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At least 973 records · Page 54Linked to original sources

PubMed1978

Cystic fibrosis. Problems encountered with sweat testing.

The sweat test is the only practical and reliable laboratory test for confirmation of the diagnosis of cystic fibrosis. Among 234 patients referred to The Johns Hopkins Hospital for sweat testing, 62 had had a previous test; 29 tests had been reported as negative, and 33 tests had been reported as positive. Results of quantitative pilocarpine-iontophoresis sweat tests at this center led to a change in diagnosis in 27 (43.5%) of these 62 patients. Most of the errors were false-positive.

Chlorides↗

PubMed1996

Treatment of diabetic gustatory sweating with topical glycopyrrolate cream.

A 42-year-old insulin-dependent diabetic man presented with severe bilateral gustatory sweating associated with a deterioration in his glycaemic control. Conventional oral antimuscarinic medication was contraindicated because of his cardiac insufficiency. Topical 0.5% glycopyrrolate cream was tried and applied on alternate days to his face, which resulted in the complete cessation of his gustatory sweating without side-effects. Topical glycopyrrolate cream is an effective treatment of diabetic gustatory sweating without the adverse effects commonly found with oral anti-muscarinic medication.

Administration, Topical↗

PubMed1981

Structure of the tight junctions of the human eccrine sweat gland.

The human eccrine sweat gland contains two anatomically and functionally discrete segments: the secretory coil, which produces an isotonic or slightly hypertonic precursor fluid, and the coiled duct, which reabsorbs Na+ and Cl- to yield a hypotonic sweat. We examined the freeze-fracture morphology of tight junctions from isolated secretory coil and coiled duct segments to assess indirectly the contribution of paracellular ion transport in secretion and resorption in the sweat gland. In the secretory coil, tight junctions of the intercellular canaliculus and main lumen consisted of approximately 9 and 6, closely spaced, parallel or anastomosing elements, respectively. Tight junctions of the coiled duct were similar in appearance to those at the main lumen of the secretory coil. In both the secretory coil and coiled duct, and average of 2 to 3, widely spaced junctional elements were usually observed basolateral to the closely spaced junctional elements in the region corresponding to the location of the zonula adherens in Epon sections. The complexity of the tight junctions of the secretory coil exceeded what we expected for an epithelium secreting an isosmotic fluid. The elaborate tight junctions of the coiled duct support other evidence for an intermediate to high transepithelial resistance.

Adolescent↗

PubMed1991

Correlation of phenotypic and genetic heterogeneity in cystic fibrosis: variability in sweat electrolyte levels contributes to heterogeneity and is increased with the XV-2c/KM19 B haplotype.

We have reinvestigated a classification of clinical heterogeneity among cystic fibrosis (CF) patients that we previously reported and investigated the possible relationship of the identified CF subgroups to haplotypes around the CF gene and to HLA-DR haplotypes. Age-corrected values for sweat electrolytes, rate of progression of lung disease as assessed by Brasfield chest x-ray scores, and severity of pancreatic insufficiency as assessed by daily supplemented enzyme dosage were obtained for 55, 59, and 59 patients, respectively. XV-2c and KM19 RFLPs were determined by hybridization to TaqI and PstI digests of human genomic DNA, respectively, and analysis of mutations by PCR amplification followed by allele-specific oligo-deoxynucleotide hybridization was performed for 29 patients. HLA-DR restriction fragment length polymorphisms (RFLPs) were determined by hybridization of cDNA beta 1 and genomic DQ alpha probes to TaqI digests of human genomic DNA. The results show that the previous subdivision on the basis of age-corrected levels of sweat electrolytes, as well as measures of severity of lung disease and pancreatic disease, is valid. In addition, the C and D haplotypes are associated with lower age-corrected sweat sodium level. No significant relationship between CF haplotypes and the other two disease variables or between HLA-DR haplotypes and any of the clinical variables was found.

Child↗

PubMed1987

Postherpetic gustatory flushing and sweating.

