Thermoregulatory sweating in palmar hyperhidrosis before and after upper thoracic sympathectomy

1979 ◽  
Vol 50 (1) ◽  
pp. 88-94 ◽  
Author(s):  
Chun-Jen Shih ◽  
Mao-Tsun Lin
Keyword(s):  
Subcutaneous Administration ◽  
Atropine Sulfate ◽  
Normal Group ◽  
Palmar Hyperhidrosis ◽  
Surgical Removal ◽  
Content Type ◽  
Ambient Temperatures ◽  
Thoracic Sympathectomy ◽  
Normal Limits ◽  
Wide Range

✓ To assess thermoregulatory sweating in palmar hyperhidrosis, the authors determined the responses of three groups of normal, hyperhidrotic, and denervated subjects to a variety of ambient temperatures (TA's), 22°, 28°, and 41° C. The normal group had no hyperhidrosis, with intact T2–3 ganglia, the hyperhidrotic group had palm hyperhidrosis with intact T2–3 ganglia, and the denervated group had hyperhydrosis treated with T2–3 ganglionectomy. Both groups of hyperhidrotic and denervated subjects maintained oral and mean skin temperatures within normal limits displayed by the normal group over a wide range of TA's tested. The local sweating rate (LSR) of both the palms and the soles of the feet in the hyperhidrotic group was decreased to a minimal level by either the T2–3 ganglionectomy or the subcutaneous administration of atropine sulfate. Furthermore, the denervated group had a significantly lower LSR of both the forehead and the upper chest regions, but showed a higher LSR of both the ventral thigh and the lateral lumbar regions at a TA of 41° C when compared to the LSR of either the normal or the unoperated hyperhidrotic group. The data demonstrate that the surgical removal of both the T-2 and the T-3 ganglia, although producing no alterations in the thermal balance, does produce abnormalities in quantitative distribution of thermoregulatory sweating in man.

Effects of cholinomimetic drugs on sudomotor, metabolic, respiratory, vasomotor, and temperature response in palmar hyperhidrosis

1980 ◽  
Vol 53 (5) ◽  
pp. 684-689 ◽  
Author(s):  
Chun-Jen Shih ◽  
Mao-Tsun Lin
Keyword(s):  
Upper Limb ◽  
Subcutaneous Administration ◽  
Cholinergic Receptors ◽  
Normal Group ◽  
Palmar Hyperhidrosis ◽  
Metabolic Responses ◽  
Autonomic Functions ◽  
Excessive Sweating ◽  
Content Type ◽  
Cholinomimetic Drugs

✓ The effects of cholinomimetic drugs such as mecholyl (methacholine) and pilocarpine on autonomic functions (including sudomotor, metabolic, respiratory, vasomotor, and temperature responses) were assessed at room temperature (24°C) in three groups of individuals, including normal, hyperhidrotic, and denervated subjects. The normal group had no palmar hyerhidrosis, with intact T2–3 ganglia, the hyperhidrotic group had palmar hyperhidrosis with intact T2–3 ganglia, and the denervated group had palmar hyperhidrosis treated with T2–3 ganglionectomy. Subcutaneous administration of mecholyl and pilocarpine each produced a fall in oral temperature in the normal group. The hypothermia was brought about by a decrease in metabolic rate, an increase in local sweating rate (mainly of the upper limb and trunk), and an increase in cutaneous circulation (estimated by an increase in the upper limb and trunk skin temperatures). The autonomic functions induced by these cholinomimetic drugs were antagonized by pretreatment with atropine sulfate (an antagonist of cholinergic receptors). Moreover, the hypothermia induced by mecholyl or pilocarpine was greatly reduced in the hyperhidrotic group. The reduction in the cholinomimetic-induced hypothermia in the hyperhidrotic group was due to the reduced sudomotor and metabolic responses after the injections of these cholinomimetic drugs, as compared to those of the normal group. However, neither the excessive sweating of the palms nor the reduced cholinergic responses in the hyperhidrotic group was observed after T2–3 ganglionectomy. The data indicate that the T2–3 ganglia play a role in the elaboration or modulation of the sudomotor and metabolic responses induced by activation of certain cholinergic receptors in humans.

