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Query: UMLS:C0009443 (cold)
 92,137 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To determine the importance of different methods of myocardial protection for combined aortic valve replacement and coronary revascularization, we analyzed the records of 82 consecutive patients who underwent the combined procedure between 1973 and 1978. Sixty-three (77%) had angina and 63 (77%) were in New York Heart Association Functional Class III or IV. Moderate to severe left ventricular impairment was present in 59%, and the mean number of diseased vessels was 1.9 per patient. Group I consisted of 18 patients with intermittent ischemia, almost all of whom had operation between 1973 and 1976. Group IIa consisted of 24 patients operated on between 1973 and December, 1976, with coronary perfusion, and Group IIb had 18 patients in whom a similar technique was used in 1977 and 1978. Group III consisted of 22 patients operated on in 1977 and 1978 in whom cold chemical cardioplegia was used. The early mortality (less than 30 days) for Group I was 50% and for Group IIa 29%. There were no deaths in Group IIb and Group III. The incidence of perioperative myocardial infarction was 21% in Group I, 6% in Group IIa, 11% in Group IIb, and zero in Group III. The incidence of cardiogenic shock requiring prolonged inotropic support and intraaortic balloon counterpulsation was significantly less in Group III (9%) than in Group IIb (50%) (p less than 0.05). If other manifestations of myocardial injury, such as perioperative infarction and cardiogenic shock requiring intraaortic balloon counterpulsation or inotropic support, are taken into consideration, cold chemical cardioplegia appears to provide better myocardial protection than coronary perfusion of the fibrillating heart.
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PMID:The importance of myocardial protection in combined aortic valve replacement and myocardial revascularization. 31 12

A comparison of the effectiveness of two renal preservation techniques was studied in 30 cannine renal pairs. In the absence of warm ischemia, 24-hr preservation by pulsatile perfusion was not significantly superior to hypothermic storage. When 15 min of warm ischemia was added as an additional insult, pulsatile perfusion afforded significantly better early function than cold storage. Combinations of pulsatile perfusion and hypothermic storage following 15 min of warm ischemia were superior to hypothermic storage alone, but inferior to pulsatile perfusion. Kidneys initially perfused for 6 hr and then cold-stored functioned slightly better than kidneys perfused for 18 hr after initial cold storage.
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PMID:Twenty-four hour canine renal preservation by pulsatile perfusion, hypothermic storage, and combinations of the two methods. 33 87

Fifty cadaveric kidney donors were randomly allocated to two groups. Group 1 received 5 grams of intravenously administered methylprednisolone two to four hours prior to organ harvesting after the pronouncement of brain death. Group 2, which served as the control group, received no pretreatment. Of 100 kidneys harvested, 16 were discarded for various reasons, and 84 were transplanted and were available for evaluation, 40 from the pretreatment group and 44 from the control group. The transplant centers using these kidneys were unaware of the status of the kidney they received, that is, whether it was from a pretreated or a control group. The two groups of kidneys, pretreated and control, did not differ according to the length of warm or cold ischemia time or presence of preformed cytotoxic antibodies. The difference in graft failure between the two groups at three months was insignificant, even when the two groups were compared according to the method of preservation used.
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PMID:Pretreatment of cadaver donors with methylprednisolone in human renal allografts. 33 44

In 30 human subjects, experimental pain was produced by either ischemia or cold-water immersion. In a double-blind procedure, intravenous doses of up to 10 milligrams of naloxone hydrochloride in saline were indistinguishable from similarly administered saline alone. There were no effects on subjective pain ratings, finger plethysmograph recordings, or responses to mood-state questionnaires. These laboratory procedures do not activate any functionally significant pain-attenuating or mood-altering effect of endorphins.
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PMID:Endorphins: naloxone fails to alter experimental pain or mood in humans. 34 50

Regional and single glomerular blood flow conditions in the transplanted rat kidney after various periods of cold ischemia were investigated with use of the microsphere method. Intravascular injection of a silicon rubber compound (Microfil) allowed identification and sampling of single glomeruli. The periods of ischemia were two hours (minor damage), 12 hr (intermediate damage), and 16 hr (severe damage). After two hours of cold ischemia, the regional and total renal blood flows were fairly normal. After 12 hr and 16 hr of cold ischemia, the total and regional blood flows were reduced five minutes after recirculation, the reduction being pronounced in the deep cortex and juxtamedullary glomeruli. In the 12-hr group, the blood flow showed complete restitution after 65 min, whereas in the 16-hr group, the blood flow in the inner cortex and juxtamedullary glomeruli remained decreased. An impairment of medullary circulation would seem to be an important component in the pathophysiology of acute renal failure in this model.
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PMID:Intrarenal hemodynamics in the transplanted rat kidney. 35 4