An 11-year-old girl who had suffered right facial herpes zoster at the age of 6 years was left with anesthetic scars in the distribution of the third division of the trigeminal nerve. Since then, certain tastes provoked flushing and sweating localized to the scarred areas, lasting for 10 to 15 minutes after a latency of a few seconds. The response was evoked most readily from the ipsilateral posterior section of the tongue and was virtually abolished by local administration of anesthesia to the tongue. It remained unaltered after blockade of the sphenopalatine and stellate ganglia but was diminished by blockade of the mandibular nerve. Thermoregulatory sweating and flushing were diminished in the scarred areas. Patchy destruction of sympathetic fibers, which are known to accompany peripheral trigeminal nerve branches, and reinnervation of the affected areas by parasympathetic fibers that normally mediate salivation may explain the phenomenon. It is thus analogous to the gustatory flushing and sweating that may follow damage to the auriculotemporal nerve in the region of the parotid gland (Frey's syndrome).

Child↗

PubMed2005

Identification of the precursor of (S)-3-methyl-3-sulfanylhexan-1-ol, the sulfury malodour of human axilla sweat.

A careful study of human axillary microflora led us to the identification of a new strain of Staphylococcus haemolyticus. The role in axillary malodour formation of this microorganism was compared to those of Corynebacterium xerosis and Staphylococcus epidermidis, upon incubation on sterile human eccrine and apocrine axilla sweat. St. haemolyticus was responsible for the strongest sulfury malodour and the generation of the volatile sulfur compound (VSC) (S)-3-methyl-3-sulfanylhexan-1-ol (3). In this study, we investigated the nonvolatile precursors of VSCs. Human axillary sweat was collected, fractionated and analysed by HPLC/APCI-MS (High-Pressure Liquid Chromatography coupled to Atmospheric Pressure Chemical Ionisation Mass Spectrometry). The precursor of 3 was identified as [1-(2-hydroxyethyl)-1-methylbutyl]-L-cysteinylglycine (Cys-Gly-(S)-conjugate; 12). Because Cys-Gly-(S)-conjugates are key intermediates in the glutathione biodetoxification pathway, other derivatives of 12, specifically glutathione-(S)-conjugate 11 and Cys-(S)-conjugate 13, were prepared. Compounds 11 and 13 were not detected by HPLC/MS of sterile sweat. Synthetic homologues 11, 12, and 13 were incubated with C. xerosis, St. heamolyticus, and St. epidermidis. We observed efficient conversion of precursors 12 and 13 to form VSCs when incubated with St. haemolyticus, with a clear preference for 12. C. xerosis and St. epidermidis were less efficient in cleaving Cys-Gly-(S)-conjugate 12 to form the corresponding thiol 3. Incubation of glutathione-(S)-conjugate 11 never led to the formation of 3 under the experimental conditions employed.

Axilla↗

PubMed2003

CFTR genotypes in patients with normal or borderline sweat chloride levels.

In recent years, some patients bearing "atypical" forms of cystic fibrosis (CF) with normal sweat chloride concentrations have been described. To identify the spectrum of mutant combinations causing such atypical CF, we collected the results of CFTR (ABCC7) mutation analysis from 15 laboratories. Thirty patients with one or more typical symptoms of the disease associated with normal or borderline sweat chloride levels and bearing two CFTR mutations were selected. Phenotypes and genotypes of these 30 patients are described. A total of 18 different CFTR mutations were observed in the 60 chromosomes analysed. F508del was present in 31.6 % of the mutated chromosomes and 3849+10kbC>T in 13.3 %. R117H, D1152H, L206W, 3272-26A>G, S1235R, G149R, R1070W, S945L, and the poly-T tract variation commonly called IVS8-5T were also observed. The relative frequency of CFTR mutations clearly differed from that observed in typical CF patients or in CBAVD patients with the same ethnic origin. A mild genotype with one or two mild or variable mutations was observed in all the patients. These findings improve our understanding of the distribution of CFTR alleles in CF with normal or borderline sweat chloride concentrations and will facilitate the development of more sensitive CFTR mutation screening.

Adolescent↗

PubMed2003

Enzyme replacement therapy improves peripheral nerve and sweat function in Fabry disease.