Effects of brain monoamine depletion on chlorpromazine-induced hypothermia in rabbits

1979 ◽  
Vol 57 (1) ◽  
pp. 16-23 ◽  
Author(s):  
M. T. Lin
Keyword(s):  
Blood Flow ◽  
Heat Production ◽  
Intraperitoneal Administration ◽  
Induced Hypothermia ◽  
Evaporative Heat Loss ◽  
Ambient Temperatures ◽  
Normal Limits ◽  
Wide Range ◽  
Monoamine Depletion ◽  
6 Hydroxydopamine

The thermal responses of three groups of control, 6-hydroxydopamine (6-OHDA) treated and 5,7-dihydroxytryptamine (5,7-DHT) treated rabbits to the administration of chlorpromazine (CPZ) were assessed at three different ambient temperatures (Ta: 2, 22, and 32 °C). Depleting catecholamines (CA) in brain with 6-OHDA produced a decrease in metabolic rate, in respiratory evaporative heat loss, and in ear blood flow at both Ta's of 2 and 22 °C, while depleting 5-hydroxytryptamine (5-HT) contents in brain with 5,7-DHT produced the opposite responses at the same Ta's. However, these amine-depleted animals maintained their rectal temperatures within normal limits over a wide range of Ta's tested. Furthermore, intraperitoneal administration of CPZ produced hypothermia at both Ta's of 2 and 22 °C. The major cause of the CPZ-induced hypothermia was an inhibition of metabolic heat production at Ta of 2 °C. At Ta of 22 °C, the CPZ-induced hypothermia was due to both a decrease in heat production and an increase in ear blood flow. However, CPZ hypothermia was attenuated in the CA-depleted animals, but was potentiated in the 5-HT-depleted animals. The data indicate that brain monoamines are involved in the central mechanisms of CPZ-induced hypothermia.

Chronological changes of postsympathectomy compensatory hyperhidrosis and recurrent sweating in patients with palmar hyperhidrosis

2005 ◽  
Vol 2 (2) ◽  
pp. 151-154 ◽  
Author(s):  
Thomas S. M. Chiou
Keyword(s):  
Patient Satisfaction ◽  
Palmar Hyperhidrosis ◽  
Analog Scale ◽  
Compensatory Hyperhidrosis ◽  
Content Type ◽  
Thoracic Sympathectomy ◽  
The Mean ◽  
Upper Thoracic ◽  
Fine Print

Object. The author sought to investigate the temporal changes of postsympathectomy compensatory hyperhidrosis and recurrent sweating in patients with primary palmar hyperhidrosis. Methods. The author examined 91 consecutive patients for this prospective 6-year study. The patients were interviewed at least twice during a 6-month interval; the first follow up was conducted at a median of 1.7 years after surgery (range 2.5–60.5 months). Overall, 24 patients (26.4%) were followed for more than 2 years. Attention was focused on patient satisfaction and the incidence of compensatory hyperhidrosis and recurrent sweating. The overall mean patient satisfaction rate was 78%, with a median 80% improvement on a visual analog scale from 0% (poor) to 100% (excellent). Overall, 88 patients (96.7%) developed compensatory hyperhidrosis, with the mean initial occurrence at 8.2 weeks. The symptoms of compensatory hyperhidrosis progressively worsened to the maximum degree within another 2 weeks after onset (mean 10.3 ± 1.83 weeks). In 19 patients (21.6%), symptoms of compensatory hyperhidrosis improved spontaneously within 3 months after sympathectomy (mean 13.3 weeks). Postoperative compensatory hyperhidrosis occurred in 71.4% of patients within the 1st year. Recurrent sweating occurred in only 17.6% of patients. None of these patients required repeated operation. The earliest onset of recurrent sweating was noted at 2 weeks postoperatively by three patients, and the mean initial postoperative reccurrence was 32.7 weeks after surgery. Conclusions. Compensatory hyperhidrosis and recurrent sweating are normal thermoregulatory responses that occurred after upper thoracic sympathectomy. Compensatory hyperhidrosis was more prevalent and developed earlier than recurrent sweating. The severity of both compensatory hyperhidrosis and recurrent sweating symptoms remained stable 6 months after surgery.

Localization of carcinoembryonic antigen in mature intracranial teratomas

1985 ◽  
Vol 62 (6) ◽  
pp. 870-873 ◽  
Author(s):  
Hirofumi Naganuma ◽  
Hiroshi K. Inoue ◽  
Masaru Nakamura ◽  
Hidehito Koizumi
Keyword(s):  
Carcinoembryonic Antigen ◽  
Germ Cell Tumors ◽  
Immunohistochemical Method ◽  
Surgical Removal ◽  
Content Type ◽  
Normal Limits ◽  
Intracranial Germ Cell Tumors ◽  
Stratified Squamous Epithelium ◽  
Csf Levels ◽  
Glandular Structures

✓ Carcinoembryonic antigen (CEA) in serum and cerebrospinal fluid (CSF) was measured in four patients with intracranial teratoma. The CEA levels were elevated in the CSF of two patients, but were within normal limits in the serum of all four. After surgical removal of the teratomas, which were verified as mature teratomas, CEA was localized by an immunohistochemical method. Positive reactions both to anti-CEA serum and to another anti-CEA serum absorbed with nonspecific cross-reacting antigen were seen in glandular structures, with or without goblet cells, and in some portions of stratified squamous epithelium. It is concluded that CEA, detected in CSF, may originate in mature teratomas, and CEA-positive structures (especially glandular) may differentiate into gastrointestinal tract structures. An examination of serum and CSF levels of CEA may offer additional clues to the diagnosis of intracranial germ-cell tumors.

