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

We report a rare case of hypothermia with acute renal failure in a patient suffering from diabetic nephropathy. A 71-year-old male who had been receiving insulin therapy for the treatment of diabetes mellitus complicated with advanced diabetic nephropathy since 1998 was malnourished with an extremely decreased muscle mass. Without any prolonged exposure to excessively low external temperatures or hypothyroidism, pituitary insufficiency, adrenal insufficiency, sepsis, hypoglycemia, and diabetic ketoacidosis, acute hypothermia appeared together with an aggravation of diabetic nephropathy. His skin temperature fell to below measurable levels and his rectal temperature fell to 30.0 degrees C. His consciousness was drowsy and the hypothermia was not accompanied by shivering. Skeletal muscle is known to play an important role as a center of heat production and shivering thermogenesis in skeletal muscle mainly operates on acute cold stress. Therefore, in this case, hypothermia may have occurred because the shivering thermogenesis could not fully act on the acute cold stress due to the dramatically reduced muscle mass. We should always keep in mind that older, malnourished diabetic patients can easily suffer from impairments of the thermoregulatory system.
 ...
PMID:Hypothermia with acute renal failure in a patient suffering from diabetic nephropathy and malnutrition. 1080 30

A 49-year-old man with herpes simplex encephalitis at age 22 was admitted with hypotension (90/60 mm Hg) and hypothermia (33.7 degrees C). His blood pressure was 80-90/50-60 mm Hg, with temperatures averaging 35 degrees C, for at least 3 years before admission. Evaluation of his hypothermia and hypotension revealed a low free triiodothyronine, low normal thyrotropin, luteinizing hormone < 2 mIU/L, follicle stimulating hormone <3 mIU/L, and low testosterone of 1.39 ng/dL. A baseline cortisol of 13.9 microg/dL was stimulated to 41.8 microg/dL with corticotropin, indicating he had partial anterior hypopituitarism with an intact pituitary-adrenal axis. Posterior pituitary function was normal. MRI revealed a "bright" posterior pituitary on a T1-weighted image, further indicating a normal posterior pituitary. Extensive decreased T1-weighting on MRI in the right and left temporal lobes was consistent with encephalomalacia. With thyroid hormone replacement, his blood pressure increased to 110/70 mm Hg with a temperature of 37 degrees C.
 ...
PMID:Post-herpes encephalitic anterior pituitary insufficiency with hypothermia and hypotension. 1106 53

A 42-year-old man was admitted to our hospital due to severe back pain. A computed tomographic scan revealed aortic dissection from the ascending aorta to the left common iliac artery. His blood pressure was well controlled untill he went into shock 21 hours after the onset. He was given a diagnosis of aortic rupture to the left pleural cavity by echocardiography and chest X-ray. He underwent emergent left thoracotomy under femoro-femoral bypass. We found a rupture of the descending aorta 3 cm above the diaphragma and replaced the ruptured segment with a woven Dacron graft. On postoperative day 9, we performed total arch replacement utilizing deep hypothermia and selective cerebral perfusion. We located the entrance tear in the aortic arch. His postoperative course was uneventful and he showed no neurological deficit. He was discharged from the hospital on postoperative day 36.
 ...
PMID:[Total arch replacement following partial replacement of the descending aorta for acute type A aortic dissection: report of a case]. 1155 70

A healthy 20-year-old man failed to return home after a jog in the Colorado mountains. His lifeless body was found the next day on an exposed mountain slope. The differential diagnosis in such mysterious, unwitnessed mountain deaths includes cardiac arrhythmia, cerebral hemorrhage, pulmonary embolism, seizures, trauma, high-altitude sickness, and hypothermia. The cause of death in this case was established on postmortem examination. The findings of ruptured tympanic membranes and a melted shoe established this as a case of lightning strike fatality. The National Lightning Detection Network can be a valuable resource to investigators by providing information on the location and date of lightning strikes in the vicinity of the victim.
 ...
PMID:Mountain medical mystery. Unwitnessed death of a healthy young man, caused by lightning. 1156 44

