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

The effects of acupuncture stimulation on the Ta-Chuei (Go-14), Nei-Kuan (EH-6), and Tsu-San-Li (St-36) loci on thermoregulatory function were assessed in normal adults. Stimulation of acupuncture locus Ta-Chuei produced hypothermia. The hypothermia was brought about by a decrease in metabolic rate, an increase in cutaneous circulation (the back region) and perspiration. On the other hand, acupuncture stimulation of either the Nei-Kuan or Tsu-San-Li loci produced a slight hyperthermia. The hyperthermia was due to a decrease in cutaneous circulation. The data indicate that each acupuncture locus may have its own function with special reference to body temperature regulation.
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PMID:Effects of stimulation of acupuncture loci Ta-Chuei (Go-14), Nei-Kuan (EH-6) and Tsu-San-Li (St-36) on thermoregulatory function of normal adults. 54 87

The catabolism of 5'-adenine nucleotides in the cortex of the rabbit kidney was studied during normothermic and hypothermic ischaemia. Changes were found in the cortical content of ATP, ADP, AMP, and SAN (the sum of 5'-adenine nucleotides) during ischaemia; those changes were delayed by hypothermia. The loss of SAN was found to be significantly correlated to the duration of normothermic as well as hypothermic ischaemia. The oxypurines hypoxanthine and xanthine and the nucleoside inosine were shown to be the final products of the catabolism of 5'-adenine nucleotides. An accumulation of hypoxanthine-xanthine and inosine in the tissue and a corresponding excretion in the perfusion fluid occurred simultaneously with the catabolism of 5'-adenine nucleotides, in equivalent amounts. It is concluded that determination of the amount of oxypurines excreted during kidney preservation is an indirect measure of the loss of SAN in the tissue, and a reflection of the changes in the metabolic state.
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PMID:Breakdown of 5'-adenine nucleotides in ischaemic renal cortex estimated by oxypurine excretion during perfusion. 115 18

At the University of California, San Diego pulmonary thromboendarterectomy (PTE) has emerged as an effective measure in the treatment of chronic thromboembolic pulmonary hypertension. Unresolved emboli become organized by incorporation into the vascular wall and may form strictures, webs, bands and/or membranous occlusions and cause pulmonary hypertension refractory to medical treatment. When pulmonary vascular resistance exceeds 300 dyn.sec.cm-5 and the vascular wall changes are located to begin at or proximal to the lobar artery level, surgery is indicated. The operation is performed using cardiopulmonary bypass, deep hypothermia and periods of circulatory arrest. The dissection of each segmental artery is carried out in the media layer from separate incisions in the right and left pulmonary artery at the level of the pericardial flexion. Pulmonary reperfusion edema may complicates the postoperative course, and pulmonary hemorrhage, respiratory insufficiency necessitating prolonged ventilatory support and secondary multi organ failure are main causes of hospital mortality. Between October 1984 and September 1988 103 patients with a mean age of 50 +/- 16 years underwent PTE. Consequently, pulmonary vascular resistance could be reduced from 788 +/- 370 to 299 +/- 150 dyn.sec.cm-5 and cardiac index increased from 2.0 +/- 0.6 to 3.2 +/- 0.8 l/min-m2. Hospital mortality was 11.7% (12/103 patients). Thus, pulmonary thromboendarterectomy effectively reduces pulmonary hypertension at an acceptable low risk. The results indicate that patients should be diagnose and referred for surgery as early as possible.
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PMID:Thoracic research scholarship 1988: pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension at the University of California, San Diego. 234 56

