• Archives of Plastic Surgery
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• v.35 no.1
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• pp.62-66
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• 2008

Purpose: Axillary osmidrosis is a distressing disorder characterized by unpleasant odor from axillary area and it is mainly associated with apocrine glands but also associated with eccrine glands. For surgical treatment of osmidrosis, recently ultrasound assisted liposuction(UAL) had been performed for many patients. According to the recent studies about ultrasound assisted liposuction for the treatment of osmidrosis, histologic studies about apocrine gland had been applied for 35 cases, but there were rare mention about eccrine gland and the relationship between two glands. The purpose of this article is to evaluate the effect of ultrasound assisted liposuction for the treatment of axillary osmidrosis on apocrine and eccrine glands. Methods: From January 2004 to January 2007, 35 patients underwent ultrasound assisted liposuction for the treatment of osmidrosis and 5 patients underwent histologic studies. Histologic examinations were performed before and after ultrasound assisted liposuction and each biopsy was performed in central axillary area. The volume ratio of both glands, presence of degeneration were examined. And in aspirates, distribution and density of both glands and their morphological changes were examined. Results: Preoperative biopsy results showed average volume ratio of apocrine glands to eccrine glands was 65 : 35. According to the postoperative biopsy results, the volume of apocrine glands in dermis were significantly reduced and glands were degenerated, but the volume of eccrine glands were slightly reduced and glands were mildly damaged. And the average volume ratio of two glands was 20 : 80. According to biopsy results of aspirates, the volume ratio of two glands was 85 : 15 and apocrine glands had significantly greater proportion. Conclusion: By comparison of each biopsy result, apocrine glands were more significantly reduced and degenerated than eccrine glands in all 5 cases. However, further studies with large sample sizes and close examinations are required.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.440-444
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• 2013

Background Axillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol. Methods A total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group) and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group). Postoperative outcomes were compared between the study and control groups. Results The length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes. Conclusions Sclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.245-249
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• 2005

Various surgical procedures have been described for treating osmidrosis axillare. Elimination of the apocrine glands is prime goal. Optimal operative procedure is characterized as follows: minimal axillary scar(which has cosmetic merits), less complications such as hematoma and seroma, short and less painful recuperating period, minimal damage to the skin and low recurrence rate. Three types of incision technique in subdermal shaving method have beeb commoly used. First, single incision method has an advantage of minimal scarring but more recurrence due to incomplete removal of apocrine glands may occur. Second, double incision technique(Bipedicled flap) has advantages of complete excision, low recurrence rate and relatively minimal scarring, but it could cause frequent necrosis of skin and folding of skin flap. Skoog's method is the third method, which makes four flaps by offset cruciate incisions. It is a better technique in aspect of complete excision of apocrine glands and low recurrence rate but has disadvantages such as development of hypertrophic scar or scar contracture in the line that lies perpendicular to natural axillary skin crease. We used a modified procedure which has shorter length in vertical and transverse incision compared with the classic Skoog's method. We dissected further subcutaneous tissue through the diamond-shaped incision and utilize wide operation field that provide adequate excision of subdermal tissue and proper hemostasis. Between 1999 and 2004, we operated 160 osmidrosis axillare in 80 patients in this technique. Most patients obtained satisfactory result with very low complications. Hematoma or seroma 3.1% Infection 0.6% Partial wound disruption 10% Recurrence 1.2%. Modified Skoog's method for treating osmidrosis axillae could be a optimal technique providing wide operation field for adequate excision of apocrine glands and proper hemostasis and leaving relatively inconspicuous scar and low incidence of scar contracture.

