Hand Skin Temperature Research Articles

めまい患者の自律神経機能 サーモグラフィを用いて

In order to determine whether thermography is useful for diagnosing abnormal autonomic nervous function (ANF) in patients with vertigo, we tested 51 patients with this procedure. Hand skin temperatures were measured bilaterally before and after ice water immersion. R-R intervals on ECG (R-R) and pulse wave velocity (PWV) were also measured to examine ANF. Thermography results were correlated with the test results, and a final diagnosis of ANF was determined. In this study, 16 patients (31 %) showed abnormal thermal findings; a useful parameter was found to be the rate of recovery of the average skin temperature. However 14 patients (27 %) with normal thermography findings were finally diagnosed as having abnormal ANF on the basis of the results of R-R and/or PWV measurements. Thus, thermography may be an abjunct diagnostic modality.

Effects of 830 nm continuous wave laser diode irradiation on median nerve function in normal subjects

The presence, magnitude, and nature of the effect that low intensity laser irradiation has on nerve function, growth, and repair constitute a contentious area of research. We have addressed one aspect of this controversy by systematically examining the influence of 830 nm laser radiation on median nerve function. In particular, we investigated median nerve motor and sensory distal latencies, action potential amplitudes, action potential areas, and conduction velocities as well as dorsal hand skin temperatures in 33 normal subjects in a double-blinded, randomized controlled study. All subjects received identical treatment: 30 seconds of "irradiation" at 10 points over the course of the right median nerve (five sites on the forearm and five sites distal to the wrist crease) with either an active (1.2 J/point) or inactive (0 J/point) 40 mW 830 nm continuous wave IR laser diode. Latencies, conduction velocities, amplitudes, areas, and skin temperatures were collected bilaterally at a baseline immediately prior to irradiation and at intervals of 1, 5, 10, 15, 20, and 30 minutes following treatment. Analysis of the results reveals that motor and sensory distal latencies were decreased in the treated limbs of the laser-treated group relative to the control group by 3-4% (P < .016 and .046, respectively, rank sum test). No significant differences in these quantities were found between the limbs within either group. Similarly, no alterations of action potential amplitudes, action potential areas, forearm conduction velocities, or skin temperatures were detected within or between the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Sympathetic nervous system activity during skin cooling in humans: relationship to stimulus intensity and pain sensation.

1. Our aim was to determine the relationship between efferent sympathetic nervous system activity to skeletal muscle (MSNA) and both the dynamics of the stimulus and pain sensation during localized skin cooling in humans. MSNA in the lower leg (peroneal microneurography), heart rate, arterial blood pressure, hand skin and muscle temperatures and perceptions of pain were recorded in ten healthy subjects before, during and after immersion (3 min) of a hand in water of different temperatures ranging from non-noxious to extremely noxious (28, 21, 14, 7 and 0 degrees C). 2. Immersion produced an abrupt, water temperature-dependent fall in hand skin temperature (initial 30 s) followed by a more gradual decline. In contrast, the fall in hand muscle temperature was almost linear during immersion. Throughout immersions at the 28, 21, and 14 degrees C water temperatures and during the initial phase of the 7 degrees C level, sensations ranged from not painful to somewhat painful; however, the latter phase of the 7 degrees C immersion and the entire 0 degrees C level were perceived as intensely painful. 3. During the initial 15-30 s of immersion at the 21-7 degrees C water temperatures, MSNA decreased from control levels in all subjects (47-58% on average, P < 0.05), whereas mean arterial blood pressure did not change. MSNA then returned to and remained at control levels throughout the 28-14 degrees C immersions, although arterial pressure, primarily systolic, rose slightly. 4. After some delay, MSNA increased during immersion at both the 7 degrees C (P < 0.05 at 90 s) and 0 degrees C (P < 0.05 at 60 s) levels in a progressive, water temperature-dependent manner, achieving peak values of approximately 200 and 300% of control, respectively, by 2.0-2.5 min. These elevations in MSNA were associated with parallel increases in arterial pressure. 5. Heart rate rose during the onset of immersion at all water temperatures (P < 0.05), but fell rapidly to control levels after 60-90 s. The increases were small (approximately 5 beats/min) and similar at the 28-7 degrees C levels, but were twice as great at the coldest water temperature.(ABSTRACT TRUNCATED AT 400 WORDS)

