Do chronic primary insomniacs have impaired heat loss when attempting sleep?

For good sleepers, distal skin temperatures (e.g., hands and feet) have been shown to increase when sleep is attempted. This process is said to reflect the body's action to lose heat from the core via the periphery. However, little is known regarding whether the same process occurs for insomniacs. It would be expected that insomniacs would have restricted heat loss due to anxiety when attempting sleep. The present study compared the finger skin temperature changes when sleep was attempted for 11 chronic primary insomniacs [mean age = 40.0 years (SD 13.3)] and 8 good sleepers [mean age = 38.6 years (SD 13.2)] in a 26-h constant routine protocol with the inclusion of multiple-sleep latency tests. Contrary to predictions, insomniacs demonstrated increases in finger skin temperature when attempting sleep that were significantly greater than those in good sleepers (P = 0.001), even though there was no significant differences in baseline finger temperature (P = 0.25). These significant increases occurred despite insomniacs reporting significantly greater sleep anticipatory anxiety (P < 0.0008). Interestingly, the core body temperature mesor of insomniacs (37.0 +/- 0.2 degrees C) was significantly higher than good sleepers (36.8 +/- 0.2 degrees C; P = 0.03). Whether insomniacs could have impaired heat loss that is masked by elevated heat production is discussed.     

Challenging the sleep homeostat does not influence the thermoregulatory system in men: evidence from a nap vs. sleep-deprivation study

The purpose of our study was to understand the relationship between the components of the three-process model of sleepiness regulation (homeostatic, circadian, and sleep inertia) and the thermoregulatory system. This was achieved by comparing the impact of a 40-h sleep deprivation vs. a 40-h multiple nap paradigm (10 cycles with 150/75 min wakefulness/sleep episodes) on distal and proximal skin temperatures, core body temperature (CBT), melatonin secretion, subjective sleepiness, and nocturnal sleep EEG slow-wave activity in eight healthy young men in a "controlled posture" protocol. The main finding of the study was that accumulation of sleep pressure increased subjective sleepiness and slow-wave activity during the succeeding recovery night but did not influence the thermoregulatory system as measured by distal, proximal, and CBT. The circadian rhythm of sleepiness (and proximal temperature) was significantly correlated and phase locked with CBT, whereas distal temperature and melatonin secretion were phase advanced (by 113 +/- 28 and 130 +/- 30 min, respectively; both P < 0.005). This provides evidence for a primary role of distal vasodilatation in the circadian regulation of CBT and its relationship with sleepiness. Specific thermoregulatory changes occur at lights off and on. After lights off, skin temperatures increased and were most pronounced for distal; after lights on, the converse occurred. The decay in distal temperature (vasoconstriction) was significantly correlated with the disappearance of sleep inertia. These effects showed minor and nonsignificant circadian modulation. In summary, the thermoregulatory system seems to be independent of the sleep homeostat, but the circadian modulation of sleepiness and sleep inertia is clearly associated with thermoregulatory changes.     

Medical history of optic chiasm compression in patients with pituitary insufficiency affects skin temperature and its relation to sleep

The hypothalamus is crucially involved in the circadian timing of the sleep-wake rhythm, yet also accommodates the most important thermoregulatory neuronal network. We have shown before that adults with pituitary insufficiency and history of chiasm compression due to a tumor with suprasellar extension fall asleep later and sleep shorter than those without such history and presumed hypothalamic involvement. To solidify the hypothesized link between vigilance and thermoregulation by the hypothalamus, we aimed to test the hypothesis that the presumed hypothalamic impairment in these patients also affects skin temperature and its association with sleep onset. In a case-control study of 50 patients (54.7?±?14.5 yrs of age, 30 males) with pituitary insufficiency, 33 of whom had a history of chiasm compression, ambulatory distal and proximal skin temperatures were assessed continuously for 24?h. Sleep parameters were assessed via questionnaire. Group differences in mean skin temperature, calculated over the wake and sleep periods separately, and group differences in the strength of association between pre-sleep skin temperature and sleep onset latency were compared. Results showed that patients with a medical history of chiasm compression had lower proximal skin temperature during the day (34.1°C?±?.7°C vs. 34.6°C?±?.7°C, p?=?.045). Additionally, the typical association between sleep onset latency and pre-sleep distal-to-proximal skin temperature gradient was absent in these patients (r?=?-.01, p?=?.96), whereas it was unimpaired in those without chiasm compression (r?=?-.61, p?=?.02). Thus, patients with history of chiasm compression show impaired skin temperature regulation in association with disturbed sleep. The findings support the hypothesis that a medical history of chiasm compression affects hypothalamic regulation of both vigilance and temperature, possibly by chronically affecting relevant nuclei, including the ventrolateral preoptic area and anterior hypothalamic preoptic area. (Corresponding Author: n.romeijn@nin.knaw.nl ).     

