No abstract available.
Glomerulonephritis, IGA* ; Immunoglobulin A* ; Raynaud Disease ; Thromboangiitis Obliterans*

BACKGROUND: Surgical scars on the palmar surface of the hand may lead to functional and also aesthetic and psychological consequences. The objective of this study was to introduce a new incision technique for periarterial sympathectomy of the hand and to compare the results of the new two-step incision technique with those of a Koman incision by using an objective questionnaire. METHODS: A total of 40 patients (17 men and 23 women) with intractable Raynaud's disease or syndrome underwent surgery in our hospital, conducted by a single surgeon, between January 2008 and January 2013. Patients who had undergone extended sympathectomy or vessel graft were excluded. Clinical evaluation of postoperative scars was performed in both groups one year after surgery using the patient and observer scar assessment scale (POSAS) and the Wake Forest University rating scale. RESULTS: The total patient score was 8.59 (range, 6-15) in the two-step incision group and 9.62 (range, 7-18) in the Koman incision group. A significant difference was found between the groups in the total PS score (P-value=0.034) but not in the total observer score. Our analysis found no significant difference in preoperative and postoperative Wake Forest University rating scale scores between the two-step and Koman incision groups. The time required for recovery prior to returning to work after surgery was shorter in the two-step incision group, with a mean of 29.48 days in the two-step incision group and 34.15 days in the Koman incision group (P=0.03). CONCLUSIONS: Compared to the Koman incision, the new two-step incision technique provides better aesthetic results, similar symptom improvement, and a reduction in the recovery time required before returning to work. Furthermore, this incision allows the surgeon to access a wide surgical field and a sufficient exposure of anatomical structures.
Cicatrix ; Hand* ; Humans ; Male ; Raynaud Disease ; Sympathectomy* ; Transplants ; Trees

A 39-year-old female was suffering from cold-induced Raynaud's attacks in both hands and feet, with symptoms being most severe in her left foot. The patient did not respond to medical treatments and was referred to our department of pain medicine. We performed sequential bipolar radiofrequency lumbar sympathectomy to the patient, which offered a long duration of symptom relief. Sequential bipolar radiofrequency lesions could create continuous strip lesion, and thus, could achieve better results, while the potential risk of liquid neurolytic agents could be avoided.
Adult ; Female ; Foot ; Hand ; Humans ; Raynaud Disease ; Stress, Psychological ; Sympathectomy

Raynaud's phenomenon is a symptom complex manifested as intermittent fingertip ischemia caused by cold or other sympathetic drivers. Secondary Raynaud's phenomenon is often more severe and could even lead to finger ulceration, making it particularly complicated to treat. We describe a case of severe Raynaud's phenomenon secondary to subclinical hypothyroidism lasting for more than 6 hours in a 65-year-old woman. The patient was also diagnosed with hypothyroidism, epilepsy, and secondary soft tissue infection of the right middle and ring fingers. After careful multidisciplinary consultation and discussion, the patient received vasodilation, anticoagulation, thyroxine supplementation, stellate ganglion block, hyperbaric oxygen therapy and debridement. The patient responded well to the medication, avoiding amputation or obviously dysfunction. Multidisciplinary team gathering the doctors from different departments proposes appropriate strategies for patients with severe Raynaud's phenomenon and could improve the prognosis and satisfaction of patient effectively.
Female ; Humans ; Aged ; Hypothyroidism/complications* ; Raynaud Disease/diagnosis*

A 54-year-old female was suffering from cold-induced Raynaud's attacks in her both hands with symptoms most severe in her left hand. As the patient did not respond to previous medical treatments and endoscopic thoracic sympathectomy, we performed percutaneous bipolar radiofrequency thoracic sympathicotomy at the left T3 vertebral level. After the procedure, the patient obtained a long duration of symptom relief over 3 years. Percutaneous bipolar radiofrequency T3 sympathicotomy is minimally invasive and effective technique by creating large continuous strip lesion.
Female ; Hand ; Humans ; Middle Aged ; Raynaud Disease ; Stress, Psychological ; Sympathectomy

OBJECTIVE: Raynaud's phenomenon is a vascular disorder characterized by reversible spasm of arteries of fingers. It is the first symptom in 70% of partlents with systemic sclerosis. The more systemic involvment the worse prognosis is expected in patients with systemic sclerosis. A more reliable indication of systemic sclerosis is the microvascular involvement by the disease (characteristic patterns of capillary abnormality in the nail-fold). Our puroses were to evaluate the significance of the degree of nailfold capillary abnormlitry in making the diagnosis fo systemic sclerosis, and in determining organ involvement in patients with systemic sclerosis. METHODS: Twenty-six patients with Raynaud's phenomenon whose diagnosis were systemic sclerosis(10 patients), SLE(10 patient), Raynaud's disease(6 patients) were observed for nailfold capillary abnormalities by widefield microscopy. RESULTS: Capillary abnormalities were seen in 100% of the systemic sclerosis (10 patients), 30% of the SLE (3 patients) and 50% of the Raynaud's disease (3 patients). A significant correlation between degree of finger lesions (r=0.718) or organ involvement (X2=20.4, p=0.015) and capillary abnormality class was found although a significant correlation was not found between the duration of the disease and the degree of capillary abnormality in patients with systemic sclerosis (r=0.32). CONCLUSIONS: Nailfold capillary abnormality can easily be observed and could be used as an assistive tools for the diagnosis and prediction of prognosis and extent of organ involvement in patients with Raynaud's phenomenon especially in patients with systemic sclerosis.
Arteries ; Capillaries* ; Connective Tissue Diseases ; Diagnosis ; Fingers ; Humans ; Microscopy ; Prognosis ; Raynaud Disease ; Scleroderma, Systemic ; Spasm