Reproductibility of carpenters' work after cold exposure

The purpose of the study was to analyse the effect of cold on manual performance. Ten carpenters performed three tasks (nailing, sawing, screwing), before and after exposure to cold. They rated their exertion, EMG activity was recorded from six arm-shoulder muscles, and performance was video-filmed. The subjects were exposed to one hour of cold (15°C ambient temperature, the dominant hand being cooled by a fan and cold water spray). Hand skin temperature was measured and the sensation of cold was rated. The number of work movements and the time taken for each task were recorded. The quality of the work performed at the first and second trials was compared. Cold stress was very individually perceived. EMG activity increased in finger flexors, wrist extensors and shoulder elevators. Rating of perceived exertion while nailing was higher. More time was needed to perform each of the tasks, but the quality of the work was mainly the same. Incidents indicating accident risks were observed.

Increase of heat loss by wearing gloves and boots in wet-suited subjects working in cold water.

The effect of wearing protective gloves and boots on thermal exchanges of wet-suited subjects in cold water was evaluated. Four male subjects, clad in 5 mm-thick neoprene wet suits and either with or without neoprene gloves (5 mm-thick) and boots (5 mm-thick) were immersed up to the neck in water at 13 degrees C while resting for 3 h or exercising for 2 h. Rectal temperature, oxygen consumption and local (chest, back, upper arm, thigh, forearm, calf, hand and foot) skin temperatures, skin heat fluxes and thermal insulations were determined during immersion. The rectal temperature was not different between conditions but the skin temperature was significantly higher with gloves and boots, especially at the distal extremities (forearm, calf, hand and foot). Consequently, the core-to-skin temperature gradient was reduced by wearing gloves and boots, but the skin heat loss was markedly increased. Calculated overall body insulation was significantly lowered by wearing gloves and boots. These results indicate that in wet-suited subjects resting or exercising in cold (13 degrees C) water, gloves and boots increase the overall rate of body heat loss. Attenuation of cold-induced vasoconstriction is proposed as the mechanism.

The effect of peripheral hypothermia on a vecuronium‐induced neuromuscular block

Seven healthy patients were investigated during midazolam-fentanyl nitrous oxide-oxygen anaesthesia. The mechanical twitch response of the adductor pollicis muscle was recorded simultaneously during bilateral supramaximal train-of-four (TOF) stimulation of the ulnar nerves at the wrist. Intense neuromuscular block was evaluated using the post-tetanic count (PTC) method. Core temperature and the peripheral skin temperature of one arm were kept normal and stable. Following cooling of the other arm to a peripheral hand skin temperature of 27 degrees C, vecuronium was administered in a bolus dose of 0.05 mg.kg-1 followed by maintenance doses of 0.02 mg.kg-1. In the hypothermic and the normothermic arm the onset time following the bolus dose was 180 +/- 40 (mean +/- s.d.) seconds and 140 +/- 30 s, respectively, the duration of action was 26.4 +/- 4.5 and 16.5 +/- 4.0 min and the recovery time was 265 +/- 90 and 130 +/- 60 s (P less than 0.01). The time course of action following maintenance doses showed a similar marked difference between the hypothermic and the normothermic arm. In the normothermic arm a close correlation was found between the number of post-tetanic twitches and the time to first response to TOF stimulation. In contrast, in the hypothermic arm the number of post-tetanic twitches showed great variation with a poor correlation to the duration of intense neuromuscular block. It is concluded that the time course of action of a vecuronium-induced neuromuscular block is markedly prolonged during peripheral hypothermia and intense neuromuscular block cannot reliably be assessed using the PTC method at low peripheral temperature.(ABSTRACT TRUNCATED AT 250 WORDS)

Transcutaneous Electrical Nerve Stimulation (TENS) in Raynaud's Phenomenon

Transcutaneous nerve stimulation (TENS) has been described as resulting in vasodilatation. The effect of 2 Hz TENS of the right hand during forty-five minutes on skin temperature and plethysmography of the third digit of both hands and feet and on transcutaneous oxygen tension (TcpO2) of the right hand was compared with that of a control study using indifferent stimulation of the iliopsoas region in 8 patients with primary Raynaud's phenomenon. After TENS a slight increase in skin temperature of both hands was found, while plethysmographic amplitude was increased in the contralateral hand only. No changes in TcpO2 occurred. The authors conclude that the observed small effects of TENS are of no clinical value in primary Raynaud's phenomenon.

