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Evaluation of the vasoconstrictor function in the finger tip by cold water immersion test
244 were synchronous in 4. These manometric findings are similar to those found in smooth muscle in achalasia. It is concluded that the dysphagia found in myotonic dystrophic patients seems to be due not only to abnormality in striated muscle functions, but also to an abnormality of smooth muscle, which results in abnormal peristalsis and transit and in functional disturbance of the lower esophageal sphincter. (The Autonomic Nervous System 25: 8-14, 1988)
Evaluation of the vasoconstrictor function in the finger tip by cold water immersion test Masanari K u n i m o t o , Yoshikazu Ugawa, K i y o h a r u lnoue, M a k o t o Iwata and T o r u M a n n e n Department of Neurology, Institute of Brain Research, School of Medicine. University of Tokyo, Japan. The skin temperature during immersion of the second finger in cold water (0 o C) was measured in 20 normal subjects (13 males, 7 females; 21-53 years old), one patient with stetlate ganglion block, two patients with peripheral neuropathy caused by angioitis (vascular neuropathy) and one diabetic patient with hypomyelination neuropathy, in order to study vasoconstrictor functions. The skin temperature was measured with a copper and constantan thermocouple attached to the glabrous side of the second finger tip with adhesive tape. The subjects, lightly dressed, were examined m a warm room without noise (temperature 24-27 o C, humidity 40-60%); they had not taken a bath. or drunken, or exercised within an hour from the examination, and they had rested for 15- 30 rain before the test. The tip of the second finger up to the proximal interphalangeal joint was immersed in the bath with circulating cold water and the skin temperature was measured every 2 s from 2 rain before immersion to 11 rain after the end of the 20-min immersion period. The normal subjects reported cold and pain sensation soon after the immersion and an increasing clinching pain for about 5 rain. Afterwards there was tingling dysesthesia at the finger t i p a n d the most painful site moved to the border zone between water and air. The skin temperature reached its lowest level 8 min after immersion.; then the temperature suddenly increased and throbbing dysesthesia occurred in the immersed part. The dysesthesia turned into a warmth sensation and it brought relief of the pain; the subject experienced no further pain. The skin temperature fluctuated within a small range and recovered rapidly after the end of the immersion. The lowest skin temperature was 0.30 + 1.0 o C in normal subjects. The values from the patient with stellate ganglion block and the two patients with vascular neuropathy were 9.1, 13.1 and 13.2 ° C, respectively. In contrast, a value within the normal range ( - 0 . 4 ° C) was measured in the diabetic patient with hypomyelination neuropathy, where a sural nerve biopsy revealed that all the myelinated fibers had disappeared. The results show that in certain pathological conditions the skin temperature of the immersed finger drops substantially less than in control subjects. The incomplete fall of skin temperature in the patient with stellate ganglion block was probably due to a block of the peripheral sympathetic activity. The occurrence of a normal pattern of temperature drop in the subject with hypomyelination neuropathy suggests that the skin response is due not to myelinated but to unmyelinated fibers. The study of the temperature of the cold-immersed finger provides a useful method for assessing vasoconstrictor functions in human skin. (The Autonomic Nervous System 25: 15-23, 1988)
Evaluation of the vasoconstrictor function in the finger tip by cold water immersion test Masanari K u n i m o t o , Yoshikazu Ugawa, K i y o h a r u lnoue, M a k o t o Iwata and T o r u M a n n e n Department of Neurology, Institute of Brain Research, School of Medicine. University of Tokyo, Japan. The skin temperature during immersion of the second finger in cold water (0 o C) was measured in 20 normal subjects (13 males, 7 females; 21-53 years old), one patient with stetlate ganglion block, two patients with peripheral neuropathy caused by angioitis (vascular neuropathy) and one diabetic patient with hypomyelination neuropathy, in order to study vasoconstrictor functions. The skin temperature was measured with a copper and constantan thermocouple attached to the glabrous side of the second finger tip with adhesive tape. The subjects, lightly dressed, were examined m a warm room without noise (temperature 24-27 o C, humidity 40-60%); they had not taken a bath. or drunken, or exercised within an hour from the examination, and they had rested for 15- 30 rain before the test. The tip of the second finger up to the proximal interphalangeal joint was immersed in the bath with circulating cold water and the skin temperature was measured every 2 s from 2 rain before immersion to 11 rain after the end of the 20-min immersion period. The normal subjects reported cold and pain sensation soon after the immersion and an increasing clinching pain for about 5 rain. Afterwards there was tingling dysesthesia at the finger t i p a n d the most painful site moved to the border zone between water and air. The skin temperature reached its lowest level 8 min after immersion.; then the temperature suddenly increased and throbbing dysesthesia occurred in the immersed part. The dysesthesia turned into a warmth sensation and it brought relief of the pain; the subject experienced no further pain. The skin temperature fluctuated within a small range and recovered rapidly after the end of the immersion. The lowest skin temperature was 0.30 + 1.0 o C in normal subjects. The values from the patient with stellate ganglion block and the two patients with vascular neuropathy were 9.1, 13.1 and 13.2 ° C, respectively. In contrast, a value within the normal range ( - 0 . 4 ° C) was measured in the diabetic patient with hypomyelination neuropathy, where a sural nerve biopsy revealed that all the myelinated fibers had disappeared. The results show that in certain pathological conditions the skin temperature of the immersed finger drops substantially less than in control subjects. The incomplete fall of skin temperature in the patient with stellate ganglion block was probably due to a block of the peripheral sympathetic activity. The occurrence of a normal pattern of temperature drop in the subject with hypomyelination neuropathy suggests that the skin response is due not to myelinated but to unmyelinated fibers. The study of the temperature of the cold-immersed finger provides a useful method for assessing vasoconstrictor functions in human skin. (The Autonomic Nervous System 25: 15-23, 1988)