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)

Isolated mongrel hearts were preserved for 6 h at 5 degrees C followed by normothermic reperfusion for 2 h. The dogs were divided into three groups; K+-cardioplegic solution alone, group C, n = 7; K+-cardioplegic solution with lidocaine 200 mg/l, group L, n = 7; and K+-cardioplegic solution with betamethasone 250 mg/l and lidocaine 200 mg/l, group B + L, n = 7. Ventricular fibrillation occurred early during reperfusion in all dogs in group C, in one of seven in group L, and in two of seven dogs in group B + L. The serum MB fraction of creatinine kinase (MB-CK), mitochondrial aspartate aminotransferase (m-AAT) and calcium overload were suppressed to a greater extent in both groups L and B + L during reperfusion compared to group C. Myocardial ATP, total adenine nucleotide, and creatine phosphate did not differ between the three groups at the end of reperfusion. Myocardial ADP and AMP declined significantly during reperfusion in group C, however, they remained unchanged in group B + L and increased in group L which showed significantly higher levels compared to group C. Left ventricular functional recovery during reperfusion was consistently better in both group L and B + L compared to group C. These results suggested that membrane stabilization prevents myocardial damage from hypothermia and cardioplegia and provides better myocardial viability and functional recovery in donor heart preservation.
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PMID:The significant role of membrane stabilization in hypothermic cardioplegic cardiac preservation in a canine experimental model. 1462 34

Separate effects of perfusion hypothermia, potassium arrest, and procaine arrest were studied in 150 hearts using the isolated rat heart preparation. Aortic flow rate (AFR), coronary flow rate (CFR), and heart rate (HR) were measured before and after ischemic periods of 90 to 300 min. Prior to the ischemic period, the aortic root was infused with Krebs-Henseleit buffer (KHB), buffer with 30 mEq KCl/L (KHB + K), or buffer with 0.2% procaine (KHB + P), at 15 degrees or 5 degrees C. During the ischemic period the hearts were maintained at 15 degrees or 5 degrees C in a hypothermic chamber. The three solutions had similar recoveries of AFR at 15 degrees and 5 degrees C following ischemic periods of 90, 180, and 240 min. The KHB + K and KHB + P had better recoveries of AFR than KHB at 5 degrees C and 300 min of ischemia. The KHB + K and KHB + P also caused more rapid arrest and a higher incidence of spontaneous recovery of sinus rhythm. Arrest at 5 degrees C was equal to or superior to arrest at 15 degrees C. Perfusion hypothermia is the main component of cold cardioplegia. The addition of procaine or potassium results in increased functional recovery at extended ischemic times at 5 degrees C, more rapid arrest, and better electrical recovery.
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PMID:Cardioplegic solutions for myocardial preservation: analysis of hypothermic arrest, potassium arrest, and procaine arrest. 1474 Jun 90

Hypothermia and localized cold injuries are largely preventable with proper preparation for activities in cold environments. Proficient field management is crucial to the final outcome in terms of function and viability because proper care is vital to preventing exacerbation of the initial exposure and injury. Rapid rewarming is optimal when further cold exposure can be avoided reliably. Repetitive freeze-thaw cycles are associated with increased morbidity and tissue loss caused by progressive microvascular injury and thrombosis. The subsequent care is largely supportive and consists of wound care and physical and hydrotherapy to promote optimal functional recovery.
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PMID:Hypothermia and localized cold injuries. 1516 68

The neuroprotective effect of hypothermia has long been recognized. Our recent studies have demonstrated the significant therapeutic value of local brain cooling in the ischemic territory prior to reperfusion in stroke, with reduced infarction and inflammatory responses up to 48 hours of reperfusion. The goal of this study was to determine if local brain cooling, produced by infusion of cold saline, could induce long-term functional improvement after stroke. A hollow filament was used to block the middle cerebral artery (MCA) for 3 hours, and then to locally infuse the ischemic territory with 6 ml cold saline (20 degrees C) for 10 minutes prior to reperfusion. This brain cooling infusion induced a significant (p < 0.01) decrease in neurologic deficits and significantly (p < 0.01) improved motor behavior in ischemic rats after 14 days of reperfusion, compared with ischemic rats without local cold saline infusion. This improvement continued for up to 28 days after reperfusion. No significant difference in motor performance was observed between the brain cooling infusion and normal control groups. Significant (p < 0.01) reductions in infarct volume were also evident. In conclusion, a local cerebral hypothermia induced by local saline infusion prior to reperfusion produced a long-term functional recovery after ischemic stroke. A therapeutic procedure, which combines prereperfusion infusion into an ischemic region with coincident cerebral hypothermia and perhaps subsequent recanalization of an occluded intracranial vessel, may improve the outcome for stroke patients.
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PMID:Long-term neuroprotection induced by regional brain cooling with saline infusion into ischemic territory in rats: a behavioral analysis. 1532 59

