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Development of a two-layer movable sweating thermal manikin.

A thermal manikin is a useful tool to evaluate thermal environments such as clothing, houses and others. A manikin needs to have the following properties: shape and size, heat production, skin temperature, sweat rate, physiological responses and others. So far, no manikin satisfying all these criteria has been available. In the present study, a two-layer movable sweating thermal manikin was newly developed as a trial to compensate for the differences between conventional thermal manikins and the human body. The manikin consisted of two layers, a core section in the trunk and a shell section divided into 17 parts over the whole body, the temperature and heat supply of which could be independently controlled. The manikin is possible to change the posture and to walk. The sweat rate from 180 pores on the skin was controlled by peristaltic pumps. The temperature performance of the manikin was investigated using thermograph. As a result, the surface temperature of the manikin decreased more in the extremities than in the trunk when the manikin was exposed to 18 degrees C after being exposed to 28 degrees C for 20 min. This is analogous to the skin temperature decline in the extremities of the human body.

Environmental Exposure↗

Innervation of human axillary sweat glands. Histochemical and electron microscopic study of hyperhidrotic and normal subjects.

Adrenergic nerves were demonstrated by formaldehyde-induced fluorescence and cholinergic nerves using thiocholine techniques to demonstrate acetylcholinesterase activities at the light and electron microscopic levels. The specimens were taken during surgery from the axillae of hyperhidrotic patients and normal voluntary controls. No fluorescent nerves were found around eccrine or apocrine sweat glands in hyperhidrotic or normally sweating axillae. Both eccrine and apocrine sweat glands exhibited a nerve network showing acetylcholinesterase activity. There was no marked difference in the innervation patterns or in the intensity of the acetylcholinesterase reaction of the nerves in the hyperhidrotic patients or normal subjects. Ultrastructurally the acetylcholinesterase-positive nerves were seen in the vicinity of both eccrine and apocrine glands, but these nerves were outside the basement membrane.

Axilla↗

Eccrine sweat gland anatomy in cockayne syndrome: a possible diagnostic aid.

Cockayne syndrome is an autosomal recessive disease, which includes as major features motor and mental retardation (beginning in the second year), microcephaly, ataxia, retinal degeneration and pigmentation, cataracts, progeroid features, intracranial calcification, hypogonadism, and growth retardation. Many other diseases have some of these features, so that diagnosis of Cockayne syndrome can be difficult, especially in younger children. Eccrine sweat glands were microdissected from autopsy or biopsy specimens from patients with Cockayne syndrome, and mean values for duct length, secretory coil volume, ratio of coil volume to duct length, and axis ratio of the secretory coil were determined. In comparison with values for eccrine glands of patients with no known genetic or chromosomal disease, eccrine glands in Cockayne syndrome are abnormally small for age. Whether other diseases with various similarities to Cockayne syndrome produce similar growth abnormality of eccrine sweat glands is not known, but determination of sweat gland size may provide data suggesting or supporting the diagnosis of Cockayne syndrome.

Child↗

Microdissection study of the incidence of branched eccrine sweat glands and the number of eccrine glands per unit area of infants' and childrens' skin.

That branched eccrine sweat glands occur has rarely been mentioned in the literature, and their incidence has never been determined. All eccrine glands in 0.5-cm2 pieces of anterior trunk skin of 59 children were microdissected, and the total number of glands and the number of branched eccrine glands determined. One-hundred fourteen of 17,539 (0.65%) were branched, 90% in the middermis and 10% at the epidermis. The apparently normal anatomic property that almost 1% of eccrine sweat glands are branched has not hitherto been appreciated. One doubly branched gland was found. Patients with leukemia (11 in the study) possibly had more branched glands than nonleukemic patients of the same body size. The best statistical relation of the number of sweat glands per unit area of skin (GUA) to surface area (SA) or age in children was the natural logarithm of GUA versus the reciprocal of surface area: LnGUA = (0.2205 X 1/SA) + 5.42. This result is consistent with the classical proposition that there is no important degree of formation of new eccrine glands, nor of loss, after birth, the density of glands per unit area of skin reducing as SA rises with growth during childhood.

Child↗

Thermoregulatory sweating in palmar hyperhidrosis before and after upper thoracic sympathectomy.

