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

We report two cases of complex renal carcinoma in which retrograde transvenous perfusion cooling (RTPC) of the kidney was used as adjunct to in situ partial nephrectomy. Definite advantages seem to favour this technique of regional renal hypothermia. We are hopeful that RTPC of the kidney will in future allow to reduce the frequency of potentially harmful extracorporeal bench surgery with autotransplantation in the conservative management of renal carcinoma. Renal RTPC is applicable whenever the kidney is approached transperitoneally with preliminary exposure of the renal vascular pedicle. Tumour cell spill has to be discussed as possible complication of this method. Both patients are alive 25 and 19 months, respectively, after surgery without evidence of haematogenous, peritoneal or retroperitoneal tumour disease.
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PMID:Retrograde transvenous perfusion cooling of the kidney, a valuable adjunct to in situ partial nephrectomy in complex renal cell carcinoma. First clinical results. 317 Jan 3

This report describes our experience in five cases, removing a massive soft tissue tumor by means of placing the patient on cardiopulmonary bypass, with profound hypothermia and circulatory arrest. This technique allowed consideration to be given to the resection of tumors previously adjudged "inoperable."
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PMID:The use of cardiopulmonary bypass and circulatory arrest in the resection of massive tumors. 317 52

Cardiopulmonary bypass, hypothermia, temporary cardiac arrest and exsanguination represent the next logical step in the evolutionary management of intracaval neoplastic extension with renal cell carcinoma. This method of management provides control of the circulation of the entire body and allows for careful dissection in a bloodless field with less risk of embolization. From 1981 to 1986, 15 patients were treated with intracaval neoplastic extension of renal cell carcinoma above the level of the most inferior hepatic veins. In 6 patients mobilization of the vena cava with division of the hepatic veins to the caudate lobe allowed excision of the tumor and tumor thrombus without cardiopulmonary bypass (group 1). The remaining 9 patients underwent cardiopulmonary bypass and hypothermia (group 2). There was 1 postoperative mortality in the entire group. Most patients had advanced regional disease but the feasibility of this technique has been demonstrated. Survival appeared to be less in the bypass group. Although some of the patients have had metastatic disease, the quality of life and survival have been prolonged in many of these acutely ill patients.
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PMID:Surgical management of renal cell carcinoma with intracaval neoplastic extension above the hepatic veins. 337 79

Endotoxin-induced tumor necrosis has been shown to be mediated by a factor termed tumor necrosis factor (TNF). The biochemical nature, source, and mode of induction of TNF have been clarified. TNF is a mediator of activated macrophages that is released into the supernatant by these cells after their stimulation with endotoxin. A number of biologic functions of TNF other than its tumoricidal activity have been demonstrated. In vivo, TNF induces reactions similar to those induced by endotoxin. Hypothermia, elevated hematocrit and plasma lactate levels, and reduced plasma glucose levels have been measured in mice injected with TNF. These reactions typically occur soon after endotoxin injection and are induced with purified recombinant TNF in mice that exhibit a low response to endotoxin. No TNF-induced production of interleukin 1 (which can induce similar effects) was detected in macrophage/monocyte cultures. Therefore, TNF appears to mediate endotoxin effects directly.
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PMID:Tumor necrosis factor: a cytokine involved in toxic effects of endotoxin. 350 Apr 95

Although there has been dramatic progress in radiotherapy for several tumor types during the last decades, it cannot be overlooked that the overall success is far from being satisfactory. Since in the course of their disease, radiotherapy is indicated for more than two-thirds of cancer patients, improvement of treatment results become of great health-political importance. As a rule a successful procedure can be realized only, if radiotherapy is integrated into the multidisciplinary overall concept of cancer treatment and the patients will receive optimal attention in diagnosis, therapy and after-care in centralized oncological institutions. Based on the principle of individualized cancer therapy, possibilities are outlined to improve quality in carrying out the different steps of the process of radiotherapy. Special importance is attached to measures of the modification of the radiation effect. In particular, scientific tackle of questions of dose fractionation, the use of neutron therapy as well as radiosensitizers and protectors and of local hypothermia are considered starting points for further improvement of radiotherapeutic results. In addition to these problems, topical research tasks are outlined.
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PMID:[A review. Current problems of experimental and clinical radiotherapy]. 355 69

Administration of high-dose uridine or cytidine (3500 mg/kg) resulted in severe hypothermia of 6-10 degrees C in mice. This effect of uridine was observed in three different mouse strains, C57B1/6, Balb/c, and Swiss. A high-dose of uridine also caused hypothermia in Wistar rats. Co-infusion of uridine with benzylacyclouridine, an inhibitor of uridine phosphorylase, partially prevented uridine-mediated hypothermia in mice. A low dose of uridine (100 mg/kg) resulted in a slight increase in temperature. Plasma pharmacokinetics of uridine (at 3500 mg/kg) were studied in two mouse strains, C57B1/6 and Balb/c, and those of cytidine only in C57B1/6 mice. Peak plasma concentrations of uridine in both strains after uridine administration were about 20 mM (at 30-60 min). The peak plasma concentration of cytidine in C57B1/6 mice after cytidine administration was about 12 mM and that of uridine, 1.3 mM. The mean residence time for uridine was about 105 min. The area under the plasma concentration-time curve for uridine was about 50 mmol h/l, and that for cytidine, about 25 mmol h/l. In various tissues of C57B1/6 mice the levels of uridine, uracil and total uracil and cytosine nucleotide pools were determined before and 2 h after uridine administration. Uridine levels increased about 53-fold in liver, about 70-fold in a colon tumor, and only about 7-fold in brain, while the corresponding uracil levels increased about 9-fold, 4-fold and 11-fold, respectively. Total uracil nucleotide pools increased about 8-fold, 3.2-fold and 1.6-fold, respectively. Cytosine nucleotide pools did not increase in the brain. In conclusion, high-dose uridine administration caused severe hypothermia. Plasma levels of uridine and uracil were enhanced to a considerably higher extent than the levels in the tissues. The hypothermia might be related to breakdown products of uridine, since inhibition of uridine breakdown partially prevented hypothermia and since in brain uracil nucleotide levels were only slightly increased after uridine administration, while those of uracil were more markedly increased than in other tissues.
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PMID:Uridine-induced hypothermia in mice and rats in relation to plasma and tissue levels of uridine and its metabolites. 366 29