Selective cerebral perfusion (SCP) and open distal anastomosis (OD) with hypothermia has been used as a popular means for circulatory assistance in aortic arch surgery. Although SCP has become accepted for brain protection, the influence of OD accompanying circulatory arrest on lower body ischemia is not known. We studied gastric tonometry (gastric intramucosal pH [pHi]) to estimate splanchnic ischemia during OD, and its relationship to postoperative organ function. In five patients (pts) (range, 65-78 years; mean, 71 years; group OD) who underwent arch replacement using SCP and OD with moderate hypothermia (25 degrees C) during the period from March to August of 1999, pHi was measured precardiopulmonary bypass (pre-CPB), 30 min of CPB (CPB30), 10 min after OD (OD10), at end of CPB, and post-CPB. Eight pts (range, 52-78 years; mean; 66 years) who underwent standard CPB (33 degrees C) during the same period (coronary artery bypass surgery in six and valve surgery in two) served as controls (group C). In group OD, pHi was significantly decreased at OD10 (7.35 +/- 0.03 at CPB30 vs. 7.23 +/- 0.07 at OD10, p < 0.05) but recovered by the end of CPB (7.32 +/- 0.02). Creatinine clearance on the first postoperative day (1POD) was significantly (p < 0.05) lower in group OD (82 +/- 40 ml/min) than in group C (126 +/- 25 ml/min), although there was no significant difference in preoperative values between the two groups. The pHi at OD10 did not correlate with the duration of OD (range, 30-47 min; mean, 38 min), whereas pHi at OD10 significantly correlated with BUN (r = -0.973, p = 0.0054), Cr(r = -0.977, p = 0.0043), and CCr (r = 0.908, p = 0.0328) on 1POD. One patient in group OD developed paraplegia and renal failure postoperatively. His pHi at OD10 was severely decreased to 7.11. These results suggest that intraoperative monitoring of pHi may be useful for the evaluation of visceral organ ischemia during OD in arch replacement and may contribute to improved technique for circulatory assistance in aortic surgery.
 ...
PMID:Gastric intramucosal pH during lower body circulatory arrest under open distal anastomosis with selective cerebral perfusion in aortic arch repair. 1157 35

The hepatic uptake of histidine and carnosine (histidyl-alanine), used as buffer agents in four preservation solutions, was studied during 24-h hypothermic storage of rat livers by use of (1)H nuclear magnetic resonance (NMR) spectroscopy. Results demonstrated that there was a progressive, concentration-linked passive diffusion of histidine into liver tissues throughout the storage period. A similar inward diffusion of carnosine was also noted. Of the carbohydrate osmotic buffers in the preservation solutions, mannitol permeated the liver tissues to a greater degree and more rapidly than raffinose after the flushing with equivalent concentrations and storage at hypothermia. In general, many solutes from preservation solutions will increasingly penetrate the hepatic inter- and intracellular spaces during extended hypothermic preservation and (1)H NMR spectroscopy is one technique that can assist in the identification of these changes.
 ...
PMID:Hepatic uptake of solutes from the preservation solution during hypothermic storage: a (1)H NMR study in rat liver. 1174 39

The aim of the present study was to improve the viability of marginal livers from non-heart beating donors upon cold preservation using two different techniques for the provision of tissue aerobiosis. Livers from male Wistar rats (250-300 g bw) were harvested after 60 min of cardiac arrest, flushed via the portal vein with 20 mL of heparinized Ringer's solution and 60 mL of histidine-tryptophan-ketoglutarate (HTK) preservation solution. Control livers were then stored submerged in HTK for 24 h at 4 degrees C while other organs were subjected to aerobic conditions by either insufflation of gaseous oxygen via the venous vascular system of the cold stored organ (VSOP) or pulsatile machine perfusion (MP) with oxygenated HTK at 5 mL/min at 4 degrees C. Superoxide dismutase (SOD) (7500 IU) was added to the last 10 mL of HTK in order to prevent adverse effects of high oxygen tensions at hypothermia. Viability of the livers was assessed upon isolated perfusion in vitro with oxygenated Krebs-Henseleit buffer at constant flow. VSOP or MP, both significantly improved vascular conductivity upon reperfusion as evaluated by portal venous pressure, reduced hepatic enzyme release and led to a rise in hepatic bile production upon reperfusion. Induction of apoptosis was also looked for in tissue homogenates by Western analysis for cleavage of poly(ADP-ribose)polymerase (PARP). Expression of cleaved PARP fragment could be found in reperfused control livers but also, though to a lesser extend, after VSOP or MP. In conclusion, provision of oxygen during cold preservation significantly contributes to improve organ viability upon reperfusion and must be regarded as a useful adjunct for marginal or pre-damaged livers. HTK has been shown for the first time to be also suitable for long-term MP preservation of the liver, but, as inferred from these data, simple insufflation of gaseous O2 may be considered a feasible alternative.
 ...
PMID:Liver preservation with HTK: salutary effect of hypothermic aerobiosis by either gaseous oxygen or machine perfusion. 1201 Jan 45

