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Effects of stimulation on the ultrastructure and Na, K, Cl composition of the fundus of the rat plantar sweat gland.

Initial stimulation of the rat plantar sweat gland with pilocarpine caused a variable degree of distension of the apical membrane of the secretory cell. This appeared to be a process of filtration of secretory cell cytoplasm through the apical terminal web. Further stimulation resulted in luminal dilatation, cytoplasmic depletion, and morbidity of some cells. These morphological changes in the footpad gland, which thus can no longer be considered as eccrine, were accompanied by a fall in potassium and a rise in sodium concentration within the secretory cells. The mode of secretion induced by pharmacological stimulation was fundamentally the same as that in the glands of species responsive to thermal stimulation.

Animals↗

The effects of thermally-induced activity in vivo upon the ultrastructure and Na, K and Cl composition of the epithelial cells of sweat glands from patients with cystic fibrosis.

The secretory cells of the fundus of sweat glands from cystic fibrosis (CF) patients had higher Na and Cl contents and showed more granule depletion, cellular disruption and dilated intercellular canaliculi than normal. The cells of the coiled duct also had higher cytoplasmic levels of Na and Cl but were structurally normal. Thermal stimulation produced ultrastructural changes in the CF fundus comparable to normal, including further dilatation of the basolateral clefts, but did not induce the marked changes in the coiled duct which normally occur. The elevated Na and fall in K in the fundus and raised Na and Cl in the coiled duct upon activation, were not observed in the CF glands in which no significant changes were detected.

Chlorides↗

Mild cystic fibrosis and normal or borderline sweat test in patients with the 3849 + 10 kb C-->T mutation.

Different mutations in the cystic fibrosis (CF) gene appear to contribute to heterogeneity of the CF phenotype. We investigated 15 patients with CF who have the 3849 + 10 kb C-->T mutation. All were Ashkenazi Jews. Their clinical features were compared with those of CF patients with the delta F508/delta F508, W1282X/W1282X, W1282X/delta F508 mutations, which are known to be associated with a severe disease. Patients with the 3849 + 10 kb mutation were older, had been diagnosed as having CF at a more advanced age, and were in a better nutritional state. Sweat chloride values were normal (below 60 mmol/L) in 5 3849 + 10 kb patients (33%). 4 of these patients and 6 others (total 66%) had normal pancreatic function. However, age-adjusted pulmonary function did not differ between the two groups. None of the patients with 3849 + 10 kb C-->T had had meconium ileus or had liver disease or diabetes mellitus. We conclude that this mutation is associated with a mild type of CF.

Age Factors↗

Formation of inositol polyphosphates in cultured human sweat duct cells in response to cholinergic stimulation.

Inositol phosphate formation in response to cholinergic stimulation was studied in cultured human sweat duct cells, prelabelled with myo-[2-3H]inositol. Formation of inositol mono-, bis-, tris- and tetrakisphosphates was increased after 15 min stimulation by 30 microM carbachol. Formation of inositol 1,3,4-trisphosphate and inositol tetrakisphosphate was significantly increased within 1 min at carbachol concentrations between 10 microM and 100 microM. No detectable increase in inositol 1,4,5-trisphosphate formation was observed at 15 s or 1 min, but an increase was observed after 15 min at a carbachol concentration of 30-100 microM. The data are consistent with an involvement of inositol polyphosphates in the biphasic response of ion transport, to cholinergic stimulation in these cells (see Pederson, P.S. (1986) 6th Professional Conference "Broken Arrow 1986". Genetic and Eptihelial Dysfunction in Cystic Fibrosis (Riordan, J.R. and Buchwalds, M., eds.), Alan Liss, New York and Pedersen, P.S. (1987) Med. Sci. Res. 15, 769-770) and suggest a different pattern of metabolism from exocrine acinar cells.

Calcium↗

A pilot study of a method of estimating the number of functional eccrine sweat glands in irradiated human skin.

Following stimulation with pilocarpine, the secretion from eccrine sweat glands produces characteristic imprints in hardening silicone polymers applied to the skin. This permits an accurate determination of the numerical density of functional eccrine glands in irradiated skin which can be compared to non-irradiated skin. A description of this inexpensive, noninvasive, and quantitative technique is presented as well as preliminary results determined in six normal subjects and 28 irradiated patients. Eleven patients, with atrophy and telangiectasia after radiotherapy to the skin to a high dose, were found to have no functional eccrine glands by this technique. A range of results from normal numbers of eccrine glands through partial and, rarely, complete loss was observed in patients given lower doses and in whom the skin was visually normal. When the irradiated side outside the boost area in 16 breast cancer patients who received postoperative radiotherapy was compared to an equivalent area on the untreated, contralateral side, 11 showed a greater than 50% reduction in the density of functional eccrine glands. The method appears to be a sensitive, quantitative assay for a permanent change in skin and so ought to facilitate meaningful comparison of different regimens of radiotherapy. Further studies are required to determine the dose-response relationship, latency and progression of the observed changes.