Ischemic preconditioning (IPC) induces distinctive changes in mitochondrial bioenergetics during warm (37 degrees C) ischemia and improves function and tissue viability on reperfusion. We examined whether IPC before 2 h of hypothermic (27 degrees C) ischemia affords additive cardioprotection and improves mitochondrial redox balance assessed by mitochondrial NADH and flavin adenine dinucleotide (FAD) autofluorescence in intact hearts. A mediating role of ATP-sensitive K(+) (K(ATP)) channel opening was investigated. NADH and FAD fluorescence was measured in the left ventricular wall of guinea pig isolated hearts assigned to five groups of eight animals each: hypothermia alone, hypothermia with ischemia, IPC with cold ischemia, 5-hydroxydecanoic acid (5-HD) alone, and 5-HD with IPC and cold ischemia. IPC consisted of two 5-min periods of warm global ischemia spaced 5 min apart and 15 min of reperfusion before 2 h of ischemia at 27 degrees C and 2 h of warm reperfusion. The K(ATP) channel inhibitor 5-HD was perfused from 5 min before until 5 min after IPC. IPC before 2 h of ischemia at 27 degrees C led to better recovery of function and less tissue damage on reperfusion than did 27 degrees C ischemia alone. These improvements were preceded by attenuated increases in NADH and decreases in FAD during cold ischemia and the reverse changes during warm reperfusion. 5-HD blocked each of these changes induced by IPC. This study indicates that IPC induces additive cardioprotection with mild hypothermic ischemia by improving mitochondrial bioenergetics during and after ischemia. Because effects of IPC on subsequent changes in NADH and FAD were inhibited by 5-HD, this suggests that mitochondrial K(ATP) channel opening plays a substantial role in improving mitochondrial bioenergetics throughout mild hypothermic ischemia and reperfusion.
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PMID:Warm ischemic preconditioning improves mitochondrial redox balance during and after mild hypothermic ischemia in guinea pig isolated hearts. 1565 57

It is now well established that neurons and other cell types may die many hours or even days after hypoxic-ischemic injury due to activation of programmed cell death (apoptotic) pathways. The potent anti-apoptotic factor IGF-1 and its binding proteins and receptors are intensely induced within damaged brain regions following brain injury suggesting a possible a role for IGF-1 in endogenous brain recovery. Exogenous administration of IGF-1 within a few hours after brain injury has now been shown to be protective in both grey and white matter, and leads to improved long-term neurological function. The limited window of opportunity for treatment with IGF-1 can be extended by spontaneous mild post-hypoxic hypothermia, probably due to delayed evolution of apoptotic processes. The efficacy of IGF-1 is specific to particular cellular phenotypes and brain regions, and its neuroprotective effects are mediated by IGF-1 receptors and binding proteins. Intriguingly its naturally cleaved N-terminal tripeptide (glycine-proline-glutamate, GPE) has been demonstrated to be neuroprotective after both central and peripheral administration. Peripheral administration of GPE also prevents the loss of dopamine neurons and improves long-term functional recovery following 6-OHDA lesion. However, GPE is unlikely to contribute significantly to the direct effects of IGF-1.
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PMID:Treatment in animal models. 1587 86

After moderate intracerebral hemorrhage (ICH), both hypothermia (HYPO) and constraint-induced movement therapy (CIMT) improve recovery and reduce the volume of brain injury. We tested the hypothesis that more severe ICH requires both cytoprotection and rehabilitation to significantly improve recovery. Rats were subjected to a unilateral striatal ICH via collagenase infusion. Rats remained normothermic or were subjected to mild HYPO ( approximately 2 days) starting 12 h later. Fourteen days after ICH, half of the rats received CIMT (7 days of restraint of the less affected limb plus daily exercises); the remainder were untreated. Walking, limb use and skilled reaching were assessed up to 60 days, at which time animals were euthanized and the volume of tissue lost was determined. The HYPO treatment alone did not improve outcome, whereas CIMT alone provided significant benefit on the limb use asymmetry test. In the staircase test, the greatest benefit was achieved with the combination of HYPO and CIMT treatments. The volume of tissue lost after ICH was similar among groups arguing against cytoprotection as a mechanism of functional recovery. Finally, these findings suggest that, at least under the present circumstances (e.g., severe striatal ICH), CIMT provides superior benefit to HYPO and that combination therapy will sometimes further improve recovery.
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PMID:Combined use of a cytoprotectant and rehabilitation therapy after severe intracerebral hemorrhage in rats. 1626 39