Results of repair of the interrupted arch complex have remained poor despite advances in operative technique. Palliative prosthetic grafts to form a transverse arch through the lateral approach have been advocated, but a need for both subsequent closure of the ventricular septal defect and replacement of the prosthetic conduit makes this approach undesirable. The total experience with this lesion at the University of California San Francisco (29 patients) is presented. Since January 1982, 10 patients, eight with type B and two with type A interrupted arch, underwent total repair. Ages ranged from 3 to 150 days (median 11 days). An anterior approach to total repair with single atrial-to-ascending aortic and transductal descending aortic bypass was used. Deep hypothermia to less than 18 degrees C was used, and during total circulatory arrest the cannula was removed from the descending aorta and direct anastomosis of the descending and ascending aorta was performed. Total circulatory arrest time was a mean of 12 min. During rewarming of the infant, the ventricular septal defect was closed. Mean pump time was 52 min. Operative mortality was 20% (two of 10 patients) at 17 and 32 days after surgery. Our results demonstrate that the anterior approach to total repair of interrupted arch complex in early infancy can be achieved with a lower mortality than palliation followed by subsequent closure of ventricular septal defect and also obviates the need for prosthetic replacement of the transverse arch. The anterior approach is the method of choice for repair of interrupted arch complex.
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PMID:The total repair of interrupted arch complex in infants: the anterior approach. 620 91

A program to alleviate chronic, major vessel thromboembolic pulmonary hypertension by pulmonary thromboendarterectomy was initiated at this institution in 1970. Multiple evolutionary changes in the diagnostic evaluation, surgical approach, and postoperative management have been implemented over the series of 323 thromboendarterectomies performed through March 1992. A sequence of five surgeons at the University of California at San Diego have performed these procedures, with the last 150 having been performed by one surgeon. We report here the changes in surgical approach developed over the last 150 cases and the results obtained. The operation involves a median sternotomy incision, the institution of cardiopulmonary bypass, and deep hypothermia with circulatory arrest periods. Incisions are made in both pulmonary arteries into the lower lobe branches. Pulmonary thromboendarterectomy is always bilateral, with removal of both organized thrombus and an endarterectomy plane from all involved vessels. The right atrium is routinely explored for atrial septal defects. Current techniques appear to allow more thorough revascularization and shorter circulatory arrest times. The surgical mortality of 8.7% over this span is below that previously reported from this and other institutions. Among survivors, the hemodynamic and functional results have been excellent. Surgically correctable chronic thromboembolic pulmonary hypertension likely remains underdiagnosed. The diagnostic, surgical, and postoperative management evolution provided by the coordinated team involved at this institution has established that pulmonary thromboendarterectomy can be performed with an acceptable risk and good hemodynamic and symptomatic results.
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PMID:Experience and results with 150 pulmonary thromboendarterectomy operations over a 29-month period. 832 Sep 90

Optimal reduction in pulmonary vascular resistance caused by chronic pulmonary embolism is obtained by bilateral pulmonary thromboendarterectomy with removal of occlusive material in all bronchopulmonary segmental arteries that are partially or completely obstructed. The most effective way to obtain this goal is the use of median sternotomy with cardiopulmonary bypass, deep hypothermia, and intermittent periods of circulatory arrest. During circulatory arrest, thromboendarterectomy is performed by specially designed dissectors that allow simultaneous dissection and removal of blood from the surgical field. The operative mortality rate for pulmonary thromboendarterectomy at the University of California, San Diego, between 1990 and 1998 was 9.2% in 1,049 patients.
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PMID:The evolution and the current state of the art of pulmonary thromboendarterectomy. 1037 59