Breast↗

Use of bromphenol blue printing method for detecting sweat on the palm.

Sympathetic nerve fibres innervating the sweat glands in the skin are known to accompany sensory nerve fibres closely. Examination of sudorific function, therefore, is a useful aid in making a diagnosis of severed peripheral nerve and also provides valuable information on nerve function in the recovery stage following injury and surgery such as neurorrhaphy. Among the many methods which have been used clinically, the one employing bromphenol blue is thought to be the most simple and accurate.

Bromphenol Blue↗

Calcium-dependent regulation of membrane ion permeability in a cell line derived from the equine sweat gland epithelium.

We measured the rates of 125I- and 86Rb+ efflux from preloaded, cultured equine sweat gland cells. The calcium ionophore ionomycin increased the efflux of both isotopes. Anion efflux was unaffected by Ba2+, but this cation inhibited 86Rb(+)-efflux, suggesting that [Ca2+]i-activated potassium channels were present. Activation of these channels was not, however, important for the efflux of anions. We measured 125I- efflux from valinomycin-depolarised cells in which anion cotransport was inhibited. Changes in 125I- efflux reflect changes in anion permeability under these conditions, and ionomycin caused a clear permeability increase that was abolished by the anion channel blocker diphenylamine-2-carboxylate. ATP and UTP increased the efflux of both isotopes, suggesting that type P2U purine receptors allow these nucleotides to regulate membrane permeability.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗

Excretion of mutagens in sweat from humans treated with anti-neoplastic drugs.

Base substitution mutagens were isolated and concentrated from sweat and urine of 7 patients treated with cyclophosphamide and other antineoplastic drugs. These samples were tested in Salmonella typhimurium TA 1535. The perspiration samples were collected under normal physiological conditions for 8 h after medication and urine samples were collected 8 h after medication. The perspiration samples from the patients were significantly more mutagenic than perspiration samples from the 7 control persons. No correlation was found between the mutagenicity of the perspiration samples and the urine samples.

Antineoplastic Agents↗

Sweat duct carcinoma of lip with multiple cervical lymph nodes metastasis.

Sclerosing sweat duct carcinoma (SSDC) is a rare cutaneous neoplasm. A 28-year-old man presented with 2-3 years history of a tetter on his upper lip, and a 3 cm x 4 cm lymph node was palpable in the left submandibular area. MRI showed a mass in the upper lip extending into the buccal mucosa and orbicular muscle, and multiple cervical lymph nodes metastasis on both sides was suspected. A biopsy was performed to have revealed syringomatous carcinoma. The patient underwent operation of extended removal of the upper lip along with right upper neck dissection and left radical neck dissection. 8 cm x 6 cm sized free forearm flap was used for the reconstruction of the lip. Postoperative course of the patient was uneventful and he has no signs of recurrence so far. Pertinent literatures on this rare tumor are reviewed.

Adult↗

Sweat-gland tumours: a clinical review of cases in one centre over 20 years.

AIMS: Sweat-gland tumours (SGTs) are uncommon, but malignant varieties are very rare. We have added our data on 30 new cases seen at the Royal Marsden NHS Foundation Trust to the published literature, particularly concentrating on clinical issues. We include a literature review. MATERIALS AND METHODS: The Royal Marsden NHS Foundation Trust database was searched for cases of SGT from 1972. Data were collected on all cases, including patient demographics and tumour characteristics, treatment and outcome. RESULTS: Thirty cases were confirmed histologically to be SGTs. Fourteen were malignant, 15 benign and the degree of malignancy in one was histologically indistinguishable. Mean age was 55 years (64 for malignant, 47 for benign tumours). The 15 patients with benign tumours were almost all treated with complete excision. Those with local relapse underwent successful re-excision. Their 5-year disease-free survival was 78% and cause-specific survival was 100%. Twelve of the 14 malignant tumours had localised disease at diagnosis, one had nodal disease and one had metastatic tumour nodules. All except one were treated with wide local excision. The patient with nodal involvement also had a lymph-node dissection. Two received adjuvant radiotherapy to the tumour bed. One received a melphalan limb perfusion. Eight of the 14 had no relapse. Six had locoregional relapse, and four of these also developed distant metastases. Visceral disease was always fatal. Radiotherapy and chemotherapy at relapse were unsuccessful. Five-year disease-free survival was 45%, and cause-specific survival was 57%. CONCLUSION: These rare tumours should be treated initially with complete wide local excision. In malignant tumours, lymph-node involvement is a poor prognostic sign. Wide local excision remains the primary treatment. Adjuvant radiotherapy may be useful in high-risk cases.

Antineoplastic Agents↗

Gustatory sweating in a free flap.

A case of Frey's syndrome arising in a free radial forearm flap used to reconstruct a defect in the parotid region is reported. To our knowledge, Frey's syndrome, although common following parotidectomy, has not been reported in a free flap. It is possible that parasympathetic secretomotor fibres gained access to the fasciocutaneous flap via the cutaneous nerve stumps in its edge, resulting in gustatory sweating.