Thermal regulation and comfort during a mild-cold exposure in young Japanese women complaining of unusual coldness.

We examined body core and skin temperatures and thermal comfort in young Japanese women suffering from unusual coldness (C, n = 6). They were selected by interview asking whether they often felt severe coldness even in an air-conditioned environment (20-26 degrees C) and compared with women not suffering from coldness (N, n = 6). Experiments were conducted twice for each subject: 120-min exposure at 23.5 degrees C or 29.5 degrees C after a 40-min baseline at 29.5 degrees C. Mean skin temperature decreased (P < 0.05) from 33.6 +/- 0.1 degrees C (mean +/- SE) to 31.1 +/- 0.1 degrees C and from 33.5 +/- 0.1 degrees C to 31.1 +/- 0.1 degrees C in C and N during the 23.5 degrees C exposure. Fingertip temperature in C decreased more than in N (P < 0.05; from 35.2 +/- 0.1 degrees C to 23.6 +/- 0.2 degrees C and from 35.5 +/- 0.1 degrees C to 25.6 +/- 0.6 degrees C). Those temperatures during the 29.5 degrees C exposure remained at the baseline levels. Rectal temperature during the 23.5 degrees C exposure was maintained at the baseline level in both groups (from 36.9 +/- 0.2 degrees C to 36.8 +/- 0.1 degrees C and 37.1 +/- 0.1 degrees C to 37.0 +/- 0.1 degrees C in C and N). The rating scores of cold discomfort for both the body and extremities were greater (P < 0.05) in C than in N. Thus the augmented thermal sensitivity of the body to cold and activated vasoconstriction of the extremities during cold exposure could be the mechanism for the severe coldness felt in C.     

Human temperature regulation during narcosis induced by inhalation of 30% nitrous oxide.

The study investigated the effect of inhalation of 30% nitrous oxide (N2O) on temperature regulation in humans. Seven male subjects were immersed to the neck in 28 degrees C water on two separate occasions. They exercised at a rate equivalent to 50% of their maximum work rate on an underwater cycle ergometer for 20 min and remained immersed for an additional 100 min after the exercise. In one trial (AIR) the subjects inspired compressed air, and in the other trial (N2O) they inspired a gas mixture containing N2O (20.93% O2-30% N2O-49.07% N2). Sweating, measured at the forehead, and shivering thermogenesis, as reflected by O2 uptake, were monitored throughout the 100-min recovery period. The threshold core temperatures at which sweating was extinguished and shivering was initiated were established relative to resting preexercise levels. Neither the magnitude of the sweating response nor the core threshold at which it was extinguished was significantly affected by the inhalation of N2O. In contrast, shivering thermogenesis was both significantly reduced during the N2O condition and initiated at significantly lower core temperatures [change in esophageal temperature (delta T(es)) = -0.98 +/- 0.33 degrees C and change in rectal temperature (delta T(re)) = -1.26 degrees C] during the N2O than during the AIR condition (delta T(es) = -0.36 +/- 0.31 degrees C and delta T(re) = -0.44 +/- 0.22 degrees C).(ABSTRACT TRUNCATED AT 250 WORDS)     

Functional link between distal vasodilation and sleep-onset latency?

