The Sympathetic Skin Responses after Thoracic Sympathicotomy for Patients with Palmar Hyperhidrosis / 대한흉부외과학회지

BACKGROUND: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. MATERIAL AND METHOD: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. RESULT: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. CONCLUSION: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.

A Case of Transient Complete Atrioventricular Block in Acute Viral Myocarditis

Arrythmias are often present and may lead to unexpected death in acute myocarditis. Occasionally, conduction disturbances are seen with varying degree of heart block yet complete atriove ntricular block is rare. We experienced a case of transient complete heart block caused by coxsackie B5myocarditis in a previously healthy 12-year-old girl. During the use of a transvenous temporary pacemaker for 5 days, the abnormal cardiac rhythm changed to sinus rhythm and clinical status improved progressively.

Comparison of anticancer drug efficacy using the short-term microplate culture and MTT dye reduction assay

Individual tumors, even those of the same histologic type, show varying sensitivity to specific cytotoxic agent. Therefore, sensitivity testing assume an increasingly important as an orientational aid in planning chemotherapy. In the past decade there have been many attempts to develop a chemosensitivity test that would predict the clinical effectiveness of various chemostherapeutic agents against human neoplasms. In the United States National Institue's anticancer drug screening program, a colorimetric assey based on the ability of live cells to reduce a tetrazolium-base compound(MTT) to a blue formazan product was used. There has been an increase in reports of a chemosensitivity assay that use tetrazolium dyes and current the assay is in use in our country. The efficacy of several anticancer drug (vincristine sulfate, Etoposide, doxorubicin CDDP) were evaluated using the in vitro chemosensitivity of MTT assay with two cancer cell lines (MOLT-4, KHOS/NP). The follows obtained. 1) CI50 on MOLT-4 are 0.55ng/ml and 0.81ng/ml for vincristine and oncovin, 142.30ng/ml and 78.75ng/ml for lastet and vepesid, and 19.75ng/ml, 20.43ng/ml and 8.66ng/ml for ADR, ADM and adriblastin, respectively. 2) CI50 on KHOS/NP are 691.35ng/ml, 873.73ng/ml, 1,205.22ng/ml, 768.81ng/ml and 672.19ng/ml for cisplan, cisplatin, cispatin, platinol and cisplatin G, and 9.22ng/ml, 11.46ng/ml and 4.28ng/ml for ADR, ADM and adriblastin, respectively. In conclusion the MTT dye reduction assay to anticancer drug sensitivity using short-term microplate culture might serve as a reliable tool for the selection of effective chemotherapeutic agents in patients with cancers.