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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of obstruction of the hepatic inferior vena cava (IVC) are presented. In Case 1, the obstruction was due to a calcified thrombus which presumably developed after lower limb trauma 19 months previously. Complete surgical correction was achieved with the aid of deep hypothermia and circulatory arrest. In Case 2, a right atrial tumor was mimicked by a propagating malignant hepatoma. Palliative removal of the tumor cleared the IVC passage. The etiology of tumors of the IVC and their surgical management are discussed.
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PMID:Surgery of tumors of the subdiaphragmatic inferior vena cava. Report of two cases and review of the literature. 20 34

Hyperthermia is a potent radio enhancer. Studies using hypothermia in combination with irradiation have given confusing results due to lack of uniformity in experimental design. This report shows that hypothermia might have potential significance in the treatment of malignant cells with both thermo- and radiotherapy. Reuber H35 hepatoma cells, clone KRC-7 were used to study the effect of hypothermia on cell kinetics and subsequent response to hyperthermia and/or X rays. Cells were incubated at 8.5 degrees C or between 25 and 37 degrees C for 24 hr prior to hyperthermia or irradiation. Hypothermia caused sensitization to both hyperthermia and X rays. Maximum sensitization was observed between 25 and 30 degrees C and no sensitization was found at 8.5 degrees C. At 25 degrees C maximum sensitization was achieved in approximately 24 hr, cell proliferation was almost completely blocked, and cells gradually accumulated in the G2 phase of the cell cycle. In contrast to the effect of hypothermia on either hyperthermia or X rays alone, thermal radiosensitization was decreased in hypothermically pretreated cells (24 hr at 25 degrees C) compared to control cells (37 degrees C). The expression of thermotolerance and the rate of development at 37 degrees C after an initial heating at 42.5 degrees C were not influenced after preincubation at 25 degrees C for 24 hr. The expression of thermotolerance for heat or heat plus X rays during incubation at 41 degrees C occurred in a significantly smaller number of cells after 24 hr preincubation at 25 degrees C. The enhanced thermo- and radiosensitivity in hypothermically treated cells disappeared in approximately 6 hr after return to 37 degrees C.
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PMID:Effect of hypothermia on cell kinetics and response to hyperthermia and X rays. 397 58

This is a report on a 42-year-old woman with a tumor thrombus in the inferior vena cava and the right atrium caused by recurrent hepatocellular carcinoma. The tumor thrombus, which extended from the retrohepatic inferior vena cava into the right atrium close to the tricuspid valve was successfully resected using a cardiopulmonary bypass and total hepatic vascular exclusion. The cardiopulmonary bypass was established by cannulating the ascending aorta, the superior vena cava and the infrarenal vena cava, and was performed under moderate hypothermia and ventricular fibrillation. To reduce the duration of ventricular fibrillation, after the tumor thrombus had been removed from the right atrium into the suprahepatic inferior vena cava through the atriotomy, the atriotomy was closed. The intrapericardial or suprahepatic vena cava was then clamped. The caval tumor thrombus was removed using the total hepatic vascular exclusion technique through a vena cava incision. To reduce total hepatic vascular exclusion time the suprahepatic vena caval clamp was released after the caval tumor had been removed from the suprahepatic vena caval. The infrahepatic vena cava just below the hepatocaval junction was then clamped and the entire tumor thrombus was removed. The vena caval incision was closed without a prosthesis. The total hepatic vascular exclusion and vena caval exclusion times were 10 and 30 minutes, respectively. The ventricular fibrillation and total cardiopulmonary bypass times were 15 and 52 minutes, respectively. The operating time was 9 hours and 30 minutes and the total blood loss was 4,000 ml.
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PMID:Surgery for tumor thrombi in the right atrium and inferior vena cava of patients with recurrent hepatocellular carcinoma. 805 4