Thermoregulatory processes have long been implicated in initiation of human sleep. The purpose of this study was to evaluate the role of heat loss in sleep initiation, under the controlled conditions of a constant-routine protocol modified to permit nocturnal sleep. Heat loss was indirectly measured by means of the distal-to-proximal skin temperature gradient (DPG). A stepwise regression analysis revealed that the DPG was the best predictor variable for sleep-onset latency (compared with core body temperature or its rate of change, heart rate, melatonin onset, and subjective sleepiness ratings). This study provides evidence that selective vasodilation of distal skin regions (and hence heat loss) promotes the rapid onset of sleep.     

Differences in the postexercise threshold for cutaneous active vasodilation between men and women

The purpose of this study was to evaluate the possible differences in the postexercise cutaneous vasodilatory response between men and women. Fourteen subjects (7 men and 7 women) of similar age, body composition, and fitness status remained seated resting for 15 min or cycled for 15 min at 70% of peak oxygen consumption followed by 15 min of seated recovery. Subjects then donned a liquid-conditioned suit. Mean skin temperature was clamped at approximately 34 degrees C for 15 min. Mean skin temperature was then increased at a rate of 4.3 +/- 0.8 degrees C/h while local skin temperature was clamped at 34 degrees C. Skin blood flow was measured continuously at two forearm skin sites, one with (UT) and without (BT) (treated with bretylium tosylate) intact alpha-adrenergic vasoconstrictor activity. The exercise threshold for cutaneous vasodilation in women (37.51 +/- 0.08 degrees C and 37.58 +/- 0.04 degrees C for UT and BT, respectively) was greater than that measured in men (37.33 +/- 0.06 degrees C and 37.35 +/- 0.06 degrees C for UT and BT, respectively) (P < 0.05). Core temperatures were similar to baseline before the start of whole body warming for all conditions. Postexercise heart rate (HR) for the men (77 +/- 4 beats/min) and women (87 +/- 6 beats/min) were elevated above baseline (61 +/- 3 and 68 +/- 4 beats/min for men and women, respectively), whereas mean arterial pressure (MAP) for the men (84 +/- 3 mmHg) and women (79 +/- 3 mmHg) was reduced from baseline (93 +/- 3 and 93 +/- 4 mmHg for men and women, respectively) (P < 0.05). A greater increase in HR and a greater decrease in the MAP postexercise were noted in women (P < 0.05). No differences in core temperature, HR, and MAP were measured in the no-exercise trial. The postexercise threshold for cutaneous vasodilation measured at the UT and BT sites for men (37.15 +/- 0.03 degrees C and 37.16 +/- 0.04 degrees C, respectively) and women (37.36 +/- 0.05 degrees C and 37.42 +/- 0.03 degrees C, respectively) were elevated above no exercise (36.94 +/- 0.07 degrees C and 36.97 +/- 0.05 degrees C for men and 36.99 +/- 0.09 degrees C and 37.03 +/- 0.11 degrees C for women for the UT and BT sites, respectively) (P < 0.05). A difference in the magnitude of the thresholds was measured between women and men (P < 0.05). We conclude that women have a greater postexercise onset threshold for cutaneous vasodilation than do men and that the primary mechanism influencing the difference between men and women in postexercise skin blood flow is likely the result of an altered active vasodilatory response and not an increase in adrenergic vasoconstrictor tone.     

Heat balance precedes stabilization of body temperatures during cold water immersion.