Tubular function in the early phase (one to three hours) after transplantation of rat kidneys was analyzed with respect to glomerular filtration, vascular and tubular pressures, and excretory variables. Kidneys exposed to a short period of cold ischemia (two hours) functioned almost normally, except for a polyuria. After 12 and 16 hr of cold ischemia, nephron heterogeneity appeared with 1) "normal" tubules, 2) dilated tubules, and 3) collapsed tubules. In the "normal" tubules, the pressure was increased to 20 mm Hg, and the filtration was reduced in proportion to the mean net driving force. The dilated tubules had no filtration due to a more or less complete tubular obstruction, probably located in the thin loop of Henle and in the collecting ducts. The collapsed tubules had no filtration due to glomerular ischemia, which in turn might be the consequence of afferent arteriolar constriction. The total GFR was greatly reduced since only the "normal" tubules contributed to the total filtration. Concentrating ability and potassium secretion were also impaired. We interpreted this impairment as being due to medullary dysfunction, which would explain the isosthenuria and the impaired potassium transport.
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PMID:Nephron function of the transplanted rat kidney. 35 5

A statistical method which accounts for the heterogeneity of clinical materials is presented and applied to a material of necrokidney transplantations. It is concluded that the recipient sex and the period in which the transplantation was performed are the most important factors (best prognosis for female recipients, best programs for transplantations in the first periods) and that the HLA-match grade has a significant influence on graft survival for male recipients and transplantations with short cold ischemia time. The present analysis has furthermore demonstrate the heterogeneity of the material as judged by the associations between factors and the overestimation of the influence of some of the factors by direct comparisons.
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PMID:The influence of 13 clinical and immunological factors on renal graft survival: a contingency table analysis. 35 1

Shock is defined as a secondary condition constituting a complication to a primary disease of which more than 100 are recorded in the literature. Shock is characterized by prolonged circulatory inadequacy leading to insufficient tissue perfusion and cell death. According to etiology shock is classified into three main groups: hypovolemic, vasogenic and cardiogenic shock. Taking hypovolemic shock as a model the pathgenesis of shock is presented. Hypovolemia acts on the baroreceptors giving rise to a sympatho-adrenal response resulting in increased vasoconstriction, which again leads to viscerocutaneous ischemia. This phase is known as the ischemic anoxic or centralized shock phase. Without treatment this phase develops into the second socalled stagnant anoxic or paralytic shock phase. "Irreversible shock" is discussed. The pathogenesis of vasogenic and cardiogenic shock is mentioned and compared with hypovolemic shock. It is emphasized that the sympatho-adrenal response is the central and common feature in every shock development. Special reference is made to septic shock with its outstanding circulatory conditions (arteriovenous shunting). Lacticacidemia and metabolic acidosis are described as the most important metabolic alterations in shock. With reference to pathenesis the main clinical symptoms of shock are presented: increased heart rate, initially pale later hyperemic, congested and terminally cyanotic mucosae, increased capillary filling time, cold skin and low body temperature. All these signs are related to the sympatho-adrenal response. It is pointed out that the patient in shock is depressed. Inevitably the primary disease will modify the shock symptoms. Hyperemia with edema, hemorrhages and thrombosis in organs and tissues are morphological manifestations of shock. Later microscopically detectable degenerative and necrotic alterations develop, and there are signs of intravascular coagulation (hyaline thrombi and spheres). Due to the rather nonspecific macroscopic alterations a post mortem shock diagnosis necessitates for completion histology and/or a clinical shock diagnosis. Some of the most important shock-provoking primary diseases dealt with in veterinary practice are mentioned along with their possible shock pathogenesis. Referring to the shock pathogenesis the therapy is discussed. The first and indispensable therapeutical measure in treating shock per se is increasing the circulating blood volume, Balanced electrolyte solutions are preferred. Examples of composition, doses (up to 80--200 ml/kg body weight) and infusion rate (initially 15--30 ml/kg body weight during the first 10--20 min., then quantum satis) are given.
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PMID:[Shock. A review (author's transl)]. 38 52

Acute digital ischemia not due to thromboembolism may be the result of either a primary vasospastic disorder (Raynaud's disease, acrocyanosis, livedo reticularis) or vasospasm associated with a systemic, regional, or traumatic disorder (Raynaud's syndrome, cold injury). Raynaud's disease versus syndrome is distinguishable up to 95% of the time from clinical criteria.
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PMID:Vasospastic disorders. 41 23

There are 2 competing methods for cooling the kidney in situ during surgical ischemia: from without by applying ice to the renal surface and from within by perfusing the renal artery. The latter procedure is said to be superior in protecting renal function. Herein the protective effect on renal function of both methods are compared. Pigs of 15--25 kg weight underwent nephrectomy on one side. The remaining kidney was subjected to cold ischemia during 90 minutes while perfusion- or surface cooling was performed. For perfusion cooling the aorta was punctured and the catheter introduced into the renal artery. The perfusing liquid consisted of a physiologic electrolyt solution (Ringer-Lactate) with heparin kept at a temperature of 3--5 degrees C. The initial perfusion lasted 10 minutes and resulted in a median renal core temperature of 23 degrees C. Then the kidney was put on a cooling pad and every 15 minutes again perfused for one minute. For surface cooling sterile melting ice made of glucose solution 5% was applied directly to the kidney. The renal core temperature could be kept at 15--20 degrees C. The two methods of hypothermia were judged by comparing the serum creatinine levels and the I131-hippuran clearances one month after surgery. There was no difference whatever as analysed by the t-test. Hypothermia by applying ice to the renal surface therefore proved to be equivalent to hypothermia by perfusion. Moreover it is much simpler.
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PMID:[Renal hypothermia in situ. Comparison between surface and perfusion cooling concerning renal function in pigs (author's transl)]. 41 41


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