The authors report a case of right renal carcinoma with a supradiaphragmatic vena cava thrombus. The patient presented to the emergency ward with a severe pulmonary embolus managed by fibrinolytic treatment. After alcohol embolization of the tumor, the patient underwent a right radical nephrectomy with cavectomy. A large tumor extending to the heart was removed by cardiopulmonary bypass combined with hypothermia and cardiac arrest. The immediate postoperative course was satisfactory. Eighteen months later, a CT scan revealed a suprarenal growth. A cytological study was performed on a specimen obtained by percutaneous fine needle aspiration under CT guidance and revealed local a recurrence of the renal cell carcinoma. This was removed without any problems. Two years later, no pulmonary metastases have been noted despite, the fibrinolytic therapy.
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PMID:[Treatment of renal cancer extending supradiaphragmatically with fibrinolytics following surgery under extracorporeal circulation, hypothermia and circulatory arrest]. 370 80

Hemorrhage and poor visualization of the interior of the vena cava frequently occur with the removal of a renal cell carcinoma with a suprahepatic vena caval tumor thrombus. The use of cardiopulmonary bypass, hypothermia, and temporary cardiac arrest facilitates surgical removal of a suprahepatic vena caval tumor thrombus. This technique provides total control of the circulation of the body and creates a disciplined, well-visualized operative field.
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PMID:Technique for removal of renal cell carcinoma with suprahepatic vena caval tumor thrombus. 372 2

Fifteen patients with intracavitary cardiac tumors were operated on at the Kobe University Hospital between September 1977 and January 1984. Three of the patients were men and twelve were women. They ranged in age from 9 to 75 years. Their symptoms were chest pain, dyspnea, cough, palpitation and syncope. Definite diagnosis was confirmed by echo- and cineangiocardiography. There were 14 benign tumors consisting of 13 myxomas, one leiomyoma and one malignant myxosarcoma. The left atrium was the most common chamber involved (12 instances), followed by the right atrium (3). Surgery was performed in all cases under cardiopulmonary bypass with moderate hypothermia and cold crystalloid cardioplegia. Tumors were removed en bloc at the base with their attachment to the atrial septum or free wall in all cases. Three patients underwent concomitant mitral annuloplasty or mitral commissurotomy. Two cases with left atrial myxoma died postoperatively: one case associated with mitral annuloplasty died of congestive heart failure due to newly developed chordal rupture two months after surgery, and the other died of congestive heart failure 13 months after the first operation. Re-excision for recurrence of the myxosarcoma in the left atrium was performed in the latter case as a second surgical procedure. The remaining 13 cases with benign tumors are doing well and are without recurrence. From these favorable results, surgical intervention should be recommended prior to the occurrence of heart failure and severe complications such as coronary or peripheral embolism whenever cardiac tumors are detected by non-invasive echocardiography and cineangiocardiography.
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PMID:Surgical management of intracavitary cardiac tumors. A review of fifteen patients and current status in Japan. 378 67

Antitumor effects of i.v. injected human recombinant tumor necrosis factor (rTNF) against solid Meth A tumors in mice appeared to be critically dependent on the dose and were limited by its toxicity. Extensive necrosis and complete cures were only induced by doses having untoward effects, such as diarrhea, hypothermia, ruffled fur, and lethargy. Murine tumor necrosis serum (TNS, 0.5 ml) had about the same antitumor potential and induced all side effects except diarrhea. More extensive necrosis and approximate doubling of the incidence of complete regression in the absence of gross side effects were observed upon administration of a low dose of rTNF combined with detoxified endotoxin, nontoxic poly A:U, or submicrogram doses of toxic endotoxin. The separate constituents had little antitumor effects, if any at all. Increasing the dose of toxic endotoxin resulted in a further potentiation of necrosis, overt toxicity, but no cures. Muramyl dipeptide and interferon alpha/beta did not potentiate effects of rTNF. In vitro growth of Meth A cells was not inhibited by toxic endotoxin, rTNF or the combination, although TNS was highly inhibitory. Data show that therapeutic effects of rTNF and its synergy with endotoxin are not due to direct effects on the tumor cells and that the extent of prompt in vivo tumor necrosis does not predict the course of tumor growth. Therapeutic effects of both TNS and toxic endotoxin probably involve a synergy between low levels of TNF and other factors/effects induced by endotoxin. Detoxified endotoxin and poly A:U probably induce the latter effects and little or no TNF, so explaining the absence of side effects, their weak antitumor potential, and their powerful synergistic action with rTNF. A role for interferon alpha/beta as an induced synergistic factor is not likely. Muramyl dipeptide and TNF might share properties needed for synergy with endotoxins.
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PMID:Synergistic action of human recombinant tumor necrosis factor with endotoxins or nontoxic poly A:U against solid Meth A tumors in mice. 382 51


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