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)

A 60-year-old man with renal cell carcinoma extending through inferior vena cava into the right atrium was scheduled for the removal of the right kidney under general anesthesia and the cardiopulmonary bypass technique. In order to obtain a clear operative field and to minimize the risk for pulmonary embolism of necrotizing tumor, total circulatory arrest under profound hypothermia (20 degrees C) was performed. Anesthesia was maintained with high doses of fentanyl (62 micrograms.kg-1), midazolam and supplemented with enflurane. We attempted to prevent circulatory collapse due to acute pulmonary embolism by tumor fragments during operation. The body temperature of the patient was decreased down to 20 degrees C for protecting central nervous system with the minimal damage. No complications occurred during anesthesia and the post-operative period. For the safe anesthetic management of the patient such as our case, adequate monitoring of circulation and protection of central nervous system are essential.
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PMID:[Anesthetic management of a patient with renal cell carcinoma extending into the right atrium]. 874 77

The effects on the human kidney parenchyma of high-energy shockwaves (HESW) with different energy densities were examined. Kidneys of patients treated by radical nephrectomy for renal cell carcinoma were perfused with cold HTK solution immediately after nephrectomy and kept in hypothermia (8 degrees C) for a maximum of 4 hours. The tumor-free parenchyma was treated with 2000 shocks at energy outputs of 15 kV (16 MPa, 0.15 mJ/mm2), 17 kV (32 MPa, 0.25 mJ/mm2), 19 kV (50 MPa, 0.4 mJ/mm2), and 21 kV (65 MPa, 0.6 mJ/mm2) in an experimental electromagnetic shockwave system (Siemens Co., Erlanger, Germany). Resulting tissue effects were analyzed by histologic and immunohistochemical examinations and confocal laser scanning microscopy. Different sensitivities of cell components, blood vessels, and tubules were found. Laser scanning microscopy revealed nuclear alterations in the vicinity of the focus up to a distance of approximately 10 mm. Severe histologic changes were found in a smaller zone, while immunohistochemistry studies revealed negative collagen IV staining in an area of approximately 4 x 4 mm (all distances measured within the plane perpendicular to the acoustic axis). From these results, it can be concluded that HESW directly damage the tubules and the vascular system, which might explain the clinical changes after extracorporeal shockwave lithotripsy in human patients. The extent of these effects seems to be dependent on the applied energy.
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PMID:Mechanisms of shockwave action in the human kidney. 877 71

The effects of amifostine on paclitaxel-induced tumor growth delay using in vivo human ovarian cancer models were evaluated. In some mouse strains amifostine causes hypothermia and/or vasodilation, leading to increased spleen weight and ascites that can result in experimental artifacts. We found, however, that amifostine alone at 100 or 200 mg/kg intraperitoneally did not substantially alter body weight, spleen weight, or body temperature in severe combined immune-deficient (scid) mice bearing human 2780 ovarian cancer cells. In a model of minimal tumor burden (tumor cells injected subcutaneously day 0, drug treatment started day 1) scid mice receiving paclitaxel (27 mg/kg intraperitoneally) with or without amifostine had increased survival at day 76 (83% to 100%) compared with mice that did not receive paclitaxel (17% to 33%). For a model of advanced ovarian cancer, mice received tumor cell injections on day 0 and did not begin drug treatment until tumors were palpable (0.2 x 0.2 cm). Paclitaxel given for five repetitive doses significantly decreased tumor growth (P = .0001) in the advanced ovarian cancer model, and these results were the same whether or not mice received amifostine prior to each paclitaxel dose. We conclude that the scid mouse is a good model for evaluating amifostine in vivo, and that there was no evidence of amifostine-induced tumor protection in these scid mouse human ovarian cancer models. In future studies we will evaluate whether the cytoprotective effects of amifostine will allow dose escalation of paclitaxel and result in enhanced antitumor effects.
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PMID:Effects of amifostine and paclitaxel on growth of human ovarian carcinoma xenografts in the severe combined immune-deficient mouse: preliminary results. 878 64

Wilms' tumor is an ideal model to demonstrate how multimodality treatment strategies have reduced disease mortality over the past three decades. More than 80% of all patients are currently long-term survivors. Greater understanding of biology and awareness of clinical syndromes have led to more risk-based therapies. Although routine imaging provides adequate information for staging, advanced radiographic techniques, including spiral CT scanning and enhanced magnetic resonance imaging, can delineate improved anatomic detail. Recently, parenchymal sparing operations have been undertaken as long-term renal insufficiency after nephrectomy for Wilms' tumor has been more frequently recognized. Primary chemotherapy with delayed tumor resection is increasingly advocated for patients with bilateral disease, tumors with intravascular extension, or for those whose tumors are considered "inoperable." Technical advances, including intraoperative ultrasonography, regional hypothermia, laser technology, and minimally invasive surgery, will influence future tumor resections. Nevertheless, primary nephrectomy with appropriate operative guidelines and systemic therapy remain important standards for management of sporadic unilateral Wilms' tumor.
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PMID:Current surgical management of Wilms' tumor. 881 6