To assess thermoregulatory sweating in palmar hyperhidrosis, the authors determined the responses of three groups of normal, hyperhidrotic, and denervated subjects to a variety of ambient temperatures (TA's), 22 degrees, 28 degrees, and 41 degrees C. The normal group had no hyperhidrosis, with intact T2-3 ganglia, the hyperhidrotic group had palm hyperhidrosis with intact T2-3 ganglia, and the denervated group had hyperhydrosis treated with T2-3 ganglionectomy. Both groups of hyperhidrotic and denervated subjects maintained oral and mean skin temperatures within normal limits displayed by the normal group over a wide range of TA's tested. The local sweating rate (LSR) of both the palms and the soles of the feet in the hyperhidrotic group was decreased to a minimal level by either the T2-3 ganglionectomy or the subcutaneous administration of atropine sulfate. Furthermore, the denervated group had a significantly lower LSR of both the forehead and the upper chest regions, but showed a higher LSR or both the ventral thigh and the lateral lumbar regions at a TA of 41 degrees C when compared to the LSR of either the normal or the unoperated hyperhidrotic group. The data demonstrate that the surgical removal of both the T-2 and the T-3 ganglia, although producing no alterations in the thermal balance, does produce abnormalities in quantitative distribution of thermoregulatory sweating in man.

Atropine↗

Cystic fibrosis screening by sweat analysis: a critical review of techniques.

Currently employed methods for the assay of electrolytes in sweat, relevant to the diagnosis of cystic fibrosis, are critically evaluated with particular reference to the measurement of electrical conductivity. Attention is drawn to the factors responsible for potentially large errors. On the basis of experimentation, supported by laboratory practice, recommendations are made for the reduction of these errors to clinically acceptable levels. Data concerning sodium and potassium content, electrical conductivity and osmolality of undiluted sweat collections are compared. The feasibility and comparative advantages of measuring sweat osmolality with a vapour pressure osmometer are discussed.

Child↗

Physiological differences for distinct somatic sensory modalities and sweating among the donor sites of cutaneous and fasciocutaneous free flaps.

Differences of sensation and sweating among the typical sites of cutaneous and fasciocutaneous flaps (scapular, lateral arm, radial forearm, groin and dorsalis pedis) were assessed in 30 healthy volunteers (20 males and 10 females) aged 17-62 years (mean 38.2 years). Standard clinical methods were used: Semmes-Weinstein monofilaments for testing light touch threshold, discriminator and blunt caliper for evaluation of static and dynamic two-point discrimination and the Marstock quantitative method for assessing the normative values of warm-cold difference limen and heat and cold pain thresholds. Spontaneous sweat secretion was observed and documented by the ninhydrin test. We established various physiological differences for distinct somatic sensory modalities and sweating among the body regions (donor sites of cutaneous and fasciocutaneous free flaps).

Adolescent↗

Catecholamines are required for the acquisition of secretory responsiveness by sweat glands.

The sympathetic innervation of sweat glands undergoes a developmental change in transmitter phenotype from catecholaminergic to cholinergic. Acetylcholine elicits sweating and is necessary for development and maintenance of secretory responsiveness, the ability of glands to produce sweat after nerve stimulation or agonist administration. To determine whether catecholamines play a role in the development or function of this system, we examined the onset of secretory responsiveness in two transgenic mouse lines, one albino and the other pigmented, that lack tyrosine hydroxylase (TH), the rate-limiting enzyme in catecholamine synthesis. Although both lines lack TH, their catecholamine levels differ because tyrosinase in pigmented mice serves as an alternative source for catecholamine synthesis (Rios et al., 1999). At postnatal day 21 (P21), 28 glands on average are active in interdigital hind footpads of albino TH wild-type mice. In contrast, fewer than one gland is active in albino TH null mice, which lack catecholamines in gland innervation. Treatment of albino TH null mice with DOPA, a catecholamine precursor, from P11 to P21 increases the number of active glands to 14. Pigmented TH null mice, which have faint catecholamine fluorescence in the developing gland innervation, possess 12 active glands at P21, indicating that catecholamines made via tyrosinase, albeit reduced from wild-type levels, support development of responsiveness. Gland formation and the appearance of cholinergic markers occur normally in albino TH null mice, suggesting that catecholamines act directly on gland cells to trigger their final differentiation and to induce responsiveness. Thus, catecholamines, like acetylcholine, are essential for the development of secretory responsiveness.

Acetylcholine↗

The English 'sweate' (Sudor Anglicus) and Hantavirus pulmonary syndrome.

