Korean Journal of Anesthesiology

The Korean Society of Anesthesiologists (대한마취통증의학회)
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Cold-stress Test Involving Finger Skin Temperature Measurement for Evaluation of Raynaud's Disease and Nonspecific Cold Sensitive Patients

레이노드질환자와 비특이적 한랭 민감 환자에서의 한냉부하검사의 평가

Kim, Yoon-Sung;Han, Kyung-Ream;Kim, Jin-Soo;Lee, Young-Ju;Kim, Chan
김윤성;한경림;김진수;이영주;김찬

  • Published : 20031100
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Abstract

Background: Cold-stress test is used for the objective diagnosis of Raynaud's disease and phenomenon, and the value of such test based on detection of recovery time of finger skin temperature, finger systolic blood pressure and finger color. We evaluate the finger skin temperature of recovery time after cold-stress test for Raynaud's disease and nonspecific cold sensitive patients. Methods: Thirty-six subjects participated in the study: 9 Raynaud's disease (group 1), 13 nonspecific cold-sensitive patients (group 2) and 14 healthy adults (group 3). Subjects were adapted for 10 min in the test room, temperature 22-24$^{\circ}C$, prior to measurements. Thermistor probe were attached to tips of both middle phalanges. After recording the baseline temperature, both hands were immersed to the level of the wrist in water controlled at 4$^{\circ}C$. After 1 min immersion, both hands were removed from the water, recording the skin temperature at 5 min interval. Results: Group 1 had the two types of recovery pattern. One; group 1 (-) was delayed recovery and the other; group 1 (+) was early recovery and hyperemic response. Group 2 showed delayed recovery. Recovery time to preimmersion temperature in group 3 were 20 min. Conclusions: Unlike results of prior report, some of Raynaud's disease (44%) with typical tricolor change had early recovery and hyperemic response after cold stress test in our study. It is suggested that Raynaud's disease has a different pathophysiology from nonspecific cold-sensitive patients. And appropriate check time is 20 min after cold immersion for the evaluation of vascular dysfunction of cold sensitive patients.

Keywords

References

  1. Allen EV, Brown GE: Raynaud's disease: a critical review of minimal requisites for diagnosis. Am J Med Sci 1932; 183:187-200. https://doi.org/10.1097/00000441-193202000-00004
  2. Loeser JD: Bonica's Management of Pain. 3rd ed. Philadelphia, Lippincott Williams & Wilkins, 2001, pp 604-5.
  3. Virokannas G, Rinatamaki H: Finger blood pressure and rewarming rate for screening and diagnosis of Raynaud's phenomenon in workers exposed to vibration. Br J Ind Med 1991;48: 480-4.
  4. Matoba T, Sakurai T: Physiological methods used in Japan for the diagnosis of suspected hand-arm vibration syndrome. Scand J Work Environ Health 1987; 13: 334-6. https://doi.org/10.5271/sjweh.2045
  5. Leppert J, Aberg H, Ringqvist I, Sorensson S: Raynaud's Phenomenon in a female population: Prevalence and association with other conditions. J Vasc Dis 1987; 12: 871-7.
  6. Maricq HR, Weinridh MC, Keil JE, Leroy EC: Prevalence of Raynaud phenomenon in the general population. J Chron Dis 1986; 39: 423-7. https://doi.org/10.1016/0021-9681(86)90109-8
  7. Mirbod SM, Yosida H, Komura Y, Fujita S, Nagata C, Miyahita K, Inaba R, Iwata H: Prevalence of Raynaud's phenomenon in different groups of workers operating handheld vibrating tools. Int Arch Occup Environ Health 1994; 66: 13-22. https://doi.org/10.1007/BF00386574
  8. Olsen N, Nielsen SL: Prevalence of primary Raynaud phenomena in young females. Scand. J Clin Lab Invest 1978; 37: 761-4.
  9. Maricq HR, Weinrich MC: Diagnosis of Raynaud's phenomenon assisted by color charts. J Rheumatol 1988; 15: 454-9.
  10. Kurozawa Y: Diagnostic value of finger systolic blood pressure in the assessment of vasospastic reactions in the finger skin of vibration-exposes subjects after finger and body cooling. Scand J Work Environ Health 1991; 17: 184-9. https://doi.org/10.5271/sjweh.1712
  11. Ekenvall L, Lindblad LE: Digital blood pressure after local cooling as a diagnostic tool in traumatic vasospastic disease. Br J Ind Med 1982; 39: 388-91.
  12. Harada N: Cold-stress tests involving finger skin temperature measurement for evaluation of vascular disorders in handarm vibration syndrome: review of the literature Int Arch Occup Environ Health 2002; 75: 14-9.
  13. Harada N, Yoshimura M, Laskar MS: A minireview of studies conducted in Japan using finger-skin temperature during coldstress tests for the diagnosis of hand-arm vibration syndrome. Int Arch Occup Environ Health 1999; 72: 330-4. https://doi.org/10.1007/s004200050383
  14. Greenstein D, Gupta NK, Martin P, Walker DR, Kester RC:imparied thermoregulation in Raynaud's phenomenon. Angiology J Vasc Dis 1995; 46: 603-11.
  15. Lindsell CJ, Griffin MJ: Interpretation of the finger skin temperature response to cold provocation. Int Arch Occup Environ Health 2001; 74: 323-35.
  16. Lewis T: Observations upon the reaction of the vessels of the human skin to cold. Heart 1930; 15: 177-208.
  17. LeBlanc JA, Hildes JA, Heroux O: Toleranc${\acute{e}}$ of Gaspefisherman to cold water. J Appl Physiol 1960; 15: 1031-4.
  18. Ashoff J: U ber der k$\ddot{a}$ ltedilation der extremit$\ddot{a}$t des menschen in eiswasser. Plugers Arch 1944; 248: 183-96. https://doi.org/10.1007/BF01751523
  19. Vanggaard L: Physiological reactions to wet cold. Aviat Space Environ Med 1975; 46: 33-6.
  20. Sendowski I, Savourey G, Launay JC, Besnard Y, CottetEmard JM, Pequignot JM, Bittel J: Sympathetic stimulation induced by hand cooling alters cold-induced vasodilatation in humans. Eur J Appl Physiol 2000; 81: 303-9. https://doi.org/10.1007/s004210050047
  21. Cohen RA, Coffman JD: Beta-adrenergic vasodilator mechanism in the finger. Circ Res 1981; 49: 1196-201. https://doi.org/10.1161/01.RES.49.5.1196
  22. Zelis R: Mechnism of vasodilation. Am J Med 1983; 74: 3-12.
  23. Brotzu G, Falchi S, Montisci R, Petruzzo P: Beta-blockers: A new therapeutic approach to Raynaud's disease. Microvasc Res 1987;33: 283-8. https://doi.org/10.1016/0026-2862(87)90023-9
  24. Bierbrauer A von, Schilk I, Lucke C, Schmidt JA: Infrared thermography in the diagnosis of Raynaud's phenomenon in vibration-induced white finger. Vasa 1998; 27: 94-9.
  25. Bovenzi M: Finger thermometry in the assessment of subjects with VWF. Sacnd J Work Environ Health 1987; 13: 348-53. https://doi.org/10.5271/sjweh.2044