The side effects of high-energy shockwaves (HESW) from two different sources on kidney parenchyma obtained from 10 patients treated by radical nephrectomy for renal cell carcinoma were examined. Immediately after nephrectomy, the kidneys were perfused with cold HTK solution and kept in hypothermia (8 degrees C) for a maximum of 4 hours. In five cases, the tumor-free parenchyma was treated at the upper or lower renal pole with 2000 shocks, energy output 21 kV, in an experimental electromagnetic shockwave system (Siemens Co., Erlangen). In the other five cases, the upper or lower poles were treated with 2000 shocks, energy output 24 kV, in an electrohydraulic spark gap system (MFL 5000; Dornier Medizintechnik, Germering). The resulting tissue defects were analyzed by histologic examinations. Changes after treatment with the electromagnetic system were found mainly in the tubules and midsized blood vessels in a well-defined focal area. Treatment with the electrohydraulic system was followed by tubular and glomerular lesions combined with vessel defects in a patchy pattern. The model is able to define the side effects of HESW in the human kidney and to test the side effects of different lithotripters.
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PMID:Side effects of high-energy shockwaves in the human kidney: first experience with model comparing two shockwave sources. 897 82

Surgical treatment of glomus jugulare tumors yields high rates of perioperative morbidity and mortality for several reasons, among them neuroendocrine secretory activity, a high degree of vascularization, intracranial extension, duration of surgery and cranial nerve lesion. Secretory activity (e.g. catecholamines and serotonin) should be investigated before surgery and treated appropriately. Carotid arteriography (and ball occlusion) are useful to assess vascularization of the tumor and determine the need to clamp the carotid artery during the procedure. Potential complications such as hemodynamic alterations (bleeding or endocrine response), pulmonary embolism (air or thrombotic), hypothermia, facial nerve lesion, should be monitored for during surgery. After surgery cranial nerve involvement, which can lead to dysphagia and bronchoaspiration, must be looked for; the risk of cerebro-spinal fluid fistula is also high. We report the case of a woman who underwent surgery for a non secreting glomus jugulare tumor with extradural intracranial invasion. The main complications during surgery were bleeding with hemodynamic repercussions, pulmonary embolism, lesions in the VII, VIII and X cranial nerves, and opening of the dura mater (which required insertion of an intradural drain to prevent formation of a fistula). After surgery oral intake was delayed until intestinal function was established and glottic sphincter competence was verified by fiberoptic laryngoscopy. The only complication presenting at this time was cephalea, which disappeared upon removal of the drain on day 4. The patient was released on day 10.
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PMID:[Glomus jugulare tumor: perioperative management]. 901 90

From 1984 to 1996, four patients with transvenous intracardiac tumor extension underwent operations in the Kobe University Hospital. The primary tumors of two were intravenous leiomyomatoses originating from the uterus; a third patient had invasive thymoma, and the fourth patient had clear cell sarcoma of the kidney. In 1985, one patient had a curative, staged resection. One-stage operations were carried out in three patients, and all intracardiac tumors were successfully resected en bloc with the primary tumors under conditions of electrical ventricular fibrillation and mild hypothermia. Combined venous reconstructions were necessary for en bloc resection in three cases. Two patients with malignancy received postoperative chemoradiotherapy, and all four patients were discharged uneventfully from our hospital. We consider radical resection with curative intent only for patients with tumors extending into the heart. In these cases, a one-stage operation is preferable, and electrical ventricular fibrillation with mild hypothermia is a recommended method of circulatory assist because of its simplicity.
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PMID:Surgical treatment for transvenous tumor extension into the heart: four cases. 957 89

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

A personal experience concerning vertebral excision and resection in a single stage for neoplasm is discussed. The surgery requires anaesthesia of long duration, hemodynamic stability, compensation of significant blood loss, monitoring of heat loss, maintenance without injury of prolonged prone position. Experience, with 24 cases lasting an average of 14.5 hours proves that inhalation or intravenous anaesthesia with a strong analgesic component is satisfactory. Normal heat saving systems reduce intraoperative hypothermia. Transfusion is always abundant, autologous contribution is moderate. Hemodilution is well-tolerated up to Hb 7%; below this amount there may be problems of a hemodynamic and coagulative nature. The quantity and quality of filling is guided by monitoring of pre-loading pressures and availability of oxygen. There were no critical complications; all of the patients left the hospital in good condition.
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PMID:Major vertebral surgery: intra- and postoperative anaesthesia-related problems. 971 16

The blood flow rates of 14 tissues in the body were determined by microsphere method using normal and tumor-bearing rats kept conscious or under urethane anesthesia. The effects on the blood flow rate in the tissues were assessed for multimodal therapy, systemic hypothermia for ischemic brain injury, and local hyperthermia and angiotensin II-induced hypertensive chemotherapy for cancer. Urethane anesthesia showed no effect on cardiac output, while there was a tendency of decrease of blood flow rate and % of cardiac output in each tissue other than muscle tissue, in which they increased as a counterbalance, in normal and tumor-bearing rats. Systemic hypothermia gave results similar to those of urethane anesthesia in normal rats, but for tumor-bearing rats, it decreased cardiac output, and consequently the blood flow rate in most tissues. Brain blood flow rate was about half of that in the conscious rats. Local hyperthermia also decreased the cardiac output and blood flow rate in each tissue, including the tumor tissue. Angiotensin II-induced hypertension showed no effect on cardiac output, had various effects on blood flow rate in each tissue, and led to no increase in the tumor blood flow rate. Simulations based on the physiological pharmacokinetic modeling suggested that intramuscular injection of a lung-specific derivative of ceftazidime would provide the ideal biodistribution to ensure its optimal therapeutic efficacy during systemic hypothermia. This methodology, namely the pharmacokinetic simulation based on the physiological values of the body, will provide a useful piece of information on drug delivery systems under various conditions.
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PMID:Blood flow rate in normal and tumor-bearing rats in conscious state, under urethane anesthesia, and during systemic hypothermia. 989 94


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