• The Korean Journal of Cytopathology
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• v.14 no.2
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• pp.76-81
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• 2003

Apocrine carcinoma of the breast is a very rare subtype. Although it has no clinical differences from usual ductal carcinoma of the breast, it should be categorized as a subtype of breast carcinoma because the cells of apocrine carcinoma reveal characteristic abundant eosinophillic cytoplasms with intraductal apical snouting as well as round or oval nuclei and central macronucleoli. On fine needle aspiration cytology, the cells of apocrine carcinoma have a lot of similarity to benign or reactive apocrine cells of the breast. Therefore, it is difficult to make a differential diagnosis of apocrine carcinoma from mammary neoplasms with similar cytologic findings unless the subtle cytologic differences are recognized. We report the cytologic and histologic findings of a case of apocrine carcinoma in the breast of a 40-year-old female patient. After the fine needle aspiration cytology, she received the lumpectomy and lymph node dissection. The cellularity was moderate to high. The cytoplasmic borders of tumor cells of three-dimensional clusters were relatively distinctive, and the cytoplasm was abundant, eosinophilic, and granular. Although the nuclear/cytoplasmic ratio was low, the nuclei of the cells were variable in size and shape with prominent macronucleoli. Histologically, it was a typical invasive apocrine carcinoma, showing numerous cytoplasmic lysosomes and mitochondriae on electron microscopy.

• Korean Journal of Veterinary Research
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• v.49 no.2
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• pp.157-161
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• 2009

A 11-year-old female mixed cat with subcutaneous mass around the left 5th mammary glands was presented to local animal hospital. According to history taking, the mass recurred 2 times on the same site of abdomen. After surgical excision, subcutaneous mass was referred to Pathology Department of Veterinary Medicine in the Jeju National University. Grossly, round to oval, milky yellow or pale red nodules, measuring 0.1${\sim}$1 cm in diameter, were occupied in the subcutis. Microscopically, the most neoplastic sweat glands were proliferated in the dermis and subcutis. Most tubules were lined by round to oval shaped epithelium with eosinophilic cytoplasm, hyperchromatic nuclei with high mitotic figures and severe central necrosis. The neoplastic epithelium also had periodic acid-Schiff-positive diastase-resistant cytoplasmic granules, but was negative for Perl's iron stain. Based on the gross, histopathologic and special staining, this cat was diagnosed as apocrine sweat gland adenocarcinoma. In our best knowledge, this is the first report of apocrine sweat gland adenocarcinoma around abdominal mammary gland in a cat.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.51-55
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• 2009

Purpose: Excessive apocrine gland secretion and bacterial decomposition cause axillary osmidrosis, which results in physical discomforts and social problems of patients. Many surgical procedures have been introduced such as skin excision and simple closure, local flap, skin graft, subcutaneous shaving and liposuction method, but the result was not satisfactory to patients and several complications, such as symptom recurrence, hematoma, seroma, delayed wound healing, skin flap necrosis and scarring remain as problems. Methods: For the purpose of reducing these problems, we employed combination treatment of liposuction and rasping method. From January 2006 to February 2008, Total 54 patients were treated with this procedure for bilateral axillary osmidrosis. Results: Follow - up evaluation period was from 2 months to 12 months, and the results were satisfactory. In our method, the length of skin incision is less than 1 cm, so the resultant scar is negligible. Apocrine glands in subcutaneous tissue were mostly removed by liposuction apparatus and remained other glands in subdermal area were mostly removed by rasping. The recurrence rate and postoperative complication were minimal. Conclusion: Our method is very simple, short operation time and excellent results without specific complication.

• Archives of Plastic Surgery
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• v.32 no.6
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• pp.723-726
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• 2005

Osmidrosis axillae is a distressing problem characterized by foul odor at the axillae due to excessive apocrine sweat gland secretion. We introduce a new non-surgical method using a specially insulated needle and high frequency electrocoagulator. From September 2001 to January 2005, 52 patients were treated with this procedure for osmidrosis axillae. In authors' procedure, insulated needle which was designed to protect skin and dermal layer was inserted into the deep dermis of axilla area and apocrine sweat glands were removed by electrocoagulation. Fifty two patients were evaluated more than 6 months after surgery. Among these patients, 48 patients received secondary coagulation procedure. After second operation, all patients were satisfied with postoperation results. We conclude that our method has several advantages such as 1) short operation time, 2) no necessity of postoperative immobilization of shoulder joints, 3) no need of hospitalization, 4) minimal scarring and no bleeding, 5) prevention of skin necrosis, 6) a safer operative method for recurred cases as a secondary method.