Evaluation of cardiac sympathetic nerve function by myocardial 123I-metaiodobenzylguanidine scintigraphy before and after endoscopic sympathectomy

2004 ◽  
Vol 100 (3) ◽  
pp. 512-516 ◽  
Author(s):  
Shingo Toyota ◽  
Hiroshi Takimoto ◽  
Jun Karasawa ◽  
Amami Kato ◽  
Toshiki Yoshimine
Keyword(s):  
Imaging Study ◽  
Palmar Hyperhidrosis ◽  
Washout Rate ◽  
Mibg Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Thoracic Sympathectomy ◽  
Before And After ◽  
Upper Thoracic ◽  
Fine Print

Object. The purpose of this study was to analyze the change in cardiac sympathetic function by performing a 123I-metaiodobenzylguanidine (MIBG) imaging study after endoscopic upper thoracic sympathectomy (EUTS) in patients with palmar hyperhidrosis before and after surgery. Methods. Between February 1999 and February 2002, 135 patients underwent bilateral EUTS to treat palmar hyperhidrosis. Between September 2001 and February 2002, 12 of these consecutively enrolled patients were also included in a 123I-MIBG imaging study. These patients underwent cardiac 123I-MIBG imaging 1 day before and 7 days after they had undergone EUTS. The heart/mediastinum (H/M) ratio and the washout rate were calculated for both early and late phases, and single-photon emission computerized tomography (SPECT) imaging of the early phase was performed. Excessive perspiration from the palms disappeared immediately after EUTS in all patients, and they showed no symptoms of a circulatory condition following the procedure. On the 123I-MIBG imaging studies, the early H/M ratio before EUTS was 2.35 ± 0.26 and postoperatively it was 2.29 ± 0.23. The delayed H/M ratio before EUTS was 2.59 ± 0.3 and after the procedure it was 2.66 ± 0.27. There was no significant difference between the H/M ratio before and after EUTS. The washout rate after EUTS (14.27 ± 4.71%) was significantly lower than that measured before EUTS (18.36 ± 5.13%; p < 0.01). No apparent local defects of accumulation of MIBG were found on SPECT images obtained post-EUTS. Conclusions. Endoscopic upper thoracic sympathectomy is a minimally invasive procedure; no local denervation was found after EUTS. Findings on 123I-MIBG imaging studies indicate that EUTS suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy.

Video endoscopic sympathectomy for palmar hyperhidrosis

1996 ◽  
Vol 84 (3) ◽  
pp. 484-486 ◽  
Author(s):  
Kheng Hin Lee ◽  
Peter Y. K. Hwang
Keyword(s):  
Surgical Techniques ◽  
Cost Effective ◽  
Palmar Hyperhidrosis ◽  
Complete Relief ◽  
Endoscopic Thoracic Sympathectomy ◽  
Compensatory Hyperhidrosis ◽  
Content Type ◽  
Thoracic Sympathectomy ◽  
Laparoscopic Grasper ◽  
Histological Confirmation

✓ Palmar hyperhidrosis has been treated using a variety of medical and surgical techniques with varying degrees of success. The authors report their experience in 82 patients in whom they performed 164 sympathectomies using a video endoscope, a laparoscopic grasper, and microscissors. Patients were monitored by palm temperature electrodes. An intraoperative histological confirmation of the sympathetic chain and a temperature rise of at least 1°C after the procedure resulted in complete relief of the hyperhidrosis. All the patients were relieved of their symptoms, and 41 experienced decreased plantar hyperhidrosis as well. Compensatory hyperhidrosis in 50 patients was the only significant side effect, which improved 6 months after the surgery. Video endoscopic thoracic sympathectomy is a safe, easy, reliable, and cost-effective way to treat palmar hyperhidrosis.