Certain previous studies suggest, as hypothesized herein, that heat balance (i.e., when heat loss is matched by heat production) is attained before stabilization of body temperatures during cold exposure. This phenomenon is explained through a theoretical analysis of heat distribution in the body applied to an experiment involving cold water immersion. Six healthy and fit men (mean +/- SD of age = 37.5 +/- 6.5 yr, height = 1.79 +/- 0.07 m, mass = 81.8 +/- 9.5 kg, body fat = 17.3 +/- 4.2%, maximal O2 uptake = 46.9 +/- 5.5 l/min) were immersed in water ranging from 16.4 to 24.1 degrees C for up to 10 h. Core temperature (Tco) underwent an insignificant transient rise during the first hour of immersion, then declined steadily for several hours, although no subject's Tco reached 35 degrees C. Despite the continued decrease in Tco, shivering had reached a steady state of approximately 2 x resting metabolism. Heat debt peaked at 932 +/- 334 kJ after 2 h of immersion, indicating the attainment of heat balance, but unexpectedly proceeded to decline at approximately 48 kJ/h, indicating a recovery of mean body temperature. These observations were rationalized by introducing a third compartment of the body, comprising fat, connective tissue, muscle, and bone, between the core (viscera and vessels) and skin. Temperature change in this "mid region" can account for the incongruity between the body's heat debt and the changes in only the core and skin temperatures. The mid region temperature decreased by 3.7 +/- 1.1 degrees C at maximal heat debt and increased slowly thereafter. The reversal in heat debt might help explain why shivering drive failed to respond to a continued decrease in Tco, as shivering drive might be modulated by changes in body heat content.     

Changes in thermal insulation during underwater exercise in Korean female wet-suit divers

The present work was undertaken to examine the effect of wet suits on the pattern of heat exchange during immersion in cold water. Four Korean women divers wearing wet suits were immersed to the neck in water of critical temperature (Tcw) while resting for 3 h or exercising (2-3 met on a bicycle ergometer) for 2 h. During immersion both rectal (Tre) and skin temperatures and O2 consumption (VO2) were measured, from which heat production (M = 4.83 VO2), skin heat loss (Hsk = 0.92 M +/- heat store change based on delta Tre), and thermal insulation were calculated. The average Tcw of the subjects with wet suits was 16.5 +/- 1.2 degrees C (SE), which was 12.3 degrees C lower than that of the same subjects with swim suits (28.8 +/- 0.4 degrees C). During the 3rd h of immersion, Tre and mean skin temperatures (Tsk) averaged 37.3 +/- 0.1 and 28.0 +/- 0.5 degrees C, and skin heat loss per unit surface area 42.3 +/- 2.66 kcal X m-2 X h. The calculated body insulation [Ibody = Tre - Tsk/Hsk] and the total shell insulation [Itotal = (Tre - TW)/Hsk] were 0.23 +/- 0.02 and 0.5 +/- 0.04 degrees C X kcal-1 X m2 X h, respectively. During immersion exercise, both Itotal and Ibody declined exponentially as the exercise intensity increased. Surprisingly, the insulation due to wet suit (Isuit = Itotal - Ibody) also decreased with exercise intensity, from 0.28 degrees C X kcal-1 X m2 X h at rest to 0.12 degrees C X kcal-1 X m2 X h at exercise levels of 2-3 met.(ABSTRACT TRUNCATED AT 250 WORDS)     

Phenotypic effects of thermal mean and fluctuations on embryonic development and hatchling traits in a lacertid lizard, Takydromus septentrionalis

How fluctuating temperatures influence reptilian embryos and hatchlings has attracted increasing scientific attention, but is poorly known. We conducted an incubation experiment with a factorial design of two mean temperatures (24 vs. 28 degrees C) and three diel thermal fluctuations (0, +/-3, +/-6 degrees C) to determine the effects of diel thermal fluctuations and mean temperature on incubation duration and hatchling phenotypes. Both diel thermal fluctuations and mean temperature significantly affected incubation duration, but not hatching success. Incubation duration increased with increasing temperature fluctuations at a mean temperature of 24 degrees C, but not at a mean temperature of 28 degrees C. The significant interaction between diel thermal fluctuations and mean temperature on hatchling morphology indicated that the effect of thermal fluctuations depended on the mean temperature. Hatchling mass differed significantly between 24+/-6 and 28+/-6 degrees C, but not between the two constant temperatures or the temperatures with +/-3 degrees C fluctuations. At a mean temperature of 24 degrees C, the effect of thermal fluctuations on hatchling size was marginally significant, with relatively large hatchlings at the constant temperature; at a mean temperature of 28 degrees C, thermal fluctuations had no impact on hatchling size. The locomotor performances were significantly affected by mean temperature rather than diel thermal fluctuations. Therefore, diel thermal fluctuations around a given mean temperature do not affect hatchling phenotypes in a relatively large magnitude, but the influence of diel thermal fluctuations may differ with changing mean temperatures.     