Fabry disease is an X-linked disorder caused by a deficiency of lysosomal alpha-galactosidase A resulting in accumulation of alpha-D-galatosyl conjugated glycosphingolipids. Clinical manifestations include a small-fiber neuropathy associated with debilitating pain and hypohidrosis. We report the effect of a 3-year open-label extension of a previously reported 6-month placebo-controlled enzyme replacement therapy (ERT) trial in which 26 hemizygous patients with Fabry disease received 0.2 mg/kg of alpha-galactosidase A every 2 weeks. The effect of ERT on neuropathic pain scores while off pain medications, quantitative sensory testing, quantitative sudomotor axon reflex test (QSART), and thermoregulatory sweat test (TST) is reported. In the patients who crossed-over from placebo to ERT (n = 10), mean pain-at-its-worst scores on a 0-10 scale decreased (from 6.9 to 4.5). There was a significant reduction in the threshold for cold and warm sensation in the foot. At the 3-year time-point, pre-ERT sweat excretion in 17 Fabry patients was 0.24 +/- 0.33 microl/mm(2) vs. 1.05 +/- 0.81 in concurrent controls (n = 38). Sweat function improved 24-72 h post-enzyme infusion (0.57 +/- 0.71 microl/mm(2)) and normalized in four anhidrotic patients. TST confirmed the QSART results. We conclude that prolonged ERT in Fabry disease leads to a modest but significant improvement in the clinical manifestations of the small-fiber neuropathy associated with this disorder. QSART may be useful to further optimize the dose and frequency of ERT.

Adult↗

PubMed1988

Incidence and implications of false-negative sweat test reports in patients with cystic fibrosis.

It is well known that false-positive sweat tests occur commonly, but since a positive test should always be repeated, such an error is likely to be discovered. False-negative results, however, are more difficult to detect and are generally assumed to be much less frequent than false-positive results. Diagnostic delay caused by false-negative reports may lead to substantial morbidity. Review of the medical records of 147 unselected patients with cystic fibrosis followed in our center revealed that 17 (12%) initially had one or more sweat tests that were falsely negative (or were so reported or interpreted). In seven patients, there was diagnostic delay with adverse clinical consequences. Many factors may contribute to the incidence of false-negative sweat tests, and negative results must not be accepted as definitively excluding cystic fibrosis if the clinical syndrome is otherwise suggestive.

Cystic Fibrosis↗

PubMed1995

The topography of eccrine sweating in humans during exercise.

The purpose of this study was to investigate the distribution of steady-state sweating rates (msw), during stressful exercise and heat exposures. Six men completed 42-min trials: 2-min rest and 40-min cycling at 40% peak power in 36.6 degrees C (relative humidity 46.0%). The msw was monitored using ventilated capsules at the forehead, and at three additional sites. Repeat trials allowed monitoring from eleven skin surfaces. Auditory canal temperature (Tac) and 11 skin temperatures were measured. After normalising msw to the forehead response within subjects, differences in Tac and onset time thresholds, and transient and steady-state msw were examined. The pooled, lower torso msw onset [mean 45.5 (SEM 42.0) s] preceded that of the head [mean 126.5 (SEM 34.8) s, P < 0.05], but was not significantly different from the legs [mean 66.6 (SEM 25.7) s], upper torso [mean 80.2 (SEM 36.8) s] or arms [mean 108.6 (SEM 31.2) s]. Transient msw did not differ among regions (P = 0.16). Mean, steady-state forehead msw [3.20 (SEM 0.51) mg.cm-2.min-1] was not significantly greater than the scapula, forearm, hand, stomach and lower back msw (in descending order), but was greater than the chest [1.6 (SEM 0.2)], upperarm [1.6 (SEM 0.2)], calf [1.5 (SEM 0.3)] and thigh msw [1.0 (SEM 0.2), P < 0.05 for all comparisons]. The results did not support the caudal-to-rostral sweat onset evident during supine, resting heat stress. Equivalent Tac sweat thresholds existed between sites, while steady-state state msw topography varied among subjects and was not dominated by central regions.

Adult↗

PubMed1994

Local sweating responses during recovery sleep after sleep deprivation in humans.