RELATIONSHIP BETWEEN BLOOD RADIOIMMUNOREACTTVE BETA-ENDORPHIN AND HAND SKIN TEMPERATURE DURING THE ELECTRO-ACUPUNCTURE INDUCTION OF OVULATION

Thirteen cycles of anovulation menstruation in 11 cases were treated with Electro-Acupuncture (EA) ovulation induction. In 6 of these cycles which showed ovulation, the hand skin temperature (HST) of these patients was increased after EA treatment. In the other 7 cycles ovulation was not induced. There were no regular changes in HST of 5 normal subjects. The level of radioimmunoreactive beta-endorphin (r beta-E) fluctuated, and returned to the preacupunctural level in 30 min. after withdrawal of needles in normal subjects. After EA, the level of blood r beta-E in cycles with ovulation declined or maintained the range of normal subjects. But the level of blood r beta-E in cycles in which the induction failed to cause ovulation was kept higher that that of normal. (P less than 0.05). There was a negative correlation in the decrease of blood r beta-E and increase of HST after EA (r = 0.677, P less than 0.01). EA is able to regulate the function of the hypothalamic-pituitary-ovarian axis. Since a good response is usually accompanied with the increase of HST, monitoring HST may provide a rough but simple method for predicting the curative effect of EA. The role of r beta-E in the mechanism of EA ovulation induction was discussed.

Mental Arithmetic Stress as a Test for Evaluation of Diabetic Sympathetic Autonomic Neuropathy

The effects of a 1-min mental arithmetic stress test on heart rate change were studied in 72 Type 1 diabetic patients, 36 without and 36 with diabetic autonomic neuropathy (mean age 33 and 44 yr, respectively), and in 80 matched normal subjects. Variation in hand skin temperature was also recorded in 25 normal subjects and 30 diabetic patients without and 32 with autonomic neuropathy. While mental arithmetic rapidly reduced skin temperature of normal volunteers and of patients without autonomic neuropathy, no effect was found in autonomic neuropath (a drop of 0.63 +/- 0.05 (+/- SE), 0.52 +/- 0.04 and 0.16 +/- 0.02 degrees C (p less than 0.001), respectively). In control subjects and in diabetic patients without and with autonomic neuropathy the heart rate increase was 22.9 +/- 6.8 (+/- SD), 21.4 +/- 8.4 and 7.0 +/- 3.7 beats min-1, respectively (p less than 0.001). The ratio between maximum mental arithmetic-induced heart rate and basal heart rate was 1.29 +/- 0.10, 1.24 +/- 0.10 and 1.07 +/- 0.05 (p less than 0.001) for healthy subjects, non-neuropathic patients, and neuropathic patients. Cut-off values (the low normal limit for these variables) are proposed: skin temperature 0.23 degrees C, heart rate increase 11.6 beats min-1 and heart rate ratio 1.12. Anxiety state, blood glucose concentration (excluding hypoglycaemia), body position, basal heart rate, and age did not interfere with responses to mental arithmetic stress.