BACKGROUND: Many patients with "cold hands/feet syndrome" have been taking herbal medicine or medicine to improve blood circulation without proven evidence. Raynaud's disease had been neglected in primary care. This study was conducted to investigate the recognition for Raynaud's disease and "cold hands/feet syndrome" by family doctors. METHODS: A questionnaire was posted to 905 family doctors who were in practice from January to July 2003. RESULTS: Among the 274 respondents, 58 (21%) reported that they have seen patients with "sensitive to cold" frequently and 208 (76%) doctors have seen such patients sometimes. Only 8 (3%) doctors answered that they have never seen patients with such symptoms. When such patients see a doctor and complain of "cold hands/feet syndrome", most doctors (60%) prescribed medicine that improved blood circulation (83%) or calcium channel blockers (9%). In case of questions like 'Do you suspect "cold hands/feet syndrome" or "sensitive to cold" contain Raynaud's disease?', 132 (48%) doctors answered 'yes'. And among the 132 doctors, only 15 (11.2%) doctors thought that those patients with "cold hands/feet syndrome" had Raynaud's disease. In addition when the doctors diagnosed the condition as Raynaud's disease, 54% prescribed medicine that improved blood circulation (52%) or calcium channel blockers (40%). CONCLUSION: Most doctors prescribe medicine that improves blood circulation for cold hands/feet syndrome. Many doctors also prescribe medicine to improve blood circulation for Raynaud's disease frequently. The result of our study suggests that there is a need to train doctors so that recognized and diagnosed Raynaud's disease can be correctly.
Blood Circulation ; Calcium Channel Blockers ; Surveys and Questionnaires ; Herbal Medicine ; Humans ; Primary Health Care ; Raynaud Disease*

BACKGROUND: Many patients with "cold hands/feet syndrome" have been taking herbal medicine or medicine to improve blood circulation without proven evidence. Raynaud's disease had been neglected in primary care. This study was conducted to investigate the recognition for Raynaud's disease and "cold hands/feet syndrome" by family doctors. METHODS: A questionnaire was posted to 905 family doctors who were in practice from January to July 2003. RESULTS: Among the 274 respondents, 58 (21%) reported that they have seen patients with "sensitive to cold" frequently and 208 (76%) doctors have seen such patients sometimes. Only 8 (3%) doctors answered that they have never seen patients with such symptoms. When such patients see a doctor and complain of "cold hands/feet syndrome", most doctors (60%) prescribed medicine that improved blood circulation (83%) or calcium channel blockers (9%). In case of questions like 'Do you suspect "cold hands/feet syndrome" or "sensitive to cold" contain Raynaud's disease?', 132 (48%) doctors answered 'yes'. And among the 132 doctors, only 15 (11.2%) doctors thought that those patients with "cold hands/feet syndrome" had Raynaud's disease. In addition when the doctors diagnosed the condition as Raynaud's disease, 54% prescribed medicine that improved blood circulation (52%) or calcium channel blockers (40%). CONCLUSION: Most doctors prescribe medicine that improves blood circulation for cold hands/feet syndrome. Many doctors also prescribe medicine to improve blood circulation for Raynaud's disease frequently. The result of our study suggests that there is a need to train doctors so that recognized and diagnosed Raynaud's disease can be correctly.
Blood Circulation ; Calcium Channel Blockers ; Surveys and Questionnaires ; Herbal Medicine ; Humans ; Primary Health Care ; Raynaud Disease*

Acupuncture Points ; Acupuncture Therapy ; Humans ; Male ; Middle Aged ; Raynaud Disease ; therapy

Although it is difficult to reach a diagnosis in patients who complain of pain or sensitivity to cold in their hands, Raynaud's phenomenon is most often suspected in such cases. Symptoms of Raynaud's phenomenon include pallor, cyanosis, and redness following cold exposure. Glomus tumors can also increase patients' sensitivity to cold. In this case, our patient complained of symptoms indicative of Raynaud's phenomenon. Although treatment of Raynaud's phenomenon improved the symptoms, pain persisted in the fourth finger of the left hand. We diagnosed the patient with a glomus tumor and, after surgical treatment, the patient's symptoms improved. Here, we have also reviewed and discussed a number of reports of glomus tumors associated with Raynaud's disease. Diagnosing a glomus tumor in the hand may take some time, and the diagnosis could be further delayed if accompanied by Raynaud's phenomenon. Although glomus tumors are rare, we suggest that clinical awareness is important for early diagnosis and treatment.
Cyanosis ; Diagnosis ; Early Diagnosis ; Fingers ; Glomus Tumor* ; Hand* ; Humans ; Pallor ; Raynaud Disease*