosperity and deficiency of each internal organ is from the limited knowledge of the anatomy. The observation of face color is considered by blood perfusion, blood oxygenation and accumulation of carotinoid, bilirubin and change of melanin in the facial skin. The prosperity and the deficiency of energy flow is considered by symptom combined with growth (<40 years) and aging (>40 years). The prosperity of energy flow includes the anger, anxious emotion and the deficiency of energy flow includes the fear, depressive emotion. The breathing type is expiratory exhalation like asthma patients in the prosperity of energy flow. The deficiency of energy flow is weakness to overcome the disease. The prosperity and the deficiency of energy flow are considered by body metabolic ratios (Basal metabolic Rate: BMR, Resting metabolic rate: RMR, Physical activity ratios: PASs). Development of subcutaneous fat is good in the person of prosperous energy flow. The person of prosperous energy flow is hard to overcome to heat weather than cold weather. The person of deficiency of energy flow has tendencies of low blood pressure, insufficiency of blood flow in the peripheral and being shocked. The person of deficiency of energy flow has tendencies of chronic fatigue syndrome or automatic nerve disorder. If the patient who has deficiency of energy flow has severe weight loss should be checked for the presence of disease. The observation of small and large of bone is to check the development and disorder of bone growth and aging. The observation of thickness and weakness of muscle is to check the development of muscle, particularly biceps, gastrocnemius, and rectus abdominal muscle. The observation of thickness and weakness of skin is to check the ability of regulating body temperature by sweating.
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