Gamma knife radiosurgery in the management of cavernous sinus meningiomas

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 68-73 ◽  
Author(s):  
Pierre-Hugues Roche ◽  
Jean Régis ◽  
Henry Dufour ◽  
Henri-Dominique Fournier ◽  
Christine Delsanti ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Tumor Growth ◽  
Gamma Knife ◽  
Cavernous Sinus ◽  
Gamma Knife Radiosurgery ◽  
Surgical Removal ◽  
Content Type ◽  
Cavernous Sinus Meningioma ◽  
The Mean ◽  
Fine Print

Object. The authors sought to assess the functional tolerance and tumor control rate of cavernous sinus meningiomas treated by gamma knife radiosurgery (GKS). Methods. Between July 1992 and October 1998, 92 patients harboring benign cavernous sinus meningiomas underwent GKS. The present study is concerned with the first 80 consecutive patients (63 women and 17 men). Gamma knife radiosurgery was performed as an alternative to surgical removal in 50 cases and as an adjuvant to microsurgery in 30 cases. The mean patient age was 49 years (range 6–71 years). The mean tumor volume was 5.8 cm3 (range 0.9–18.6 cm3). On magnetic resonance (MR) imaging the tumor was confined in 66 cases and extensive in 14 cases. The mean prescription dose was 28 Gy (range 12–50 Gy), delivered with an average of eight isocenters (range two–18). The median peripheral isodose was 50% (range 30–70%). Patients were evaluated at 6 months, and at 1, 2, 3, 5, and 7 years after GKS. The median follow-up period was 30.5 months (range 12–79 months). Tumor stabilization after GKS was noted in 51 patients, tumor shrinkage in 25 patients, and enlargement in four patients requiring surgical removal in two cases. The 5-year actuarial progression-free survival was 92.8%. No new oculomotor deficit was observed. Among the 54 patients with oculomotor nerve deficits, 15 improved, eight recovered, and one worsened. Among the 13 patients with trigeminal neuralgia, one worsened (contemporary of tumor growing), five remained unchanged, four improved, and three recovered. In a patient with a remnant surrounding the optic nerve and preoperative low vision (3/10) the decision was to treat the lesion and deliberately sacrifice the residual visual acuity. Only one transient unexpected optic neuropathy has been observed. One case of delayed intracavernous carotid artery occlusion occurred 3 months after GKS, without permanent deficit. Another patient presented with partial complex seizures 18 months after GKS. All cases of tumor growth and neurological deficits observed after GKS occurred before the use of GammaPlan. Since the initiation of systematic use of stereotactic MR imaging and computer-assisted modern dose planning, no more side effects or cases of tumor growth have occurred. Conclusions. Gamma knife radiosurgery was found to be an effective low morbidity—related tool for the treatment of cavernous sinus meningioma. In a significant number of patients, oculomotor functional restoration was observed. The treatment appears to be an alternative to surgical removal of confined enclosed cavernous sinus meningioma and should be proposed as an adjuvant to surgery in case of extensive meningiomas.

scholarly journals Transfer of Plasmid DNA to Clinical Coagulase-Negative Staphylococcal Pathogens by Using a Unique Bacteriophage

2015 ◽  
Vol 81 (7) ◽  
pp. 2481-2488 ◽  
Author(s):  
Volker Winstel ◽  
Petra Kühner ◽  
Bernhard Krismer ◽  
Andreas Peschel ◽  
Holger Rohde
Keyword(s):  
Plasmid Dna ◽  
Genetic Manipulation ◽  
Current Knowledge ◽  
Virulence Determinants ◽  
Coagulase Negative Staphylococci ◽  
Reliable Technique ◽  
Content Type ◽  
Research Activities ◽  
Wide Range ◽  
Genetic Barriers

ABSTRACTGenetic manipulation of emerging bacterial pathogens, such as coagulase-negative staphylococci (CoNS), is a major hurdle in clinical and basic microbiological research. Strong genetic barriers, such as restriction modification systems or clustered regularly interspaced short palindromic repeats (CRISPR), usually interfere with available techniques for DNA transformation and therefore complicate manipulation of CoNS or render it impossible. Thus, current knowledge of pathogenicity and virulence determinants of CoNS is very limited. Here, a rapid, efficient, and highly reliable technique is presented to transfer plasmid DNA essential for genetic engineering to important CoNS pathogens from a uniqueStaphylococcus aureusstrain via a specificS. aureusbacteriophage, Φ187. Even strains refractory to electroporation can be transduced by this technique once donor and recipient strains share similar Φ187 receptor properties. As a proof of principle, this technique was used to delete the alternative transcription factor sigma B (SigB) via allelic replacement in nasal and clinicalStaphylococcus epidermidisisolates at high efficiencies. The described approach will allow the genetic manipulation of a wide range of CoNS pathogens and might inspire research activities to manipulate other important pathogens in a similar fashion.

