Pathophysiology of Hyperhidrosis.

Studies and case reports on excessive sweating frequently state that hyperhidrosis is a disease whose origin and mechanism are unknown. However, the term excessive is rarely based on systematic diagnostic measurements, instead being a description of the symptoms from patient histories, which suggests that hyperhidrosis is purely a problem involving the quantity of sweat, whereas it is a change in the control mechanism of sweating in which the need for and production of sweat are strongly disproportionate. This lack of proportion is perceived by those affected to be a limitation of activities of daily living and is thus pathologic.

Radiofrequency Thermotherapy for Treating Axillary Hyperhidrosis.

Background: Thermotherapy has been established between conservative and surgical options as a minimally invasive method for the treatment of axillary hyperhidrosis.

Objective: The objective of this study was to present radiofrequency thermotherapy (RFTT) as a safe and effective new treatment method.

Materials And Methods: Thirty adult patients with pronounced axillary hyperhidrosis were treated with RFTT with noninsulated microneedles 3 times at intervals of 6 weeks.

Thoracic sympathectomy: a review of current indications.

Background: Thoracic sympathetic ablation was introduced over a century ago. While some of the early indications have become obsolete, new ones have emerged. Sympathetic ablation is being still performed for some odd indications thus prompting the present study, which reviews the evidence base for current practice.

Thoracoscopic sympathectomy at the T2 or T3 level facilitates bradykinin-induced protein extravasation in human forearm skin.

Background: The endogenous peptide bradykinin (BK) is an inflammatory mediator that induces nociceptor activation and sensitization as well as protein extravasation and vasodilation.

Objective: To test the hypothesis if sympathectomy affects BK-induced inflammation in humans.

Methods: Dermal microdialysis was employed on the volar forearm in 10 patients (21-41 years) with regional hyperhidrosis before and three months after preganglionic endoscopic transthoracic sympathetic clipping (ETSC) at the T2 or T3 level and in 10 healthy volunteers (22-36 years).

Origin of glassy dynamics in a liquid crystal studied by broadband dielectric and specific heat spectroscopy.

A combination of broadband dielectric (10{-2}Hz-10{9}Hz) and specific heat (10{-3}Hz-2 x 10{3}Hz) spectroscopy is employed to study the molecular dynamics of the glass-forming nematic liquid crystal E7 in a wide temperature range. In the region of the nematic phase the dielectric spectra show two relaxation processes which are expected theoretically: the delta relaxation which corresponds to rotational fluctuations of the molecules around its short axis and the tumbling mode at higher frequencies than the former one. For both processes the temperature dependence of the relaxation rates follows the Vogel-Fulcher-Tammann formula which is characteristic for glassy dynamics.

[Generalized compartment syndrome after excessive drinking. A rare complication of psychological disorders?].

Psychogenic polydipsia can lead to compartment syndromes, which is too infrequently considered in psychiatric patients who binge-drink on hypotonic fluids. If masked by the leading clinical presentation of cerebral edema, compartment syndromes of the extremities may be diagnosed too late or remain undetected. Based on a literature review and case report, we discuss additional factors and the specific features of diagnosis and treatment.

Light fields for minimal invasive surgery using an endoscope positioning robot.

Objectives: To generate a fast and robust 3-D visualization of the operation site during minimal invasive surgery.

Methods: Light fields are used to model and visualize the 3-D operation site during minimal invasive surgery. An endoscope positioning robot provides the position and orientation of the endoscope.

Evaluation of computer-assisted image enhancement in minimal invasive endoscopic surgery.

Objectives: This paper focuses on the evaluation of the usage of computer-aided image processing methods for minimal invasive surgery. During video endoscopy of visceral cavities the images are displayed directly on the monitor without further processing. In the course of the operation the former good quality of the images decreases due to typical disturbances like bleeding, smoke or flying particles.

Glassy dynamics of polymers confined to nanoporous glasses revealed by relaxational and scattering experiments.

The glassy dynamics of poly(propylene glycol) (PPG) and poly(dimethyl siloxane) (PDMS) confined to a nanoporous host system revealed by dielectric spectroscopy, temperature-modulated DSC and neutron scattering is compared. For both systems the relaxation rates estimated from dielectric spectroscopy and temperature-modulated DSC agree quantitatively indicating that both experiments sense the glass transition. For PPG the segmental dynamics is determined by a counterbalance of adsorption and confinement effect.

Differential effects of surgical sympathetic block at the T2 and T4 level on vasoconstrictor function.

Endoscopic sympathetic block (ESB) is used as a treatment of excessive palmar sweating. In a prospective study we compared the effect of ESB at the level of the second (T2) and fourth thoracic ganglion (T4) on vasoconstriction and sweating of the hands. Sympathetic vasoconstriction was measured by computerassisted infrared thermography following ice water immersion of the hands in 22 hyperhidrosis patients before, two days and 3 months post op.

Effects of gender and level of surgical sympathetic block on vasoconstrictor function.

Interruption of sympathetic outflow by surgical sympathetic block has been used to treat hyperhidrosis for decades. In this study the effect of gender and the level of sympathetic block (T2 vs. T3) on the rewarming kinetics following ice water immersion were assessed in a prospective study on 60 hyperhidrosis patients before, 2 days, and 3 months postoperatively.

Sequelae of endoscopic sympathetic block.

Endoscopic sympathetic block as a treatment for primary hyperhidrosis is associated with certain sequelae. The reported occurrence of side effects still varies in the literature. As the majority of patients describe sequelae after sympathetic surgery, the frequency and importance of these persisting changes are still underestimated.

Differential effects of surgical sympathetic block on sudomotor and vasoconstrictor function.

Objective: To assess the effects of a surgical block of the sympathetic chain at the T2 level on vasoconstriction and palmar sweating in patients with palmar hyperhidrosis.

Methods: In a prospective study, sympathetic vasoconstriction was measured by laser-Doppler imaging and by computer-assisted infrared thermography (rewarming kinetics following immersion of both hands in ice water [4 degrees C, 30 seconds]) in 61 patients with hyperhidrosis preoperatively and 2 days and 3 months postoperatively. In addition, palmar sweating preoperatively and 3 months postoperatively was assessed by quantitative sudometry.

Mesorectal lymph node dissection: is it beneficial?

Locoregional recurrences and distant metastases are the determinants of the long-term prognosis following curative resection of rectal carcinoma. While distant metastases cannot be affected by the surgical treatment of the primary tumor, avoidance of local recurrence by the surgeon is of special significance as the predominant prognostic factor. Analysis of the long-term results achieved by various surgeons led to the concept of mesorectal excision - the removal of the rectum together with all additional tissue invested by the adjacent visceral fascia, that is, fatty tissue, lymph nodes, and lymphatic vessels, by sharp dissection of the appropriate anatomical plane.