A rapidly fatal viral infectious disease appeared in England in 1485, persisted for the summer months and disappeared as winter approached. This pattern of infection re-appeared in 1508, 1517, 1528, and finally 1551. The epidemic never returned. It had no respect for wealth or rank, and predominantly attacked males between the ages of 15 and 45 years. The incubation period was frighteningly short and the outcome normally fatal. The symptoms of acute respiratory disease and copious sweating were characteristic, providing the name 'the English sweating disease'. It was never in the big league of killer epidemics, such as plague and influenza, but its pockets of instant lethality in communities gave it a special ranking of horror. The infective cause of this disease remained a total mystery until it was compared with Hantavirus pulmonary syndrome (HPS) in 1994. The strength of this theory is examined in this paper, and it is concluded that, although there is a close resemblance, HPS does not match the English sweating disease completely and positive identification of a possible rodent carrier for the latter was not established.

Animals↗

[Cystic fibrosis and normal sweat chloride values: a case-report].

UNLABELLED: In a suggestive context, normal sweat chloride values (<60 mmol/L) do not always suffice to exclude the diagnosis of CF. CASE-REPORT: A 19-year-old female presented with a diagnosis of bronchiectasis. Her past medical history was noteworthy for the onset of respiratory symptoms in the infancy, colonization of the respiratory tract by Pseudomonas aeruginosa for three years and previous treatment for allergic bronchopulmonary aspergillosis. She was heterozygote for the DeltaF 508 mutation of the CFTR gene. Sweat chloride values were repeatedly normal, ranging from 25 to 46 mmol/L. The diagnosis of CF was confirmed by the identification of a second CFTR mutation (D1152H) and the demonstration of typical nasal potential. CONCLUSION: It is now estimated that approximately 2% of CF patients will present an "atypical" phenotype with sweat chloride values<60 mmol/L. For these patients, the diagnosis can be confirmed by the identification of a CF-causing mutation in each CFTR allele or in vivo demonstration of CFTR dysfunction by nasal potential difference study.

Adolescent↗

Effect of systemically administered epinephrine on palmar sweating.

We have described our experience with a modified Bullard sudorometer for the continuous recording of sweating rates from selected skin areas. This involves an electrical system for sensing water vapor pressure and expressing it as relative humidity. This sensitive device was used to study the effect of systemically administered epinephrine on palmar sweating. Thirty-three young adults were tested; ten demonstrated a decrease after epinephrine administration. Those subjects demonstrating a decrease in palmar sweating were from the group of subjects who perspired heavily. The possible mechanisms for this are discussed.

Adolescent↗

[Morphology of sweat glands].

There are two types of sweat glands: eccrine glands, which do not show cytological changes during secretion and apocrine glands, characterised by decapitation secretion, in which part of the cell is pinched off and released into the lumen. Eccrine glands play a major role in thermoregulation and electrolyte balance. They are present everywhere in the human skin and are composed of a secretory portion, an intradermal duct and an upper intraepidermal part, called acrosyringium. The acrosyringium has a unique symmetrical and helicoidal course, which length is correlated to the thickness of the epidermis. Apocrine glands are located only on genital, axillary and mammary areas, where they are always connected to a hair follicle. Their exact role in humans is unknown. A third type of intermediate sweat glands, the apoeccrine glands, was recently described in axillary areas. Sweat glands can be involved in various inflammatory processes and can lead to a large range of both benign and malignant tumors.

Animals↗

[Regularities in the distribution of sweat glands and the principles of their grouping in man].

Under study were skin pieces from 80 regions of the body of 41 human fetuses and embryos, 5 corpses of newborns and 43 corpses of people of different age. Series of paraffin sections stained by conventional methods as well as total preparations and thick sections stained with methylene blue were examined. The laying of eccrine and apocrine sweat glands in the skin covered or not with hair was shown to occur repeatedly. Basing on the succession of their appearance they are called the glands of the first, second and third generations. The principle of grouping of eccrine sweat glands is shown both in the composition of glandular-hair complexes and in the groups independent of hair. The author proposes using of letter and figure symbols to signify variations of their disposition in formulars. The appocrine sweat glands are also laid repeatedly in the sites of their typical localization.

Age Factors↗

[Diagnosis of cystic fibrosis; simple genotyping to rule out the disease preferable to starting with the sweat test].