Although the resectability of hepatocellular carcinoma (HCC) has increased due to recent advances in diagnostic methods, the long-term results are far from satisfactory. Major hepatic resection is indicated in patients with noncirrhotic or mildly cirrhotic liver. Otherwise, limited resection should be carried out. Total or lobar hepatic inflow occlusion appears to decrease blood loss during surgery, and therefore to reduce postoperative morbidity and mortality rates. Total vascular exclusion with or without hypothermia may be indicated in selected patients. Hepatic resection is not necessarily contraindicated for HCC with tumor thrombus in the major portal veins, hepatic veins, inferior vena cava, and bile ducts. There are various postoperative complications, especially in cirrhotic patients, but if hepatic failure occurs, it is usually fatal. To prevent this complication, two factors may be most important: avoiding too great a resection and preventing such trigerring factors as hemorrhagic shock, infection, and gastrointestinal bleeding. Favorable prognostic factors are young age, female sex, and low serum AFP clinically, and small tumor, presence of capsule, absence of vascular invasion and/or daughter nodule, diploid or low proliferative tumor, and negative surgical margin pathologically. Increased necroinflammatory activity of the liver irrespective of viral type and hepatitis C virus-associated liver disease are associated with tumor recurrence in the remnant liver. The significance of adjuvant chemotherapy or interferon therapy remains to be elucidated.
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PMID:Liver resection for hepatocellular carcinoma: indications, techniques, complications, and prognostic factors. 968 47

Primary liver cancers are a significant cause of both morbidity and mortality. Although surgical resection remains the treatment of choice for these tumors, only 10 to 20 per cent of the primary liver tumors are found to be resectable. Presently, the options for these patients include liver transplantation, cryosurgery, or nonsurgical therapy, such as transarterial chemoembolization. Techniques such as alcohol injection, interstitial radiotherapy, laser hypothermia, and radiofrequency electrodissection have all been attempted with limited success. We present a case of a 68-year-old woman with a 10-year history of liver cirrhosis secondary to chronic active hepatitis C. A lateral segmentectomy was recommended but could not be done due to severe underlying cirrhosis. Cryosurgery aided by intraoperative ultrasonography was performed successfully. The patient developed recurrent disease at 58 months and died with disease at 62 months. Advances in instrumentation and intraoperative ultrasonography are making cryosurgery a viable surgical therapeutic alternative in the management of patients with unresectable hepatocellular carcinoma. The procedure can be performed safely with low morbidity.
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PMID:Cryosurgery for unresectable primary hepatocellular carcinoma: a case report and review of literature. 1023 Dec 4

Accidental hypothermia has been described in the forensic literature but reports of occurrence in hospitalized patients are rare. Associated anatomic lesions include acute hemorrhagic pancreatitis and characteristic acute gastric ulcers termed Wischnewski ulcers. We report here two patients with cirrhosis and ascites; one also had hepatocellular carcinoma. Portal vein thrombosis, acute hemorrhagic pancreatitis and Wischnewski ulcers were present in both. The clinical records documented hypothermia that progressed over several days. Temperature nadirs of 31.0 degrees C (87.8 degrees F) and 32.2 degrees C (90.0 degrees F) were recorded in each patient, respectively, one day before death, although each transiently reached temperatures that did not register on standard monitoring devices. This is the first report that chronicles antemortem body temperatures in hypothermic patients with Wischnewski ulcers and pancreatitis at autopsy. Also, the association of these findings with portal vein thrombosis and cirrhosis has not been previously described. We discuss this constellation of findings with regard to possible mechanistic interrelations.
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PMID:Wischnewski ulcers and acute pancreatitis in two hospitalized patients with cirrhosis, portal vein thrombosis, and hypothermia. 1048 64