A comparison of the immediate effects of moderate exercise in the late morning and late afternoon on core temperature and cutaneous thermoregulatory mechanisms

Twelve healthy male subjects each undertook two bouts of moderate exercise (70% VO2max for 30 minutes) in the morning (08:00) and late afternoon (18:00) at least 4 days apart. Measurements were made of heart rate, core (rectal) temperature, sternum skin temperature, and forearm skin blood flow during baseline conditions, during the bout of exercise, and throughout a 30-minute recovery period. Comparisons were made of the changes of heart rate, temperature, and skin blood flow produced by the exercise at the two times of day. Student t tests indicated that baseline values for core temperature (37.15 degrees C +/- 0.06 degrees C vs. 36.77 degrees C +/- 0.06 degrees C) and sternum temperature (33.60 degrees C +/- 0.29 degrees C vs. 32.70 degrees C + 0.38 degrees C) were significantly (p < .05) higher in the late afternoon than the early morning. Two-way analysis of variance (ANOVA) indicated that the increases in core and sternum temperatures during exercise were significantly less (p = .0039 and .0421, respectively) during the afternoon bout of exercise compared with the morning, even though the work loads, as determined by changes in heart rate, were not significantly different (p = .798) at the two times of testing. There were also tendencies for resting forearm skin blood flow to be higher in the afternoon than in the morning and for exercise to produce a more rapid rise in this variable in the afternoon. The possible mechanisms producing these responses to exercise are discussed in terms of those that are responsible for the normal circadian rhythm of core temperature. It is concluded that the body's ability to remove a heat load is less in the early morning, when the circadian system is in a "heat gain" mode, than in the late afternoon, when heat gain and "heat loss" modes are balanced more evenly.     

Effects of hypothermia on rat brain pHi and phosphate metabolite regulation by 31P-NMR

The effects of arterial alphastat regulation on brain intracellular pH (pHi) and several phosphate metabolites were assessed in anesthetized rats during hypothermia (28.6 +/- 0.2 degrees C) and normothermia (36.2 +/- 0.2 degrees C) by using 31P high-field (8.5 T) nuclear magnetic resonance (NMR). There were significant differences in pHi and metabolite ratios at the two temperatures under conditions of equal minute ventilation. During hypothermia, the brain pHi was 0.09 U higher, the phosphocreatine-to-inorganic phosphate (PCR/Pi) ratio 49% larger, and Pi-to-ATP 20% lower than at normothermia. These changes were fully reversible on warming the animal. The change in brain pHi/temperature was -0.011U/degrees C (95% confidence interval -0.007 to -0.016). The brain's ability to regulate its pHi and phosphate metabolism during hypercapnic acid-base stress was studied by using 10% CO2 ventilation. Hypothermic rats showed a larger fall in brain pHi (0.145 +/- 0.01 U, 7.15-7.01) with 10% CO2 than normothermic rats (0.10 +/- 0.02 U, 7.06-6.96). Similarly ventilated rats had a larger fall in arterial pH with 10% CO2 at hypothermia (0.36 +/- 0.04 U) than normothermia (0.24 +/- 0.01 U), so the delta brain pH/delta arterial pH was the same at both temperatures. The brain PCr-to-Pi ratio decreased approximately 20% during 10% CO2 breathing in both hypothermic and normothermic animals. Brain pHi and metabolite ratios returned to base line 30-50 min after CO2 washout in both groups. In summary, lowering body temperature while maintaining constant ventilation leads to changes in brain pHi and metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)     