• Applied Microscopy
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• v.28 no.4
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• pp.539-549
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• 1998

The silk glands of the spiders are of several types. Among the several types of spider's silk glands, the principal fibers used in constructing the eggcase are products of the tubuliform glands (TBG), which are present only in females. Development of these glands parallels maturations of the ovaries and fat bodies. In order to understand the mechanism of eggcase-silk production, this paper has examined the fine structural changes of the TBG during the period of egg maturation in the garden spider, Argiope aurentia. Between the two kinds of secretory granules observed in the glandular epithelium of the mature TBG, the electron-dense granules which have paracrystalline structure are revealed to be the precursors of the eggcase silk fibers. During the production of eggcase, rapid release of the secretory product occurs at apical surface by the mechanism of apocrine secretion. Moreover, secondary lysosomes appear due to the rapid disorganization of cellular components during the eggcase formation. Examinations of formed fibers indicate a multicomponent internal structure, and electron micrographs reveal each fiber contains numerous electron lucent fibrils embedded in an amorphous electron dense matrix. The secretory precursors are produced as separated vesicles via well-oriented rER, and no Golgi complex has been found in the glandular epithelial cells.

• Korean Journal of Veterinary Research
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• v.48 no.3
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• pp.311-316
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• 2008

A 7-year-old female Shih Tzu dog with lots of masses in the whole mammary gland was presented to the surgery department of the Veterinary Teaching Hospital in the Cheju National University. After surgical excision, all mammary samples were referred to Pathology Department of Veterinary Medicine. Grossly, masses were measuring up to $6.5{\times}4{\times}1cm$ and on cut surface of masses in right 1st, 3rd, 4th, 5th and left 1st, 3rd, 4th, 5th mammary masses were well delineated and firm, sulphur yellow, solid round to oval shape. Microscopically, most neoplastic sweat glands were severely proliferated in dermis and subcutis. Most tubules were lined by round to oval shaped epithelium with eosinophilic cytoplasm, hyperchromatic nuclei with high mitotic figures and severe central necrosis. The neoplastic epithelium also had PAS-positive diastase-resistant cytoplasmic granules, but negative with Perls iron stain. The left 2nd mass was well delineated, and had several dark brown areas and yellowish white glittered areas. Mass was well circumscribed with dense connective tissue. Neoplastic areas contained irregular sized mammary gland with papillary grown luminal epithelial cells in single or double cells layer with mitotic figures and small amounts of proliferated myoepithelial cells. Proliferated myoepithelial cells also produced slightly basophilic mucinous materials. Based on the gross, histopathologic and special staining characteristics, this dog was diagnosed as 90% of apocrine sweat gland aenocarcinoma and 10% mammary. complex adenomas in mammary masses. In our best knowledge, this is the first report for concurrent occurrence of apocrine sweat gland adenocarcinoma and mammary gland complex adenoma in mammary masses of the same dog.

• Annals of Clinical Neurophysiology
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• v.14 no.1
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• pp.12-19
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• 2012

Thermoregulatory sweat is principal mean for homeostasis of temperature. Sweat glands have eccrine gland, apocrine gland, and apoeccrine glands. Disorders of sweating are manifested by excess (hyperhidrosis) or deficit (hypohidrosis, anhidrosis) of sweat. Hyperhidrosis can be defined as excessive sweating beyond a level required to maintain normal body temperature. The sweating can be generalized or localized (axilla, palms, soles, palmar-plantar, perineal). Usually hypohidrosis or anhidrosis may be more serious than hyperhidrosis. Hyperhidrosis is usually benign, but interferes with one's daily activities. First step for diagnostic approach for sweating disorders might be dividing them into localized or generalized, and primary or secondary forms. Treatement for hyperhidrosis include topical agents, botulinum toxin A injections, systemic anticholinergics, and sympathectomy.