The influence of 0.5 % isoflurane on a vecuronium‐induced neuromuscular blockade

The influence of adding 0.5% isoflurane to a narcotic-based anaesthesia on the duration of effect and recovery time after repetitive administration of vecuronium was studied in ten healthy patients. The twitch response in the adductor pollicis muscle was recorded after supramaximal train-of-four (TOF) stimulation of the ulnar nerve at the wrist. Prior to endotracheal intubation a bolus dose of vecuronium (0.08 mg/kg b.w.) was given. During surgery repeated injections of vecuronium (0.02 mg/kg b.w.) were administered at a TOF ratio of 0.25. Hand-skin temperature, systolic blood pressure, end-tidal CO2 and isoflurane concentrations were continuously monitored. Before and after 90 min administration of isoflurane, the duration of effect was 21 +/- 4 and 24 +/- 5 min (mean +/- s.d., P less than 0.05) respectively. Corresponding recovery times were 270 +/- 60 and 280 +/- 70 s (n.s.). Skin temperature remained unchanged and systolic blood pressure showed only minor variations. The addition of 0.5% isoflurane to a narcotic-based anaesthesia causes a moderate increase in duration of effect but no change in recovery time from a repetitive vecuronium-induced neuromuscular blockade of 0.02 mg/kg.

Rosacea: disturbed defense against brain overheating

Tympanic (Tty), esophageal (Tes), forehead, and hand skin temperatures, as well as the forehead evaporation rate were recorded in six men (four suffering from rosacea and two healthy controls) before, during, and after 1 h of warm bath (38 degrees-39 degrees C). During the last 30 min of the bath, the subject's face was vigorously fanned (14 m/s). Blood flow was explored with ultrasonic Doppler in the emissary veins of the cranium during normothermia before entering the bath, and during hyperthermia just after leaving it. Under normothermic conditions, Tty was higher than Tes in all subjects. In three patients, no blood flow could be detected in the ophthalmic emissary veins whereas in the fourth patient as well as in both control subjects, blood flowed from the intracranium to the face. During hyperthermia, face fanning decreased Tty by 0.25 degrees +/- 0.05 degrees C (+/- SEM) below Tes in the control subjects whereas in all patients Tty remained warmer than Tes by 0.1 degrees C. Doppler recordings showed a rapid inward blood flow from the skin to the brain in the controls during hyperthermia. In patients, however, there was no change from normothermia in the blood flow patterns of vena angularis oculi. Their forehead temperature was permanently higher than in control subjects. Venous blood flow from the skin to the brain appears to be suppressed in rosacea, thus inhibiting selective brain cooling in hyperthermic conditions. The importance of this mechanism in the pathogenesis of rosacea and its significance as a means of investigation are discussed.

The heated dorsal hand vein: an alternative arterial sampling site.

Studies of substrate flux, isotope activity and metabolic balance frequently require arterial sampling. We evaluated: (1) whether substrate concentrations obtained from heated dorsal hand veins (HDHV) were comparable to samples obtained from the radial artery, (2) whether heat sufficient to arterialize HDHV altered contralateral forearm blood flow thus affecting flux calculations, (3) whether a +14 heating pad equaled a cumbersome +700 heating chamber, and (4) whether HDHV showed a dose-response curve to varying heat loads. In 12 normals, dorsal hand temperature was raised from 31.8 +/- 0.6 degrees C to 39.8 +/- 0.8 degrees C (chamber) and 39.3 +/- 0.3 degrees C (pad). Basal contralateral forearm blood flow (3.37 +/- 0.7 ml/100 ml tissue/min) was not significantly altered in the chamber (3.39 +/- 0.5 ml) or the pad (3.44 +/- 0.5 ml). Skin temperature of the unheated hand, an index of superficial blood flow (31.5 +/- 0.7 degrees C) did not change significantly in the chamber (31.6 +/- 0.7 degrees C) or the pad (31.2 +/- 0.7 degrees C). Forearm blood flow did not change with heating in eight postoperative patients. Comparative arterial and HDHV blood gases and 10 metabolic substrates from simultaneously drawn samples at various temperatures showed HDHV PO2 approached but did not equal arterial PO2 at temperatures greater than 39 degrees C. Glucose, amino acid, and substrate concentrations were comparable at 39 degrees C and did not change with increasing temperature. HDHV can reliably determine arterial substrate concentrations using an inexpensive heating pad. In cool environments (20-22 degrees C), contralateral forearm blood flow is not significantly altered. There is no benefit to heating the hand above 39 degrees C.