Relationships between the circadian rhythms of finger temperature, core temperature, sleep latency, and subjective sleepiness

Skin temperature circadian rhythms have been explored relatively recently. It has been suggested that distal and proximal skin temperature changes play a role in the regulation of the core temperature circadian rhythm and sleepiness. The authors investigated the circadian finger and core temperature rhythms in conjunction with the circadian rhythms of subjective and objective sleepiness. Fourteen healthy, young, good sleepers participated in a modified constant-routine procedure in which palmar finger temperature, rectal temperature, subjective sleepiness, and objective sleep latency were measured half-hourly across a 48-h period of enforced wakeful bed rest. Individual curves were adjusted to the group mean temperature minimum time of 0500 h and averaged to create the 4 mean curves. The 5 possible cross-correlation curves between these 4 measures were calculated for half-hourly phase lags from 12 h before to 12 h after the group mean core temperature minimum time. Maximum cross-correlations for each curve suggested that finger temperature preceded core temperature by 3 h (r = -0.22), and subjective sleepiness followed core temperature by 0.5 h (r = -0.33) and objective sleepiness by 2 h (r = 0.29). Although these data are correlational, they are consistent with the notion that finger temperature changes drive core temperature changes, which determine changes of subjective and objective sleepiness.     

Fat energy use and plasma lipid changes associated with exercise intensity and temperature

The effect of 60 min of exercise at two intensities (50 and 60% VO2max) and temperatures (0 and 22 degrees C) on changes (delta) in plasma lipids [triglycerides (TG), glycerol (GLY), total cholesterol (TC), and HDL-cholesterol (HDL-C)] was examined. Subjects were 10 men aged 27 +/- 7 years (VO2max = 3.81 +/- 0.45 1 min, % fat = 12.2% +/- 7.1%). VO2 and respiratory exchange ratio results indicated that total energy and fat energy use were similar at the two temperatures. Changes in plasma volume (%delta PV) were different (P less than 0.05) at the two temperatures (22 degrees C: -2.3% vs 0 degrees C: 1.1%). Combining the data at each temperature revealed that the increases in concentrations were greater (P less than 0.05) at 22 degrees C (delta TG = 0.22, delta GLY = 0.20, delta TC = 0.14, delta HDL-C = 0.05 mmol l-1) vs 0 degrees C (delta TG = 0.10, delta GLY = 0.12, delta TC = 0.05, delta HDL-C = 0.02 mmol l-1). Combining the data for each intensity revealed that the increases in concentration were greater (P less than 0.05) at 60% VO2max for delta TG and delta HDL-C. The 60% VO2max/22 degrees C bout produced greater changes (P less than 0.05) than all other bouts for delta TC and delta HDL-C (0.21 and 0.08 mmol l-1, respectively). Only delta TG and delta GLY were greater at 22 degrees C when adjusted for %delta PV. These metabolic and plasma lipid results indicate that cold exposure does not act synergistically with exercise to further stimulate fat metabolism.     

Cutaneous and subcutaneous blood flow during general anaesthesia

The vasodilator effect of anaesthetic agents on cutaneous vessels has often been investigated. In contrast, although subcutaneous tissue is concerned with metabolism and thermoregulation, the effects of anaesthesia on subcutaneous blood flow have not been well documented. The purpose of this study was to determine the magnitude of changes in cutaneous and subcutaneous blood flow during general anaesthesia in Man. Anaesthesia was induced with flunitrazepam in 15 patients before facial plastic surgery. Blood flow was estimated using heat thermal clearance (HC). Two HC sensors in different areas allowed the measurement of superficial and deep HC. Systolic (SABP), diastolic (DABP) and mean arterial blood pressure (MABP), heart rate (HR), and rectal and mean skin temperature were also recorded. After induction of anaesthesia, HR increased significantly (p less than 0.05) whereas SABP, DABP and MABP remained unchanged. The rectal-toe temperature gradient fell from 6.3 +/- 4.1 degrees C to 3.4 +/- 1.1 degrees C (p less than 0.01) suggesting a reduction in vasomotor tone. Superficial HC increased from 0.37 +/- 0.06 to 0.42 +/- 0.08 W.m-1.degrees C-1 (p less than 0.05) whereas deep HC decreased from 0.33 +/- 0.07 to 0.31 +/- 0.09 W.m-1.degrees C-1 (NS) and returned to the control value thereafter. Rectal temperature and mean skin temperature were unchanged. The changes in deep HC are similar to those previously observed in muscle during induction of anaesthesia. Our results show that anaesthesia mainly affects cutaneous blood flow, without any significant change in subcutaneous blood flow during the early phase of anaesthesia in human beings.     

