Three hundred palmar hyperhidrosis (PH) patients have been treated with video endoscopic laser sympathectomy during the last 2 years. Monitoring the palmar skin perfusion (PSP) and palmar skin temperature (PST) has been used intraoperatively to aid the confirmation of the correct sympathetic segment for laser ablation. The preoperative and postoperative PSP and PST and sympathetic skin response (SSR) also have been measured to evaluate the therapeutic effect of this method. An apparent increase of PSP would occur intraoperatively after the interruption of the T2 sympathetic segment, and then a gradual elevation of PST would follow after the extirpation of the segment. A rise of PST of about 3 degrees C after laser ablation of the appropriate segment indicated sufficient denervation of the hand and predicted long-lasting relief of PH. Furthermore, both PSP and PST also significantly increased after the operation. The postoperative elevation of the PST (usually about 3 degrees C) is similar to that recorded during intraoperative monitoring. The amplitude and the latency of SSR in the palm and sole were recorded both before and after sympathectomy. A remarkable decrease of palmar SSR amplitude and its ratio was found postoperatively by comparing it with that of plantar SSR in the same patient. These autonomic activity changes have correlated well with the postoperative satisfaction of the patients. Based on our study, the anatomic identification confirmed by the sympathetic monitorings has proved essential to achieve a definite and adequate sympathectomy leading to a satisfactory resolution of PH without the need of a tissue diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Background and Objective The purpose of this study was to compare the differential susceptibility to photodynamic therapy (PDT) mediated damage in human U‐105MG glioma cells and CH‐157MN meningioma cells in vitro using 5‐aminolevulinic acid (ALA) as photosensitizer, and to determine if growth factors would enhance PDT‐mediated damage of these cells. Study Design/Materials and Methods U‐105MG or CH‐157MN cells were irradiated with polychromatic light in the presence of ALA. A Xenon lamp (150 W) was used as the light source. For the study on the effect of growth factor on ALA‐PDT, cells were cultured in serum free medium for 24 hours. Epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), or platelet derived growth factor BB (PDGF‐BB) was added to achieve a final concentration of 50 ng/ml. 30 minutes later, cells were incubated with ALA (100 μg/ml) for 24 hours, washed, and irradiated with light (11 J/cm2). MTT tetrazolium assays were performed 24 hours after light irradiation. Results The inhibition of metabolic cellular function in U‐105MG cells by ALA depended on both light energy density and ALA concentration. The susceptibility to ALA‐PDT was profoundly lower for CH‐157MN meningioma cells than U‐105MG glioma cells. When incubated with ALA (100 μg/ml), U‐105MG cells exhibited an LD50 around 8 J/cm2 of light irradiation, whereas that of CH‐157MN cells was more than 25 J/cm2. EGF, bFGF, or PDGF‐BB did not have any effects on the susceptibility of these two cell lines to ALA‐PDT. Conclusion ALA‐PDT was more effective in killing U‐105MG glioma cells than CH‐157MN meningioma cells. The differential susceptibility was likely due to differential accumulation of PpIX in these cells. EGF, bFGF, or PDGF‐BB did not have stimulatory or inhibitory effect on the efficiency of ALA‐PDT. Lasers Surg. Med. 24:296–305, 1999. © 1999 Wiley‐Liss, Inc.

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