Effectiveness and complications of subdermal excision of apocrine glands in 206 cases with axillary osmidrosis.

Patients with osmidrosis are particularly concerned with malodour elimination after surgery. Open excision of the subcutaneous apocrine glands through a small incision seems to be the most logical and effective method available for osmidrosis. However, literature on long-term results and complications after such surgery based on large case series are rare. From January 2005 to May 2008, 256 consecutive patients with axillary osmidrosis were treated with our subcutaneous glands excision technique, of which 206 could be followed up from 3 to 40 (mean 18.1) months. Patients ranged in age from 14 to 52 (mean 23.4) years and the female to male ratio was 131:75. Among the 206 cases, 183 cases had family histories of the disease and 16 were accompanied with axillary hyperhidrosis. Postoperatively, as high as 97% of the patients achieved good results in terms of malodour elimination during the follow-up period. All patients reported reduction in axillary sweating; among them 16 patients complicated with axillary hyperhidrosis reported a significant reduction. Axillary hair growth was much reduced in most (95%) patients, and four female patients complicated with axillary hirsutism were extremely satisfied with axillary hair reduction. Early postoperative complications included haematoma (0.7%), seroma (1.2%), folding of skin flap (0.7%), pressure blister (3.6%), contact dermatitis (1%), superficial epidermis necrosis (37%), small granuloma (0.5%), wound infection (0.7%) and wound dehiscence (5.1%). Late complications included comedones (1.2%), milia (0.5%), sebaceous cyst (or with abscess) (0.7%), hypertrophic scar (1%), temporary skin pigmentation (0.5%), temporary mild lactation (0.5%) and temporary sweating outside the axillae (1%). In general, 196 patients (95%) were totally satisfied with the procedure and nine (4.4%) patients partially satisfied, with only one (0.5%) regretful. The procedure has a very high success rate with minor complications. It should become the preferred procedure for the surgical treatment of axillary osmidrosis.

Noonan syndrome and correction of the webbed neck.

We report on a 16-year-old boy with Noonan syndrome who had short stature, hypertelorism, mild hearing loss, webbed neck, pectus deformities, hypertrophic cardiomyopathy, low posterior hairline, redundant skin, café au lait spot, curled hairs, foetal pads, and undescended testes. The father and a sister of the boy were also found with mild webbed neck, being possibly mildly affected individuals. The significant webbed-neck deformity of the boy was completely corrected by subcutaneous resection of the proximal half of the hypertrophic fascia bands, through small incisions hidden within the hairline. The advantage of this procedure is simple, safe and effective, with no visible scar on the surface of the neck.

Radical treatment of axillary osmidrosis by subdermal excision of apocrine glands: a prospective study in 31 cases.

Axillary osmidrosis is a troublesome and distressing problem. Medical treatment is only temporally effective. From March 2003 to November 2004, 36 patients with axillary osmidrosis (nine cases combined with axillary hyperhidrosis) have been treated by excision of the subcutaneous glands via a small transverse incision, of which 31 cases could be followed up for a minimum of 3 months (average 7.3 months). In terms of malodour elimination, 30 cases had good results, one had fair result, and none had a poor result. All patients reported significant reducing of sweating, especially those with hyperhidrosis. Postoperative complications were minor, including small haematoma (one axillae), small seroma (two axillae), and superficial epidermal necrosis (21 axillae) which were all spontaneously healed within a week. Twenty-nine (93.5%) patients were very satisfied with the procedure and two (6.5%) patients satisfied, with none regretful. The operation has the advantage of a high success rate in radical elimination of the malodour with minor complications.

Severe cicatrical ectropion: repair with a large advancement flap and autologous fascia sling.

We present a 35-year-old male who, 9 years ago, had his right orbit and face injured in a gun blast accident resulting in severe cicatrical ectropion of the right lower lid. A large advancement facial flap with incision at the naso-labial fold was designed to repair the skin defect, and a strip of autologous fascia lata was grafted in the lower lid to serve as a static sling. The facial flap was dissected and elevated at the subcutaneous fat layer. With adequate separation of the flap and suspension sutures at the undersurface of the flap, tension free closure of the wound was obtained and the ectropion completely corrected. The postoperative course was uneventful and the patient very satisfied with the results.

Is delayed micro-graft hair transplantation possible?--evaluation of viabilities of hair follicles preserved in two storage media.

BACKGROUND: Preservation of hair grafts for the purpose of delayed transplantation would allow use of thousands of hair grafts at one time. OBJECTIVE: To evaluate the viabilities of hair follicle units preserved in DMEM and Ringer's solution at 0 degrees C for various periods. METHODS: Cell cultures and transplantation of hair follicle units into athymic mice were used. RESULTS: Outer root sheath cells could be cultivated in 95.8% of those follicles preserved in Ringer's solution, and in 86.7% of those preserved in DMEM culture medium (p < 0.01). In 84.5% of those preserved in Ringer's and 72.5% of those preserved in DMEM for 24 h, hair follicles grew well after implantation into an athymic mouse model (p < 0.05).

Posterior tibialis transfer for foot-drop due to leprosy: a case with 40 years follow up.

A 56-year-old male was transferred to our centre because of a relapse of leprosy neuritis in the hands. We found that the patient had received a posterior tibialis tendon transfer for correction of his left dropped foot 40 years previously. On examination active dorsiflexion of the left ankle joint was close to 0 degrees with grade 4 power of dorsiflexion, and the plantar flexion was about 35 degrees. Walking gait was almost normal. There were some scars on the plantar surface of the left metatarsal area; but with the continuous use of a soft dressing pad under the middle part of the sole, plantar ulceration has been avoided for many years even with active daily activities of the patient. The patient is very satisfied with the operative results.

Radiotracer study on residues and residue distribution of zineb in plant-soil system.

In view of the widespread use of zineb on food plants and the toxicity of one of its metabolites, ETU, a study on the residues and residue distribution of zineb and ETU in plant-soil systems was carried out. The half-life values for total zineb residues on egg-plant leaves and in soil were observed to be over three and two weeks, respectively. Egg-plant skin contained higher amount of zineb residues than the fruit pulp. Washing with water greatly reduced zineb residue levels, especially those in the fruit skin. Compared with zineb, ETU is much easier to be uptaken by plants and to leach into deeper layer of soil due to its high water solubility. Therefore, attention should be paid to the contents of ETU in zineb formulations as impurity and formation of ETU in the environment.