Carcinoma, Squamous Cell↗

Pseudohypoaldosteronism with increased sweat and saliva electrolyte values and frequent lower respiratory tract infections mimicking cystic fibrosis.

Four patients with severe pseudohypoaldosteronism caused by multiple end-organ resistance to aldosterone had frequently recurring lower respiratory tract infections and persistently elevated sweat and saliva electrolyte values. The increased saliva electrolyte values in these patients probably affect normal mucociliary function in the respiratory tract and facilitate the occurrence of frequent lower respiratory tract involvement. Patients with pseudohypoaldosteronism may require treatment similar to that for cystic fibrosis to prevent long-term respiratory complications.

Aldosterone↗

Immunohistochemical investigations in epidermal Merkel cells--a common phenotype with eccrine sweat gland epithelium.

Mono- and polyclonal antibodies were used for immunofluorescence investigations in cytoskeletal and associated antigens on frozen sections of adult human skin. Epidermal Merkel cells were identified in the stratum basale. Their phenotype was compared with other epithelial cells of human skin. The inner duct epithelium of eccrine sweat glands showed an immunoreactivity similar to that of epidermal Merkel cells. A common origin of both cell types is suggested.

Antibodies↗

Sclerosing sweat duct carcinoma of the eyelid margin: unusual presentation of a rare tumor.

OBJECTIVE: Sclerosing sweat duct carcinoma (SSDC) is a rare, slow-growing, locally invasive skin tumor of eccrine and pilar origin. It is usually located on the face, particularly the upper lip, cheek, and forehead. It has been infrequently reported on the eyelid, secondarily involved from adjacent cheek and brow tumors. Only four previous cases have reported primary eyelid tumors. The authors present four cases of primary eyelid margin involvement, which show the variability in clinical presentations. DESIGN: Retrospective case series. The authors present four case studies of lower eyelid margin tumors diagnosed as SSDC. PARTICIPANTS/METHODS: The history of this recently recognized neoplasm is discussed in relation to the cases presented and the role of the ophthalmologist and pathologist in such cases. RESULTS: Primary SSDC of the eyelid margin is a reportedly rare entity. This particular presentation can occur in all age groups; can mimic benign, acanthotic, or basal cell-like tumors; and is usually misdiagnosed initially. This can lead to a delay in definitive treatment for a tumor that classically presents late in its natural history to health professionals. All eight cases of primary eyelid SSDC now reported in the literature have occurred in the lower lid. CONCLUSION: This rare but aggressive tumor is difficult to diagnose from a simple biopsy and may be more common than previously believed. Initial or early diagnosis is important because of unusually invasive characteristics. Recurrence is common and usually leads to extensive tissue loss via direct invasion or subsequent wide resection. Correct histologic diagnosis at the time of initial tumor removal will likely aid in achieving complete excision with fewer recurrences.

Adult↗

Multiple follicular hamartomas with sweat gland and sebaceous differentiation, vermiculate atrophoderma, milia, hypotrichosis, and late development of multiple basal cell carcinomas.

We describe a 46-year-old woman with multiple symmetrical papulocystic lesions on the face, neck, chest, back, and upper arms since childhood. Vermiculate atrophoderma, entropion, and progressive loss of eyelashes was also noted. Since the age of 30, 12 basal cell carcinomas have developed on the face. Histopathologic examination revealed multiple anastomosing nests and strands that arose from the lower part of a hair follicle in early lesions. In more advanced lesions, multiple keratinizing microcysts within a moderately sclerotic stroma were noted in the upper and mid dermis. In some biopsy specimens, focal areas showing sweat gland (ductal) and sebaceous differentiation were also observed. Basal cell carcinomas developed from the basaloid component of the hamartomatous proliferation.

Atrophy↗

[Simultaneaous bilateral pulmonary metastasectomy of carcinoma of the sweat glands].

A 51-year-old woman with carcinoma of the right axillary sweat glands was treated by radical surgery and radiotherapy. Six years later she developed multiple bilateral lung metastases. Nine nodes were resected from both lungs using a clamshell approach (bilateral transsternal, anterolateral thoracotomy). After surgery, the patient received 6 cycles of adjuvant chemotherapy with cisplatin and 5-fluoruracil. Three years after treatment, no intrathoracic recurrences had occurred and the patient was asymptomatic, with good quality of life.

Adenocarcinoma↗

Hippocampus in relation to mental sweating response evoked by memory recall and mental calculation: a human electroencephalography study with dipole tracing.

Mental-sweating response (MSR) was observed in the palm when the subject was asked to perform a mentally stressful task such as memory recall or mental calculation. About 4 s before the development of MSR, small MSR-related wavelets (MSR wavelets) and large waves were randomly generated on electroencephalograph. After differentiating the two types of waves, we calculated locations of the current dipole of MSR wavelets using the two-dipole model of the SSB/dipole tracing method. The result showed that one current dipole of MSR wavelets was consistently located in the hippocampus while the other dipole was widely dispersed in the cortex during memory recall and mental calculation.

Adult↗