For historical reasons, the sweat test remains the cornerstone in the diagnostic work-up for cystic fibrosis (CF). If CF is suspected, the sweat test (following pilocarpine iontophoresis) is usually performed first to confirm or rule out the diagnosis of CF. Sweat testing, however, is cumbersome to the patient, prone to technical difficulties and unreliable in young children < 4 weeks as well as in adults because of increasing chloride concentrations with age. False-positive and false-negative results do exist. Simple DNA testing with PCR in peripheral blood for a small number of the most common mutations causing CF, notably the delta F508-mutation in the Dutch population, rules out CF with a likelihood of more than 99%. Because of the high negative predictive value of DNA testing, in combination with its speed, reliability and convenience for the patient, starting the diagnostic work-up for CF with DNA testing can be justified in hospitals which possess the laboratory facilities for this type of test.

Cystic Fibrosis↗

The kallikrein-kinin system of sweat in normal and cystic fibrosis subjects.

The mechanisms of kallikrein secretion was studied in 25 normal subjects (11 male, 14 female) and 5 subjects with cystic fibrosis (identified by the usual criteria). The results obtained show a decreasing of prekallikrein and total kallikrein in cystic fibrosis stimulated by IPR or pilocarpine compare to controls. On the other hand sweat from males shows more prekallikrein and total kallikrein than females. According with this results we can concluded that the basic defect in sweat cystic fibrosis gland could be the possible involvement of the kallikrein-kinin system on the high osmolality of the sweat secretion.

Child↗

[Significance of drug determination in pilocarpine sweat for detection of past drug abuse].

The presence of cocaine, morphine and methadone in sweat samples obtained after stimulation of the eccrine sweat glands, from drugs users after six drugs-free days, was investigated. The stimulation of the sweat elimination was proved using pilocarpine-iontophoresis every hour for 7 hours. The drugs concentrations were determined by radioimmunoassay. Consequently, the values measured represent the sum of the drug and its metabolites. Measurable levels of cocaine, morphine and methadone were obtained after the third stimulation of the glands.

Adult↗

Treatment of axillary hyperhidrosis by chemodenervation of sweat glands using botulinum toxin type A.

Primary axillary hyperhidrosis is a medical condition characterized by excessive underarm sweating that is thought to result from localized hyperstimulation of sweat glands by cholinergic sympathetic nerve fibers. It can be associated with significant professional, physical, and emotional impairment as well as considerable difficulties in social situations and in personal relationships. Available therapies have been limited by short-lived effectiveness and in some cases significant adverse effects that can put patients at risk for potentially serious complications. Chemodenervation of sweat glands using botulinum toxin type A (BTX-A), which has long-lasting therapeutic efficacy with minimal adverse effects, has emerged as a unique therapy for treating primary axillary hyperhidrosis. This article reviews the chemodenervation procedure, including patient preparation, BTX-A administration, and patient assessment and follow-up.

Axilla↗

Host-finding behavior of Strongyloides stercoralis infective larvae to sodium cation, human serum, and sweat.

The host-finding behavior of Strongyloides stercoralis infective larvae was examined by in vitro agarose assay method. As human body fluid contains 0.85% (ca 0.15 molar) NaCl, various concentrations of sodium chloride, from 0.5M to 0.01M (7 steps), were examined. Many larvae were attracted at concentrations between 0.5 and 0.05M of sodium chloride. The concentration of 0.05M attracted the most larvae. The concentration of 0.02M of sodium chloride showed greatly reduced larval attraction compared with 0.05M. Therefore, the threshold concentration was determined as 0.05M. Then, 0.05M of chemicals were examined in a further experiment. Chloride compounds (NaCl, KCl, CaCl2, MgCl2) were investigated. These chemicals are components of human body fluids. Distilled water was used as the control in all experiments. Only sodium chloride attracted the larvae. Next, alkaline compounds were examined [NaOH, KOH, Ca(OH)2, and Mg(OH)2]. Larvae accumulated only at the NaOH site. The results suggested that the Na cation is important for larval attraction. A high pH value did not influence attraction at all. Next, human serum was tested. The human serum used was from normal serum to 1:32 diluted sera by distilled water (7 steps). Hierarchical attraction was seen according to serum concentration. Next, human sweat was collected from a limited zone of chest skin where only eccrine glands were distributed. Non-diluted sweat attracted the most larvae. Sweat might act as one of the most probable factors for infection by this skin-penetrating nematode.

Agar↗