Muscle and femoral vein temperatures during short-term maximal exercise in heart failure

Core temperature decreases throughout short-term maximal exercise in heart-failure patients. To investigate possible causes for this unusual response to exercise, we studied core (pulmonary arterial blood), femoral vein, muscle, and skin temperatures in eight patients with severe heart failure who performed maximal upright incremental bicycle exercise to 50 W. A normal group (n = 4) was exercised for comparison. In the heart-failure patients, core temperature was 36.95 +/- 0.37 degrees C at rest, significantly (P less than 0.05) decreased at 25 W of exercise to 36.59 +/- 0.40 degrees C, and at 50 W remained decreased to 36.57 +/- 0.40 degrees C. In comparison, we found that the resting core temperature in the normal subjects was 37.28 +/- 0.34 degrees C, was the same at 25 W (37.29 +/- 0.41 degrees C), and increased significantly (P less than 0.05) to 37.50 +/- 0.32 degrees C at 50 W of exercise. Femoral vein temperature in heart-failure patients (n = 6) was below core temperature throughout exercise to 25 and 50 W (36.22 +/- 0.62 and 36.34 +/- 0.65 degrees C, respectively). Muscle temperature (n = 7) was significantly (P less than 0.05) lower in the heart-failure patients (34.8 +/- 1.1 degrees C) at rest compared with the normal subjects (36.2 +/- 1.0 degrees C). During exercise, muscle temperature increased above core temperature in only four of the heart-failure patients and was significantly (P less than 0.05) lower (36.5 +/- 1.3 degrees C) compared with the normal subjects (38.0 +/- 0.2 degrees C).(ABSTRACT TRUNCATED AT 250 WORDS)     

The effects of lowered temperature on spontaneous eye movements in a teleost fish

A new opto-electronic method has been used to measure spontaneous eye movements in a lightly restrained unanaesthetized marine teleost fish (Parore). The normal scanning pattern of eye movement is similar to that previously described in goldfish. The effects of cooling on eye movements were investigated by 2 degrees C step changes down from ambient temperature (13-14 degrees C). Lowered temperature altered the scanning pattern, decreased saccade velocity, increased mean saccade amplitude and impaired the ability of the fish to hold the eye stationary between saccades. All eye movements stopped at temperatures around 6 degrees C, but could be restored by subsequent warming.     

Prediction of mean skin temperature in warm environments

The data collected by the authors in four experimental series have been analysed together with data from the literature, to study the relationship between mean skin temperature and climatic parameters, subject metabolic rate and clothing insulation. The subjects involved in the various studies were young male subjects, unacclimatized to heat. The range of conditions examined involved mean skin temperatures between 33 degrees C and 38 degrees C, air temperatures (Ta) between 23 degrees C and 50 degrees C, ambient water vapour pressures (Pa) between 1 and 4.8 kPa, air velocities (Va) between 0.2 and 0.9 m.s-1, metabolic rates (M) between 50 and 270 W.m-2, and Clo values between 0.1 and 0.6. In 95% of the data, mean radiant temperature was within +/- 3 degrees C of air temperature. Based on 190 data averaged over individual values, the following equation was derived by a multiple linear regression technique: Tsk = 30.0 + 0.138 Ta + 0.254 Pa-0.57 Va + 1.28.10(-3) M-0.553 Clo. This equation was used to predict mean skin temperature from 629 individual data. The difference between observed and predicted values was within +/- 0.6 degrees C in 70% of the cases and within +/- 1 degrees C in 90% of the cases. It is concluded that the proposed formula may be used to predict mean skin temperature with satisfactory accuracy in nude to lightly clad subjects exposed to warm ambient conditions with no significant radiant heat load.     

