Intrarater and interrater reliability of a hand-held dynamometric technique to quantify palmar thumb abduction strength in individuals with and without carpal tunnel syndrome

Study Design

Clinical measurement.

Plasma catecholamine concentrations in essential hyperhidrosis and effects of thoracoscopic D2–D3 sympathicolysis

Essential hyperhidrosis (EH) is caused by a poorly understood overactivity of the sympathetic fibres passing through the upper dorsal sympathetic ganglia D₂ and D₃. These ganglia are also in the pathway of the sympathetic innervation of the heart and lungs. Therefore, although the predominant sympathetic neurotransmitter at the eccrine sweat glands is acetylcholine, the plasma concentration of noradrenaline (NA) (which is the main sympathetic neurotransmitter at the end organs including the heart and the lungs) may be elevated. Furthermore, as there are some indications for generalized sympathetic overactivity in EH, the plasma concentration of adrenaline (A) may also be elevated. Plasma levels of NA and A were therefore determined in 13 EH patients before and after thoracoscopic D₂–D₃ sympathicolysis (TS). Preoperative NA and A plasma levels were all within the normal limits used in our laboratory. After TS, mean NA plasma levels are significantly decreased, whereas mean A are unchanged. We conclude that sympathetic overactivity in EH is limited to the upper dorsal sympathetic ganglia and that some of the cardiovascular and pulmonary effects that are observed after TS may be associated with the decrease in NA.     

Presence of Pig IgG and IgM in Sera Samples From Baboons After an Orthotopic Liver Xenotransplantation

Introduction

The immunorejection in xenotransplantation has mostly been studied from the host's immune system activation point of view and there is very little information about the graft-vs-host reaction.

胸腔镜下胸交感神经链切断术治疗手汗症的临床应用

目的探讨胸腔镜下胸交感神经链切断术治疗手汗症的疗效及安全性。方法 2008年8月～2009年8月,对13例患者行胸腔镜下胸交感神经链切断术,术中监测双手温度变化,术后随访,评价手汗症的消失情况。结果 13例患者手术全部成功。术中监测胸交感神经链切断术前后手掌温度平均升高2.8℃。平均手术时间（42.3±8.6）min,术后2～5d出院。术后患者手掌多汗的症状均消失,4例腋汗及足汗消失,1例减轻,1例术后出现代偿性多汗。随访1～12个月,平均5.3个月,无1例多汗复发。结论胸腔镜下胸交感神经链切断术是治疗手汗症的一种安全有效的手段。     

计算机辅助下胸交感神经阻滞治疗手汗症

目的：观察利用计算机辅助下胸交感神经阻滞治疗手汗症的效果。方法：对6例原发性手多汗症患者,术前行CT扫描,应用Mimics软件对患者进行三维重建,设计手术路径,根据设计方案完成手术。结果：术前的模拟手术使手术时间明显缩短,减少了术中气胸和出血概率。6例患者均获得了良好效果。结论：计算机辅助下胸交感神经阻滞治疗手汗症可以在临床中推广应用,并发症减少,手术时间缩短,手术的精确度提高。     

大鼠前肢足垫皮肤交感神经HRP逆行示踪研究

目的研究支配大鼠前肢足垫皮肤的交感节后神经元在交感神经链内的定位。方法选择15只正常大鼠,左侧为实验组,右侧为对照组。30%HRP10μL注入左侧前肢足垫皮下,右侧注射10μL生理盐水作为对照。60～72h后切除两侧的交感神经节,连续冰冻切片,按TMB法呈色反应。结果 15例大鼠共找到3150个标记细胞,分别为同侧颈中神经节741个(23.5%)、颈胸神经节2297个(72.9%)、T3神经节88个(2.8%)、T4神经节21个(0.7%)、T5神经节3个(0.1%),其分布的差异有统计学意义(P<0.05)。结论支配大鼠前肢足垫皮肤的交感节后神经元主要位于颈中神经节、颈胸神经节、T3神经节。治疗手汗症没有必要行交感神经节切除术,低位切断交感神经干可以减少术后代偿性多汗。     

胸腔镜下胸交感神经链切断术治疗手汗症术后并发症的观察和护理

目的总结胸腔镜下胸交感神经链切断术治疗手汗症术后并发症的发生情况及护理对策。方法回顾分析我科应用电视胸腔镜下胸交感神经链切断术治疗手汗症250例的临床资料和随访资料。结果本组所有病例手术均获成功,术后双手干燥、红润。无Homer综合征、血气胸等并发症发生。术后随访,无复发病例,远期主要并发症为转移代偿性多汗,其发生率与术前病情分级相关,大部分转移性多汗可自愈。结论良好的围手术期护理,术后严密病情观察,及时发现并采取积极有效的处理并发症,做好出院康复指导和随访是保证手术成功的重要环节。     

Botulinum toxin type A in the treatment of focal, axillary and palmar hyperhidrosis and other hyperhidrotic conditions

Focal essential hyperhidrosis is a common and often disabling disorder mainly involving the palms, axillae, face, and soles of the feet. Focal hyperhidrosis may also arise from several neurological or internal diseases. Current therapeutic options include topical aluminium chloride salts, systemic anticholinergic drugs, tap-water iontophoresis, and a number of surgical approaches. However, none of these are entirely satisfactory. In recent studies, injection of botulinum toxin type A (BTX-A) into the hyperhidrotic area has proved very effective in reducing or abolishing focal sweating of different aetiologies without major side effects. BTX-A therefore has the potential to replace more invasive therapies.     

Botulinum toxin type A: new therapeutic directions

Intramuscular injections of botulinum toxin type A (BTX-A) have been used successfully to treat disorders such as cerebral palsy and cervical dystonia for many years. New and exciting directions for the toxin are currently under clinical investigation for a number of unlicensed indications including tension-type headache, myofascial pain and hyperhidrosis. Although research on BTX-A is prolific, there is still much to be learnt regarding the toxin's mode of action, clinical application and perhaps more importantly, its place in the overall treatment strategy implemented by physicians to ensure treatment is a success for both the patient and the physician. This review will focus on these issues, by outlining some of the future directions for BTX-A research.