A 37 year old man was found in his garden cold with no signs of life. Pupils were fixed and dilated. Electrocardiography showed asystole initially. The paramedic crew started cardiopulmonary resuscitation and transferred him to the accident and emergency department. His temperature was 17.0 degrees C. Cardiopulmonary resuscitation was continued for three hours before rewarming using partial cardiopulmonary bypass. He eventually regained spontaneous cardiac output and made a full neurological recovery. Hypothermic patients with no evidence of life cannot be assumed to be dead as there is a chance of full recovery when fully warmed.
 ...
PMID:Dead? Or just cold: profoundly hypothermic patient with no signs of life. 1220 20

Donor cells can be preserved in University of Wisconsin (UW), histidine-tryptophan-ketoglutarate (HTK), or Celsior solution. However, differences in efficacy and mode of action in preventing hypothermia-induced cell injury have not been unequivocally clarified. Therefore, we investigated and compared necrotic and apoptotic cell death of freshly isolated primary porcine hepatocytes after hypothermic preservation in UW, HTK, and Celsior solutions and subsequent normothermic culturing. Hepatocytes were isolated from porcine livers, divided in fractions, and hypothermically (4 degrees C) stored in phosphate-buffered saline (PBS), UW, HTK, or Celsior solution. Cell necrosis and apoptosis were assessed after 24- and 48-h hypothermic storage and after 24-h normothermic culturing following the hypothermic preservation periods. Necrosis was assessed by trypan blue exclusion, lactate dehydrogenase (LDH) release, and mitochondrial 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) reduction. Apoptosis was assessed by the induction of histone-associated DNA fragments and cellular caspase-3 activity. Trypan blue exclusion, LDH release, and MTT reduction of hypothermically preserved hepatocytes showed a decrease in cell viability of more than 50% during the first 24 h of hypothermic preservation. Cell viability was further decreased after 48-h preservation. DNA fragmentation was slightly enhanced in hepatocytes after preservation in all solutions, but caspase-3 activity was not significantly increased in these cells. Normothermic culturing of hypothermically preserved cells further decreased cell viability as assessed by LDH release and MTT reduction. Normothermic culturing of hypothermically preserved hepatocytes induced DNA fragmentation, but caspase-3 activity was not hanced in these cells. Trypan blue exclusion, LDH leakage, and MTT reduction demonstrated the highest cell viability after storage in Celsior, and DNA fragmentation was the lowest in cells that had been stored in PBS and UW solutions. None of the preservation solutions tested in this study was capable of adequately preventing cell death of isolated porcine hepatocytes after 24-h hypothermic preservation and subsequent 24-h normothermic culturing. Culturing of isolated and hypothermically preserved hepatocytes induces DNA fragmentation, but does not lead to caspase-3 activation. With respect to necrosis and DNA fragmentation of hypothermically preserved cells, UW and Celsior were superior to PBS and HTK solutions in this model of isolated porcine hepatocyte preservation.
 ...
PMID:Induction of necrosis and DNA fragmentation during hypothermic preservation of hepatocytes in UW, HTK, and Celsior solutions. 1269 65

Common variable immunodeficiency is a heterogeneous group of disorders with arthritis and/or arthralgia as its most commonly associated autoimmune manifestation. We report 2 cases of common variable immunodeficiency in siblings who also had other unusual signs and symptoms. A 10-year-old boy suffered from bradycardia, hypothermia, hypoglycemia, and chronic eczema. His 13-year-old sister suffered from Kikuchi lymphadenitis, hypoperfusion and atrophy of the left cerebral hemisphere, and hemiparesis. They both showed classical laboratory findings of common variable immunodeficiency and the boy's associated symptoms responded to intravenous immunoglobulin therapy. The findings from these cases suggest that a defect in the neuro-endocrine-immune axis may be one of the genetic bases of common variable immunodeficiency.
 ...
PMID:Common variable immunodeficiency with hypoglycemia, Kikuchi lymphadenitis, and hemiparesis in two siblings. 1274 37


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>