To determine whether or not participants in open water swim events experience hypothermia and afterdrop, rectal temperature was measured for up to 45 minutes in 11 subjects following the New Year's Day Alcatraz Swim. This event was held in open water (11.7 degrees C [53.0 degrees F]) in the San Francisco Bay, and participants did not wear wetsuits or other protective clothing. Biophysical parameters, including surfacelvolume ratio, body mass index, and percent body fat were measured before the swim, and statistical analysis was done to determine predictors of temperature decrease and afterdrop duration. Applying the American Heart Association definition of hypothermia (less than 36.0 C [96.8 degrees F]), hypothermia was seen in 5 of the 11 subjects. Using a more rigorous and traditional definition (less than 35.0 degrees C [95.0 degrees F]), hypothermia was seen in only one subject. Afterdrop, defined as continued cooling following removal from cold stress, was seen in 10 of the 11 subjects. Surface/volume ratio (S/V) and body mass index (BMI) predicted the lowest recorded temperatures (P < .05; r(S/V) = -.71, r(BMI) = .72) and afterdrop duration (P < .05; r(SN) = -.75, r(BMI) = .69). These results suggest that hypothermia and afterdrop can occur commonly after recreational open water swimming, and that participants should be observed for signs of temperature decrease following removal from cold stress.
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PMID:Hypothermia and afterdrop following open water swimming: the Alcatraz/San Francisco Swim Study. 1104 27

Necrotizing soft tissue infections are potentially fatal infections that often involve extremities. Studies of mixed anatomic sites suggest several factors increase mortality (eg, age, medical comorbidities, laboratory values, treatment timing). We hypothesized that patients with necrotizing soft tissue infections of the extremities would have similar factors associated with mortality. We retrospectively reviewed 150 patients with necrotizing soft tissue infections of the extremities treated at San Francisco General Hospital from 1993-1997. We recorded cofactors, treatment, physical findings, radio- graphs, and laboratory findings at presentation. No cofactor or examination finding was associated with increased mortality. Compared with survivors, nonsurvivors had a higher leukocyte count, blood urea nitrogen, creatinine, potassium, partial thromboplastin time, and aspartate aminotransferase, but had lower pH and bicarbonate. Nonsurvivors did not have delays in treatment relative to survivors. Univariate analysis showed an increased risk of mortality in patients with hypotension, hypothermia, Clostridium species in the wound culture, low leukocyte count and bicarbonate levels, and elevated blood urea nitrogen, aspartate aminotransferase, creatinine, and potassium levels. Several signs of shock and organ dysfunction were associated with mortality in patients with necrotizing soft tissue infections of the extremities. The overall mortality rate (9.3%) was lower than in some other reports.
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PMID:Necrotizing soft tissue infections of the extremities and back. 1667 2

After training in physics during World War II, I spent 2 years designing radar at Massachusetts Institute of Technology and then switched to biophysics. After medical school and a residency, I was doctor drafted to National Institutes of Health where I studied blood gas transport in hypothermia and developed the carbon dioxide electrode and the blood gas analyzer (pH, partial pressure of O2, and partial pressure of CO2). I joined the University of California San Francisco in 1958 in a new anesthesia department and new Cardiovascular Research Institute. My research aims were anesthesia patient monitoring, respiratory physiology, blood gas transport, and high-altitude acclimatization and pathology.
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PMID:Career perspective: John W. Severinghaus. 2419 65

The large randomized, controlled trials of therapeutic hypothermia for hypoxic-ischemic encephalopathy excluded neonates with congenital disorders. The objective of this study was to report our experience using hypothermia in neonates with signs of hypoxic-ischemic encephalopathy and a syndromic disorder or brain anomaly. Subjects were identified from a database of neonates admitted to the Neuro-Intensive Care Nursery at University of California, San Francisco. Of 169 patients fulfilling criteria for hypothermia, 8 (5%) had a syndromic disorder and were cooled per guidelines for nonsyndromic neonates. Perinatal characteristics of infants with and without syndromic disorder were not significantly different. Overall outcome was poor: 38% had evidence of acute hypoxic-ischemic injury, 3 subjects died, and 2 survivors had low developmental quotient (ie, 25). The risk versus benefit of therapeutic hypothermia for hypoxic-ischemic encephalopathy among neonates with congenital brain malformations or syndromic diagnoses is uncertain.
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PMID:Outcome After Therapeutic Hypothermia in Term Neonates With Encephalopathy and a Syndromic Diagnosis. 2576 85


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