To understand hypothermia as a stress condition we determined the expression and localization of Hsp70 under hyperthermic and hypothermic stress in human hepatoma HepG2 cells. Western blot analysis indicates that there was a statistically significant increase of Hsp70 expression under thermal stresses. Immunohistochemically, the distribution of inducible Hsp70 in stressed cells showed a granular pattern mostly in the cytoplasm. At subcellular level, Hsp70 was localized in the nucleus, vacuoles, cytoskeletal components and dispersed throughout the cytoplasm. Accumulation of Hsp70 in cells under hypothermia could be related to restitution of cell equilibrium modified by this thermal stress condition. The protective effect of hypothermia could be associated with promotion of Hsp expression. We suggest that hypothermia is a stress capable of inducing Hsp70 expression in human HepG2 cells.
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PMID:Is hypothermia a stress condition in HepG2 cells? Expression and localization of Hsp70 in human hepatoma cell line. 1569 77

This paper reports the use of cardiopulmonary bypass with mild hypothermia for the successful en bloc resection of a hepatocellular carcinoma in a cirrhotic liver with a tumor thrombus extending into inferior vena cava (IVC) and to the right atrium (RA), often prolapsing the tricuspid valve. The patient was a 77-year-old woman with antibodies against hepatitis C virus (HCV) and a serum alpha-fetoprotein (AFP) concentration of 13,566ng/mL. Imaging showed a large tumor in the left lobe of the liver extending into the RA, which often was prolapsed the tricuspid valve to produce mitral valve regurgitation. To prevent intraoperative pulmonary thromboembolism, both cardiac arrest and hepatic vascular occlusion with mild hypothermia were applied. The RA and IVC tumor thrombus and left liver were resected in en bloc. The cardiac arrest and hepatic vascular exclusion times were 56 and 15 min, respectively. The operation took 11 h, and the total blood loss was 1,078mL. The resected specimen weighed 1,000g and the tumor measured 8.0 x 7.8cm.
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PMID:Hepatocellular carcinoma with a tumour thrombus extending to the tricuspid valve: report of a successful en bloc resection. 1870 94

We investigated the feasibility of hypothermic- orcryogenically-preserved human hepatoma Hep G2 cell preculturedin 96-well plates in cytotoxicity testings. First, we observedthat microplates precoated with both collagen (CN) and pronectin (PN) showed significantly improved living cell adhesion (71.0 +/- 5.5%) after 48 hr of cryopreservation with 10%-DMSO containing culture medium, whereas non-coated surfaces gave very low living cell adhesion (33.5 +/- 2.1%). Hypothermic preservation was most suitable for short-term storage, and cryogenic preservation at -20 degrees C allowed cells to be used within a week of the storage period. Only cryopreservation in a deep freezer (-85 degrees C) gave satisfactory results in much longer period of storage. Second, we evaluated the cytotoxicity of ten chemicals during 48 hr of exposure using hypothermically - (4 degrees C for 2 days) or cryogenically - (-85 degrees C for 7 days) preserved cells cultured inCN/PN-precoated microplates in comparison with results fromfreshly inoculated cells. Although almost the same LD(50)values were obtained, LD(10) values of relatively hydrophilic chemicals obtained with cryopreserved cell were significantly lowered. These results shown that CN/PN-precoating is effective in keeping cells attached even in recultivation of preserved cells and that the toxicities of relatively hydrophilic chemicals tend to be overestimated when we use preserved cells in that manner.
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PMID:Preservation of microplate-attached human hepatoma cells and their use in cytotoxicity tests. 1900 76

This paper describes a modeling method of the tissue temperature evolution over time in hyper or hypothermia. The tissue temperature evolution over time is classically described by Pennes' bioheat transfer equation which is generally solved by a finite difference method. In this paper we will present a method where the bioheat transfer equation can be algebraically solved after a Fourier transformation over the space coordinates. As an example, we implemented this method for the simulation of a percutaneous high intensity ultrasound hepatocellular carcinoma curative treatment and compared it with the finite difference method and experimental data.
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PMID:Fast FFT-based bioheat transfer equation computation. 2001 77


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