Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We experienced surgical treatment on two patients having renal cell carcinoma with a tumor thrombus extending into the right atrium. In these patients, we performed nephrectomy, dissection of lymph nodes and removal of a tumor thrombus using cardiopulmonary bypass. One died of multiple organ failure 42 days postoperatively; the other was discharged from the hospital and is currently doing well 12 months after the operation. Cardiopulmonary bypass combined with hypothermia and low blood flow significantly facilitated removal of the tumor thrombus extending into the right atrium without the risk of pulmonary embolism or brisk hemorrhage.
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PMID:Surgical treatment of renal cell carcinoma with a tumor thrombus extending into the right atrium. 235 88

A case of hypopharyngeal lipoma is reported and the fundamental role of C.T. in the diagnosis of laryngo-pharyngeal neoplastic pathologies is emphasized. Laryngoscopy made it quite easy to detect the lesion, showing the smooth surface of a large tumor, although it proved difficult to explore the lower portion because of the narrowing of the larynx. Thermography showed a hypothermia area in the right neck region but did not offer any further information. Only C.T. made correct identification of the site and extension of the lesion possible. It was also possible to identify its fat composition, as suggested by the typical density pattern. The tumor presented a homogeneous hypodense structure and its limits were well defined throughout their entire extension. Furthermore, it was possible to rule out any macroscopic infiltration of the adjacent cartilaginous surfaces of the larynx. The latter feature was confirmed by the C.T. images obtained after intravenous administration of an iodine contrast medium and was consistent with the hypothesis of a benign lesion. Thus the lesion could be considered a lipoma; a highly uncommon non-epithelial tumor of the hypopharyngeal region but which occurs more frequently than liposarcoma. Nonetheless, such C.T. tissue characterization requires histological support so as to prevent distinguishing a well differentiated liposarcoma only after recurrence. The greatest likelihood for accurate diagnosis lies in complete utilization of the data derived from the entire diagnostic procedure. The direct laryngoscopy of the lesion is very important as it makes it possible to inspect the surface and first evaluate any anatomo-pathological alterations. Nonetheless, the most extensive information is provided by C.T.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Lipoma of the hypopharynx: role of computerized tomography in the diagnosis protocol]. 239 26

Concomitant application of hyperthermia, bleomycin and irradiation led to a maximal effect, compared with findings in cells treated with a single or two modalities in vitro. The synergistic effect of the combination with hyperthermia and irradiation was exhibited in all layers of multicellular tumor spheroids (MTS). The combined effects of water-bath hypothermia at 42.5 degrees C for 30 min, 1/10 LD50 bleomycin iv, and 200 rad irradiation were also demonstrated in DDD strain male mice with Ehrlich ascites tumor. According to the results of in vitro and in vivo studies, hyperthermia combined with irradiation and chemotherapy was prescribed for patients with squamous cell carcinoma of the esophagus. The long term results were compared between two groups of patients treated with hyperthermo-chemo-radiotherapy and those treated with chemo-radiotherapy but not hyperthermia. The five year survival rates of patients with resectable carcinoma, given preoperative hyperthermo-chemo-radiotherapy or chemo-radiotherapy were 43.2% and 14.7%, respectively. As severe side effects in patients given hyperthermia were nil, this treatment deserves serious consideration when treating patients with a malignant lesion of the esophagus.
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PMID:[Basic and clinical investigations of the effectiveness of hyperthermia combined with chemotherapy and irradiation in the treatment in patients with esophageal carcinoma]. 248 61

Twenty cases of renal carcinoma with tumor thrombus extending into the vena cava or atrium, in which cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) were used, are reviewed. Arterial, central venous (n = 9), or pulmonary artery catheters (n = 11), ECG, and rectal or bladder and pharyngeal temperatures were used for monitoring. The anesthetic was a high-dose narcotic supplemented with a nondepolarizing relaxant and a volatile agent. The surgery consisted of mobilization of the kidney followed by CPB via atrial and aortic cannulae, cooling via CPB, exsanguination, and removal of thrombus during DHCA. Duration of cooling was 21 +/- 7 minutes to a pharyngeal temperature of 15.8 degrees +/- 2.6 degrees C with alpha-stat pH management; DHCA lasted 26 +/- 10 minutes, and rewarming was continued to a mean pelvic temperature of 36.2 degrees C. Duration of surgery was 8.1 +/- 1.6 hours. The mean initial hematocrit was 33.5%, mean lowest Hct during CPB was 16.9%, and mean Hct at the end of surgery was 30%. Intraoperatively, 9.0 +/- 6.4 units of blood were used, and most patients received component therapy. Average crystalloid use was 7 L, and albumin or hetastarch (1.3 +/- 0.9 L) was used in 13 patients. One patient with severe cardiac disease could not be weaned from CPB. In the 19 operative survivors, there were no neurological deficits. There was one late death from pulmonary complications. The use of thiopental (n = 13), dexamethasone (n = 11), or mannitol (n = 19) was not clearly related to outcome. Hypothermia, hemodilution, alpha-stat pH management, and normoglycemia are believed to be important aspects of perioperative care.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Anesthetic management for surgical removal of renal carcinoma with caval or atrial tumor thrombus using deep hypothermic circulatory arrest. 252 Sep 37