Water warming garment versus forced air warming system in prevention of intraoperative hypothermia during liver transplantation: a randomized controlled trial [ISRCTN32154832

BACKGROUND: The authors compared two strategies for the maintenance of intraoperative normothermia during orthotopic liver transplantation (OLT): the routine forced-air warming system and the newly developed, whole body water garment. METHODS: In this prospective, randomized and open-labelled study, 24 adult patients were enrolled in one of two intraoperative temperature management groups during OLT. The water-garment group (N = 12) received warming with a body temperature (esophageal) set point of 36.8 degrees C. The forced air-warmer group (N = 12) received routine warming therapy using upper- and lower-body forced-air warming system. Body core temperature (primary outcome) was recorded intraoperatively and during the two hours after surgery in both groups. RESULTS: The mean core temperatures during incision, one hour after incision and during the skin closing were significantly higher (p < 0.05, t test with Bonferroni corrections for the individual tests) in the water warmer group compared to the control group (36.7 PlusMinus; 0.1, 36.7 PlusMinus; 0.2, 36.8 PlusMinus; 0.1 vs 36.1 PlusMinus; 0.4, 36.1 PlusMinus; 0.4, 36.07 PlusMinus; 0.4 degrees C, respectively). Moreover, significantly higher core temperatures were observed in the water warmer group than in the control group during the placement of cold liver allograft (36.75 PlusMinus; 0.17 vs 36.09 PlusMinus; 0.38 degrees C, respectively) and during the allograft reperfusion period (36.3 PlusMinus; 0.26 vs 35.52 PlusMinus; 0.42 degrees C, respectively). In addition, the core temperatures immediately after admission to the SICU (36.75 PlusMinus; 0.13 vs 36.22 PlusMinus; 0.3 degrees C, respectively) and at one hr (36.95 PlusMinus; 0.13 vs 36.46 PlusMinus; 0.2 degrees C, respectively) were significantly higher in the water warmer group, compared to the control group, whereas the core temperature did not differ significantly afte two hours in ICU in both groups. CONCLUSIONS: The investigated water warming system results in better maintenance of intraoperative normothermia than routine air forced warming applied to upper- and lower body.     

Venous return from distal regions affects heat loss from the arms and legs during exercise-induced thermal loads

To study the role of venous return from distal parts of the extremities in influencing heat loss from the more proximal parts, changes in mean skin temperature (Tsk) of the non-exercising extremities were measured by color thermography during leg and arm exercise in eight healthy subjects. Thirty minutes of either leg or arm exercise at an ambient temperature (Ta) of 20 degrees C or 30 degrees C produced a greatly increased blood flow in the hand or foot and a great increase in venous return through the superficial skin veins of the extremities. During the first 10 min of recovery from the exercise, blood flow to and venous return from the hand or foot on the tested side was occluded with a wrist or ankle cuff at a pressure of 33.3 kPa (250 mm Hg), while blood flow to the control hand or foot remained undisturbed. During the 10-min wrist occlusion, Tsk increased significantly from 28.3 degrees +/- 0.41 degrees C to 30.1 degrees +/- 0.29 degrees C in the control forearm, but remained at nearly the same level (28.0 degrees +/- 0.34 degrees C to 28.2 degrees +/- 0.25 degrees C) in the occluded forearm. In the legs, although Tsk on both sides was virtually identical (32.0 degrees +/- 0.31 degrees C, control vs 32.0 degrees +/- 0.36 degrees C, tested) before occlusion, Tsk on the control side (32.6 degrees +/- 0.27 degrees C) was significantly higher than that on the tested side (32.2 degrees +/- 0.21 degrees C) after ankle occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)