scholarly journals Use of Proteins Identified through a Functional Genomic Screen To Develop a Protein Subunit Vaccine That Provides Significant Protection against Virulent Streptococcus suis in Pigs

2017 ◽  
Vol 86 (3) ◽  
Author(s):  
Susan L. Brockmeier ◽  
Crystal L. Loving ◽  
Tracy L. Nicholson ◽  
Jinhong Wang ◽  
Sarah E. Peters ◽  
...  
Keyword(s):  
Immune Response ◽  
Vaccine Trial ◽  
Streptococcus Suis ◽  
Protein Subunit ◽  
Content Type ◽  
Degree Of Protection ◽  
Wide Range ◽  
Associated Proteins ◽  
Clinical Protection ◽  
Cellular Immune

ABSTRACT Streptococcus suis is a bacterium that is commonly carried in the respiratory tract and that is also one of the most important invasive pathogens of swine, commonly causing meningitis, arthritis, and septicemia. Due to the existence of many serotypes and a wide range of immune evasion capabilities, efficacious vaccines are not readily available. The selection of S. suis protein candidates for inclusion in a vaccine was accomplished by identifying fitness genes through a functional genomics screen and selecting conserved predicted surface-associated proteins. Five candidate proteins were selected for evaluation in a vaccine trial and administered both intranasally and intramuscularly with one of two different adjuvant formulations. Clinical protection was evaluated by subsequent intranasal challenge with virulent S. suis . While subunit vaccination with the S. suis proteins induced IgG antibodies to each individual protein and a cellular immune response to the pool of proteins and provided substantial protection from challenge with virulent S. suis , the immune response elicited and the degree of protection were dependent on the parenteral adjuvant given. Subunit vaccination induced IgG reactive against different S. suis serotypes, indicating a potential for cross protection.

The role of organizational culture in the knowledge management process

2015 ◽  
Vol 19 (3) ◽  
pp. 433-455 ◽  
Author(s):  
Christina Ling-hsing Chang ◽  
Tung-Ching Lin
Keyword(s):  
Organizational Culture ◽  
Knowledge Management ◽  
Customer Service ◽  
Survey Methodology ◽  
Cultural Dimensions ◽  
Content Type ◽  
Knowledge Resources ◽  
Positive Effects ◽  
Wide Range ◽  
The Individual

Purpose – The purpose of the study is to focus on the enhancement of knowledge management (KM) performance and the relationship between organizational culture and KM process intention of individuals because of the diversity of organizational cultures (which include results-oriented, tightly controlled, job-oriented, closed system and professional-oriented cultures). Knowledge is a primary resource in organizations. If firms are able to effectively manage their knowledge resources, then a wide range of benefits can be reaped such as improved corporate efficiency, effectiveness, innovation and customer service. Design/methodology/approach – The survey methodology, which has the ability to enhance generalization of results (Dooley, 2001), was used to collect the data utilized in the testing of the research hypotheses. Findings – Results- and job-oriented cultures have positive effects on employee intention in the KM process (creation, storage, transfer and application), whereas a tightly controlled culture has negative effects. Research limitations/implications – However, it would have been better to use a longitudinal study to collect useful long-term data to understand how the KM process would be influenced when organizational culture dimensions are changed through/by management. This is the first limitation of this study. According to Mason and Pauleen (2003), KM culture is a powerful predictor of individual knowledge-sharing behavior, which is not included in this study. Thus, this is the second limitation of this paper. Moreover, national culture could be an important issue in the KM process (Jacks et al., 2012), which is the third limitation of this paper for not comprising it. Practical implications – In researchers’ point of view, results- and job-oriented cultures have positive effects, whereas a tightly controlled culture has a negative effect on the KM process intention of the individual. These findings provide evidences that challenge the perspective of Kayworth and Leidner (2003) on this issue. As for practitioners, management has a direction to modify their organizational culture to improve the performance of KM process. Social implications – Both behavioral and value perspectives of the organizational cultural dimensions (results-oriented, tightly control, job-oriented, sociability, solidarity, need for achievement and democracy) should be examined to ascertain their effects firstly on KM culture and then on the KM process intention of the individual. It is hoped that the current study will spawn future investigations that lead to the development of an integrated model which includes organizational culture, KM culture and the KM process intention of the individual. Originality/value – The results-oriented, loosely controlled and job-oriented cultures will improve the effectiveness of the KM process and will also increase employees’ satisfaction and willingness to stay with the organization.

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