Effects of intra-arterial ketanserin in Raynaud's phenomenon assessed by 99MTc-pertechnetate scintigraphy

The severity of the peripheral vasopastic condition in 10 patients with Raynaud's phenomenon was investigated using scintigraphy of both hands. 99MTc-pertechnetate was used as a diffusable tracer and scintigrams were recorded with normal hand skin temperature and following immersion of the hands in ice-cold water. Cold provocation resulted in a marked reduction of the rate of blood inflow and tissue perfusion in affected hands. The selective peripheral S2-antagonist ketanserin and placebo were administered intra-arterially according to a double-blind cross-over design. As compared to placebo, ketanserin significantly improved the rate of inflow following cold provocation, and it increased tissue perfusion in the hands of the patients to values normally observed in healthy individuals. The results support the use of ketanserin in the treatment of Raynaud's phenomenon.

Effect of Glove Liners on Sweat Rate, Comfort, and Psychomotor Task Performance

Military subjects participated in a study to evaluate four glove liners worn beneath chemical protective gloves, with regard to sweating of the hands, manual dexterity performance, and perceived comfort in a moderate thermal environment. Although there was a trend for subjects wearing the standard Army liner to experience the lowest sweat rate, the liner effect was not significant due to individual variation. No liner differences were found for manual dexterity performance, hand skin temperature, perceived temperature, and thermal comfort. Differences by liner were found for tactile descriptors used to assess liner comfort. Skin temperature, perceived temperature, and perceived thermal discomfort increased over the duration of the two-hour test, regardless of the liner worn.

Partial Gloves and Reduced Temperatures

When the ambient temperature is below 55°F (12.8°C) and a person's hands have been exposed to that reduced temperature for at least 20 minutes, a person's dexterity performance is reduced. The purpose of this investigation was to evaluate the use of partial gloves in reduced temperatures to determine if the dexterity performance decrement could be significantly abated. The partial gloves used in this study were wool and they allowed the distal and middle phalange to be exposed. Three male and three female subjects performed a variety of tasks at ambient temperatures of 40°F, 50°F and 60°F. The dexterity performance tasks were two pencil-point tapping tasks and the Purdue Pegboard. In addition, grip strength, finger pinch strength, and reaction time tasks were performed. The performance testing was performed at each temperature level with and without the partial gloves. Testing required approximately one hour. The order of the testing was randomized. Hand skin and finger skin temperatures data were collected. Results of the pilot study showed that partial gloves allowed the subjects to maintain warmer finger skin and hand skin temperatures while maintaining the same level of dexterity when compared to conditions and performance without the partial gloves.

Differential efficacy of biofeedback in headache.

SYNOPSISThis paper presents a retrospective study of 84 headache patients seen in the Behavioural Medicine Unit of Sunnybrook Medical Centre, of whom 53 were treated with biofeedback.Of the 84 patients assessed, half were tension headache and half were migraine. Both groups were treated in one of three ways:1. Frontal EMG FB only.2. Hand skin temperature (HST) only.3. EMG FB followed by HST FB.Assessment results showed the migraine group to have longer headache histories and more severe headaches than the tension group. The tension group had significantly higher frontal muscle tension than the migraine group, while the migraine group had significantly colder peripheral hand temperature. No differences were found in psychometric assessment data.EMG feedback results showed significant decreases in frontal EMG for both headache groups. Both groups showed a moderate improvement in headache at the end of treatment.HST feedback treatment results showed significant increases in peripheral temperature and a significant improvement in headache for those migraine patients who achieved a pre‐determined criterion level of performance. Non‐significant increases in skin temperature occurred for the tension headache group. HST feedback after EMG feedback did not provide further improvement for the tension group. The results are discussed in the context of the differential effects of treatment and highlight the importance of a “trials to criterion” training paradigm.