Extension into vena cava and right atrium of tumor thrombus from a renal cell carcinoma presents a surgical challenge. The use of cardiopulmonary by-pass, hypothermia and cardiac arrest with temporary exsanguination has allowed the successful surgical excision of this tumor. During 1986 and 1987 3 patients with cancer of kidney invading the vena cava were operated on with this surgical technique. No deaths occurred. The possibility of curing this type of cancer with minimal operative risk and good results is discussed.
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PMID:Neoplastic thrombosis of the inferior vena cava and right atrium due to kidney cancer. Three surgically treated cases. 260 79

The use of cardiopulmonary bypass, deep hypothermia and circulatory arrest has decreased the risks of hemorrhage, tumor embolization, incomplete thrombus resection, and warm hepatic and renal ischemia associated with resection of renal cell carcinoma extending into the inferior vena cava above the hepatic veins. Patients about to undergo this operation frequently have significant coronary artery and carotid artery disease, and are at risk for perioperative myocardial infarction and stroke. Preoperative evaluation of the coronary artery and carotid artery circulation by coronary angiography, duplex carotid artery scan and digital subtraction carotid angiography is recommended. Depending upon the severity and location of the cardiovascular disease a sequential or simultaneous operation may be performed. This surgical approach can be used in selected patients to facilitate complete tumor thrombectomy with a low operative risk.
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PMID:Cardiovascular evaluation before circulatory arrest for removal of vena caval extension of renal carcinoma. 272 26

With the use of ultrasonography synchronous and asynchronous bilateral renal tumors and tumors in single kidneys are diagnosed more frequently also in the stage I. Organ-preserving operations as partial kidney resection or tumor enucleation combined with contralateral radical nephrectomy are used stage-related successfully. Hypothermia in vivo or ex vivo seems to be advantageous in some cases. The tumor stage (according to Robson) and an optimal operative technique are of significant prognostic importance. In the own material of 15 bilateral renal tumors and 5 tumors in single kidneys only 5 patients do survive currently without tumor signs. The other 15 patients were at the time of operation in the tumor stages III and IV. Therefore, the diagnosis should made earlier, especially by more frequently and qualified ultrasonographic examinations.
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PMID:[Partial kidney resection in kidney tumors--indications and results]. 274 61

A patient with right adrenocortical carcinoma extending into the inferior vena cava and right atrium is presented. Tumor extension was demonstrated by magnetic resonance imaging (MRI) preoperatively. Successful resection of the adrenal tumor and its intravascular extension was achieved with the help of cardiopulmonary bypass and hypothermia. The patient was maintained on mitotane (o,p'-DDD), and was well for 12 months after surgery. It was concluded that intravascular extension of adrenocortical carcinoma is not a contraindication to radical surgery.
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PMID:Right atrial extension of adrenocortical carcinoma. Surgical management using hypothermia and cardiopulmonary bypass. 274 74

The risk of fatal hemorrhage may limit the completeness of resection in hepatic malignancies and in vascular extensions of Wilms' tumors. We have used Ein's technique of deep hypothermia (average 17 degrees C) with cardiac arrest (average 39 minutes) and exsanguination in performing five hepatic and two intravenous Wilms' tumor resections. The initial hepatic resection takes less than 15 minutes to perform in a bloodless field and the specimen is immediately examined by frozen section for determination of adequacy of margin. Additional resection is easily performed. Of four trisegmentectomies and one left lobectomy, two required additional resections. Mattress sutures were used to control hemorrhage during recirculation. One patient died from bleeding and cardiac decompensation and another from recurrence of tumor. The Wilms' tumors extended from the iliac vein into the right atrium in one child and from the right renal vein to the right atrium with extensions into the hepatic and lumbar veins in another. After nephrectomy, the atria and inferior vena cava were opened and the tumor extracted under direct vision. Both patients are well.
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PMID:Extensive tumor resection under deep hypothermia and circulatory arrest. 283 96

1-N,N-bis-(Dichloroethyl)carbamate-delta 9-THC (THC carbamate), a nitrogen mustard analog of delta 9-THC, was recently synthesized as a potential anti-tumor agent. The decrease in spontaneous activity, induction of hypothermia, and the antinociceptive properties of THC carbamate and delta 9-THC were compared. THC carbamate and delta 9-THC were administered by a number of peripheral routes as well as intraventricularly (ivt). THC carbamate lacked cannabinoid activity following peripheral administration, with the exception of iv administration which produced very weak cannabimimetic effects. In contrast, THC carbamate was equipotent to delta 9-THC in reducing rectal temperature by 3 degrees C, and 5 times less active in decreasing spontaneous activity following ivt administration. The apparent lack of central effects following peripheral administration might limit the effectiveness of THC carbamate as an anti-emetic agent, but its use as a site-directed alkylator (a receptor probe) holds promise.
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PMID:Pharmacological profile of delta 9-THC carbamate. 304 25


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