Considerable effort and substantial funding has gone towards the development of a neuroprotective agent that could be given after brain trauma to reduce mortality and improve functional recovery. There have been many failed or inconclusive studies to date. In Europe two promising studies have been stopped or shelved (Lubeluzole, Janssen-Cilag and BAYx3702, Bayer) and the future of pharmacological neuroprotection after traumatic brain injury is in doubt. Clinicians managing patients with a head injury are therefore left with the detection and prevention of secondary insults to the brain, including the management of medical complications of brain injury, and non-pharmaceutical interventions that might beneficially modify the brain's response to trauma. Of the potential interventions, moderate hypothermia is the most promising.
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PMID:Head injury: complications and management. 1701 60

Severe cardiac hypoxia is responsible for significant morbidity and mortality in an emergency setting. Most cardiac hypoxia relates to ischemia and surgical events. Although the ischemic mortality rate and the risks of cardiac surgery have significantly decreased in past decades, myocardial protection still plays a major role in survival of hypoxic injury. Cross adaptation as a physiological regulation for homeostasis can resist injury caused by harmful environmental effects and diseases, including hypothermic adaptation. Treatment with hypothermia has been used for fifty years as a protective mechanism to avoid hypoxic injury. Since cold temperatures can cause damage, it is important to gather physiological data to distinguish protective from injurious temperatures. Although results of temperature trials in clinical practice vary, a critical temperature to resist hypoxic/ischemic injury in heart was found to be around 30 degrees C, suggesting a hypothermia protective threshold. Pretreatment with mild hypothermia can resist subsequent hypoxia/ischemia, implying involvement of cross adaptation in protection. Safeguard hypothermia can directly reduce the build up of harmful metabolites and energy demand in hypoxic tissues, as well as preserve mitochondrial membrane specific proteins beta subunit of F1-ATPase and adenine nucleotide translocase isoform 1. Mechanisms of preservation include inactivation of the p53 related pathways, representing anti-apoptosis, and modification of the mRNA level of succinodehydrogenease, indicating a beneficial effect on the aerobic pathway. Stress proteins are also induced. Resultant cellular adaptations serve to maintain myocardial integrity and improve functional recovery during reoxygenation or reperfusion.
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PMID:Mild hypothermic cross adaptation resists hypoxic injury in hearts: a brief review. 1729 29

Brain ischemia induces the IGF-1 system in damaged regions, and exogenous administration of IGF-1 after injury is neuroprotective and improves long-term neurological function. The short treatment window can be extended by mild hypothermia, probably due to delayed apoptosis. Nevertheless, the poor central uptake of IGF-1 and its mitogenic potential preclude clinical application. The N-terminal tripeptide of IGF-1 (glycine-proline-glutamate, GPE) is neuroprotective after central administration. Central uptake of GPE is injury dependent, and it is rapidly degraded in the plasma. Intravenous infusion of GPE prevents brain injury and improves long-term functional recovery, with a broad effective dose range and a 3-7 hour therapeutic window. GPE does not interact with IGF receptors. G-2meth-PE, a GPE analogue with improved stability, has a prolonged plasma half life and is neuroprotective after ischemic injury. Neuroprotection by GPE and its analogue may involve modulating inflammation, promoting astrocytosis and inhibiting apoptosis, and the analogue may have a vascular effect. Cyclo-glycyl-proline (cGP) is an endogenous diketopiperazine possibly derived from GPE. Cyclic GP and its analogue cyclo-L-glycyl-L-2-allylproline (cG-2allylP) are neuroprotective after ischemic injury. cG-2allylP crosses the BBB independent of injury and remains detectable several hours after a single administration. Repeated peripheral administration of cG-2allyP improves somatosensory-motor function and long-term histological outcome.
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PMID:Insulin-like growth factor-1 and its derivatives: potential pharmaceutical application for ischemic brain injury. 1853 71


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