The Use of Touch-Sensitive Human-Computer Interfaces: Behavioral and Design Implications

Interest in optimized human-computer interfaces has resulted in the development of a number of interesting devices that allow the computer and human operator to interact through a common drawing surface. These devices include the lightpen, lightgun (Goodwin, 1975), and a variety of touch-sensitive display overlay devices. Although touch devices were being investigated as early as 1965 (Orr and Hopkin, circa 1966), behavioral and performance data are scarce in relation to other sources of human-machine interface data. Availability of these devices has increased in the last 10 years and it is now possible to retrofit such devices to a wide variety of video display terminals at a reasonable cost. With the possibility of increased use looming on the horizon, it would be quite useful to examine the ergonomics of such devices and the behavioral adaptation or maladaptation that occurs for each user. Performance data available at this point from previous studies suggests that some positive increments in performance can be expected for graphic-based tasks while no serious decrements should be expected for discrete data entry tasks (Beringer, 1980; Stammers and Bird, 1980). The performance gains expected from this format of interaction are not to be won without some sacrifice elsewhere, however. Positioning of the display surface for optimum viewing may cause serious operator fatigue problems after extended use of the device if the device is to be used with relatively high frequency. The relationship of device positioning, device sensing resolution, and task type are being examined as they contribute to the comission of errors and the onset of fatigue. Experimentation was planned to examine how positioning of the device, or what can truly be called a “control/display unit”, affected the performance of visual discrimination tasks and manual designation tasks. Initial investigations used a single task to examine these questions by requiring the operator/subject to visually detect and manually designate the location of a break in one of 54 circles presented on a color c.r.t. display (essentially a Landholt C target). Responses were accepted by an infrared touch panel mounted on the display face. The c.r.t. was placed at four declinations during the blocks of trials; 90, 67, 45, and 35 degrees to the line of sight. Although a very strong learning effect was observed over the first 8 blocks of 25 trials each, performance leveled off, on the average, beginning with the ninth block of trials. No reliable effects of screen declination were found in the examination of response times or number of errors. Responses did tend to be located slightly lower than the target, however, for the greater declinations of the display surface. Subjective reports of physical difficulty of responding and fatigue did vary regularly with declination of the display. The relatively high location of the device resulted in shoulder and arm fatigue when the display was at 90 degrees and wrist fatigue when the display was at 35 degrees. Subsequent phases of the investigation will allow subjects to adjust parameters of height and declination (Brown and Schaum, 1980) and will use hand skin temperature and quantified postural information to assess the degree of fatigue incurred during device operation.

Perception of hand cooling during local cold air exposure at three different temperatures.

The effect of local hand cooling in air on skin temperature, thermal sensation and pain was studied at three different temperatures, 0, 7 and 15°C, in a cooling box. Eighteen subjects were exposed to each local temperature condition for 95 min. The inter-individual variation in cooling reaction was considerable, especially in the two colder conditions. There was, however, a significant individual consistency in reaction between conditions. Initial hand skin temperature, overall body heat balance, time of day of testing and site of temperature measurement are among the factors discussed in relation to the reactions to local hand cooling. The relation calculated between thermal sensation and hand skin temperature appeared consistent and unaffected by local ambient temperature conditions, and thus by the corresponding variation in rate of cooling, within the limited temperature range studied. Similar results were found for the relation between experienced pain and hand skin temperature.

A Basic Study on the Change of the Hand Skin Temperature by a Thermograph to General Cooling under Seasonal Conditions

A Basic Study on the Change of the Hand Skin Temperature by a Thermograph to General Cooling under Seasonal Conditions

Effects of suggestion on increasing or decreasing skin temperature control.

In a 2 x 3 factorial design, 44 college students were assigned the task of either increasing or decreasing their hand skin temperature, receiving either suggestions, pseudo-suggestions, or no suggestions (response-specific instructions only). Subjects receiving suggestions heard imagery phrases related to increasing or decreasing hand skin temperature; subjects in the pseudo-suggestion condition heard phrases related to electronics; subjects in the response-specific condition were told only to increase or decrease their skin temperature prior to training. All subjects participated in three training sessions. Analyses of the third session indicated a significant main effect for temperature direction and a significant interaction effect. A marginally significant main effect for suggestion was obtained. The results suggest that the ability of a subject to regulate hand skin temperature is influenced by the combination of required direction of change and type of suggestion. The data support the notion that pseudo-suggestions may act as a distractor which disrupts the ability of a subject to control hand skin temperature in both the increase and decrease directions.