Changes in the central control of sweating were investigated in five sleep-deprived subjects (kept awake for 40 h) during their recovery sleep under warm ambient conditions [operative temperature (T(o)) was either 35 or 38 degrees C]. Oesophageal (T(oes)) and mean skin (Tsk) temperatures, chest sweat rate (msw,ch), and concomitant electro-encephalographic data were recorded. Throughout the night at 35 or 38 degrees C T(o), msw,ch changes were measured at a constant local chest skin temperature (Tch) of 35.5 degrees C. The results showed that body temperatures (T(oes) and Tsk) of sleep-deprived subjects were influenced by thermal and hypnogogic conditions. The msw,ch levels correlated positively with T(oes) in the subjects studied during sleep stage 1-2 (light sleep: LS), sleep stage 3-4 (slow wave sleep: SWS) and rapid eye movement (REM) sleep. Contrary to what has been reported in normal sleep, firstly, the T(oes) threshold for sweating onset differed between REM sleep and both LS and SWS, and, secondly, the slopes of the msw,ch versus T(oes) relationships were unchanged between REM and non-REM (i.e. LS or SWS) sleep. The changes observed after sleep deprivation were hypothesized to be due to alterations in the functioning of the central nervous system controller.

Adult↗

PubMed1977

[The so-called sweat-gland carcinoma of the human breast. A review (author's transl)].

The term sweat-gland carcinoma of the breast is used in widely different meanings. Nonetheless, two histologically well-characterized types may be recognized: 1. The apocrine (oncocytic) carcinoma is composed of large well-delimited cells with finely granular, oxyphilic cytoplasm similar to that of oncocytes of other organs. They resemble the "pale" oxyphilic cells of the aging normal breast whose cytoplasm in part show the same quality. These carcinoma cells are regarded as mammary cells in a state of transition into oncocytes. Any similarity they have to cells of the apocrine axillary sweat-gland is purely superficial and in no way influences the interpretation of apocrine carcinomas. 2. The secreting carcinoma histologically is reminiscent of the functioning, hormonally stimulated breast of pregnancy. It reveals apocrine extrusion of nuclei and an accumulation of neutral fat in cytoplasm and duct lumina. A case of secreting carcinoma is described in detail to exemplify the association with exogenous hormonal stimulation. Both types of differentiation of carcinomas may arise together or with other types of mammary carcinomas, and share the clinical prognosis with them. The term sweat-gland carcinoma of the human breast should be abolished since there exists no proof that they really occur.

Aged↗

PubMed1996

Differences in regional sweating responses during exercise between athletes trained on land and in water.

We investigated whether there are any differences in regional sweating responses during exercise between athletes trained on land and in water. We measured the local sweating rates on the left forearm (mswf) and the left scapula (msws), body temperatures (mean skin temperature, and rectal temperature Tre) in eight athletes trained on land (five soccer players, one distance runner and two baseball players, L group) and seven athletes trained in water (seven swimmers, W group) during cycle ergometer exercise at 50% maximal oxygen uptake for 40 min. The heart rate and oxygen uptake in the two groups during exercise showed nearly the same pattern of change. The Tre at the end of the exercise were 38.13 (SEM 0.19) degrees C in the L group and 38.26 (SEM 0.34) degrees C in the W group. Although the mswf in the two groups were similar, msws were significantly higher in L than in W at 30, 35 and 40 min of exercise. The msws at any given mean body temperature tended to be greater in L than in W. These results showed that a difference in regional sweating rate during exercise between the athletes trained on land and in water was present on the scapula.

Adult↗

PubMed1996

Regional differences in age-related decrements of the cutaneous vascular and sweating responses to passive heating.

Ten older (aged 64-76 years) and ten younger (aged 20-24 years) healthy men were exposed to a standard heat stress [by placing the lower legs and feet in a water bath at 42 degrees C while sitting in a controlled environment (ambient temperature 35 degrees C and 45% relative humidity) for 60 min]. During passive heating, the rectal temperature of the older men was significantly greater (P < 0.05) and mean skin temperature was lower (P < 0.001), compared to the younger men. Skin blood flow by laser Doppler flowmetry (LDF) was significantly lower on the chest and thigh for the older men (P < 0.001), but forehead LDF did not differ between the groups. The percentages of total LDF in the older men to total LDF in the younger men for the last 30 min were 99%, 58% and 50% on the forehead, chest and thigh, respectively. The age-related differences in LDF responses mirrored cutaneous vascular conductances (CVC), since no group and time effects were observed in mean arterial blood pressure during the test. During the last 30 min the local sweat rates (msw) on the back and thigh were significantly lower for the older men (P < 0.02), but not on forehead, chest and forearm, although the older men had lower msw during the first 30 min exposure regardless of site (P < 0.03). The percentages of total msw in the older men to total msw in the younger men during the last 30 min were 105%, 99%, 63%, 106% and 88% on the forehead, chest, thigh, forearm, and back, respectively. During the latter half of the exposure, the older men had similar LDF, CVC and msw on the forehead, lower LDF and CVC and a similar msw on the chest, and lower LDF, CVC and msw on the thigh, compared to the younger men. These results suggest firstly that regional differences exist in the age-related decrement of cutaneous vasodilatation as well as sweat gland function, secondly that the age-related decrement in cutaneous vascular function may precede a decrement in sweat gland function, and thirdly that the successive decrements may develop sequentially from the lower limbs to the upper body, and head.

Adult↗

PubMed1990

Consequences of partial body warming and cooling for the drives to local sweat rates.

Climatic chamber experiments were carried out on young, healthy male students. The ambient temperature was 36 degrees C, while local warming of one extremity was compensated for by heatflow-equivalent cooling of the ipsilateral extremity by on-line calculation of the heat balance. When warming the arm and cooling the leg (type 1 experiments), a slight, but not statistically significant increase of local sweat rates at these extremities was recorded. However, when cooling the arm and warming the leg (type 2 experiments), both corresponding local sweat rates declined. The divergent results are interpreted in terms of previously reported different central weighting factors for skin temperatures as determined: (1) by the weighting for the area, or (2) by the weighting for the area and the sensitivity of the local sweat rate to warming and cooling. This means that the central processing of the mean skin temperature may be different for cooling and warming and that in both cases values can be different from recorded (area weighted) skin temperature. Calculating this modified mean skin temperature, we conclude that type 1 experiments may be interpreted by the hypothesis that the central regulator has a status very near an overall heat-balance, whereas type 2 experiments, although also carried out at heat-balance, may be centrally evaluated as predominant cooling. In these experiments again the central drives representing the whole body thermal state seem to override both the direct and centrally mediated local drives.

Adult↗

PubMed1981

Eyelid tumors of sweat gland origin.

Tumors of sweat gland origin are not uncommon in the periocular region. These tumors frequently pose diagnostic difficulty due to the wide range of histopathological patterns, and to the fact that they may be infiltrative or have metastatic potential despite their relatively benign appearance. This report discusses the classification and diagnosis of five sweat gland tumors with variable histological appearance, including syringoma, mixed tumors, adenoma of ductal origin, and mucinous adenocarcinoma of sweat gland origin.

Adenocarcinoma, Mucinous↗

PubMed1986

The distribution of sympathetic adrenergic, tyrosine hydroxylase- and neuropeptide Y-immunoreactive nerves in human axillary sweat glands.

The innervation of human axillary sweat glands was studied by using the specific SPG (sucrose-potassium phosphate-glyoxylic acid) catecholamine histofluorescence method and the peroxidase-antiperoxidase (PAP) immunocytochemical method. The present results demonstrated that human sweat glands are surrounded by nerves containing a weak tyrosine hydroxylase activity. Nerves showing catecholamine histofluorescence could be visualized around the sweat glands only in the presence of exogenous catecholamine (adrenaline in the local anestheticum). In all tissue specimens studied fluorescent adrenergic nerves could be seen around arteries and arterioles corresponding to the distribution of neuropeptide Y-like immunoreactive nerves.

Adrenergic Fibers↗

PubMed1987

The effect of diazepam on the responsiveness of human eccrine sweat glands to carbachol: influence of ambient temperature.

The effect of diazepam (10 mg, p.o.) on the responsiveness of eccrine sweat glands to intradermally injected carbachol and on critical flicker fusion frequency was compared in 6 male healthy volunteers under two ambient temperature conditions, 22 degrees C and 35 degrees C. Carbachol evoked dose-related increases in sweat gland activity. Responsiveness to carbachol was significantly enhanced under the 35 degrees C condition as compared to the 22 degrees C condition, this being reflected in a higher value of Emax of the dose-response curve for carbachol under the 35 degrees C condition. Diazepam had no significant effect on responses to carbachol under the 22 degrees C condition, but prevented the increase in responsiveness produced by high ambient temperature. High ambient temperature had no significant effect on critical flicker fusion frequency. Diazepam significantly reduced critical flicker fusion frequency under both temperature conditions. It is suggested that diazepam may block the increase in sympathetic outflow normally evoked by high ambient temperature, thereby preventing the development of sweat gland hyper-responsiveness.

Adult↗